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Brazilian Dental Journal 2024This study was designed to investigate the impact of access cavity designs on fracture resistance of endodontically treated maxillary first premolars. The study sample...
This study was designed to investigate the impact of access cavity designs on fracture resistance of endodontically treated maxillary first premolars. The study sample consisted of 72 intact maxillary first premolars, randomly divided into six groups (n = 12). A standardized proximal cavity preparation was prepared for all samples using standard bur. Groups I: control group with only standard proximal cavity and no endodontic access, group II: Truss access cavity, group III: Separated access to buccal and palatal canals without removal of dentine in between, group IV: Access to buccal and palatal canals with removal of dentine in between, group V: Traditional access cavity, group VI: Mesio-occlusal-distal cavity (MOD). For groups I and VI, only composite restoration was used to restore the proximal cavity, while for groups II- V, the access was prepared and endodontic treatment was performed on all teeth, then composite restoration was placed. The root canals were instrumented using nickel-titanium files, irrigated with sodium hypochlorite, and filled with AH plus sealer and gutta-percha using warm vertical condensation. All samples were then placed in an acrylic mold and underwent thermal aging for 10,000 cycles between 5 and 55°C. The samples were fixed in a universal testing machine with the long axis of the roots positioned at 20° to a load applied at a crosshead speed of 1 mm/min using a stainless steel semi-spherical indenter (Ø = 3 mm) until fracture occurred to determine the fracture resistance force in Newton. The normality test (Shapiro-Wilk) showed that data are normally distributed. Group II exhibited the highest mean fracture resistance, and group VI was the least likely to resist the fracture. No statistically significant differences between tested groups (p-value = 0.237). The MOD group showed a more unfavorable mode of fracture compared to other groups. No significant difference in fracture resistance between conservative and traditional access cavities. The missing marginal ridges, such as in MOD cavities played an important role in decreasing the fracture resistance of endodontically treated teeth.
Topics: Humans; Dental Restoration, Permanent; Composite Resins; Bicuspid; Dental Cavity Preparation; Gutta-Percha; Tooth Fractures; Tooth, Nonvital; Dental Stress Analysis
PubMed: 38537021
DOI: 10.1590/0103-6440202405676 -
Dentistry Journal Mar 2024Oral mucosa inflammation can cause severe pain and interfere with eating, reducing quality of life. However, few options for self-care are available. An oral liquid...
Oral mucosa inflammation can cause severe pain and interfere with eating, reducing quality of life. However, few options for self-care are available. An oral liquid bandage forms a protective film over the affected area. We aimed to assess the acid erosion risk when a newly developed oral liquid bandage (ORAPLA) is accidentally deposited on teeth and to examine the relative acid erosion risk at multiple time points of the maximum recommended duration of continuous use. ORAPLA was applied to both enamel and dentin blocks from 45 bovine anterior mandibular teeth, and an acid challenge was performed in a simulated oral cavity with artificial saliva, with one exposure cycle lasting 6 h. The enamel showed substantial defects and a decrease in Vickers hardness after nine cycles, with no change in surface roughness. Dentin showed an increase in parenchymal defects and surface roughness and a trend toward decreased Vickers hardness with increasing exposure time. We found no significant acid corrosion in enamel after up to nine times the upper limit of normal use time or in dentin after up to six times the upper limit. We conclude that the acid erosion risk due to accidental attachment to teeth is low, and in the human oral cavity with salivary buffering and remineralization, likely even lower.
PubMed: 38534294
DOI: 10.3390/dj12030070 -
BMC Oral Health Mar 2024AH Plus, an epoxy resin-based sealer, is widely used in endodontic practice, owing to its good physical properties that confers longstanding dimensional stability and...
Characterisation and evaluation of physical properties of AH-Plus sealer with and without the incorporation of petasin, pachymic acid, curcumin and shilajit-an invitro study.
BACKGROUND
AH Plus, an epoxy resin-based sealer, is widely used in endodontic practice, owing to its good physical properties that confers longstanding dimensional stability and good adhesion to dentin. Nevertheless, its propensity to trigger inflammation, especially in its freshly mixed state, has been extensively documented. Phytochemicals such as Petasin, Pachymic acid, Curcumin, and Shilajit are known for their anti-inflammatory and analgesic effects. This study aimed to analyze and determine the effect of these natural products on the physical properties of AH Plus sealer when incorporated with the sealer.
METHODS
AH Plus (AHR) sealer was mixed with 10% petasin, 0.75% pachymic, 0.5% and 6%shilajit to obtain AHP, AHA, AHC and AHS in the ratio of 10:1 and 5:1 respectively. Five samples of each material were assessed for setting time, solubility, flow, and dimensional stability in accordance with the ISO 6876:2012 standardization. Sealers were characterized through scanning electron microscopy (SEM), X-ray energy dispersive spectroscopy, X-ray diffraction (XRD), and Fourier transform infrared (FTIR) spectroscopy. Statistical evaluation involved the Kolmogorov-Smirnov and Shapiro-Wilks tests for normality and the one-way ANOVA test for analysis.
RESULTS
In this investigation, the characterisation analysis revealed a relatively similar microstructure in all the experimental root canal sealers. All experimental groups, excluding the control group, exhibited an increase in flow ranging from 11.9 to 31.4% at a 10:1 ratio. Similarly, for the 5:1 ratio, the increase ranged from 12.02 to 31.83%. In terms of dimensional stability, all groups at the 10:1 ratio showed a decrease compared to the control group. The addition of natural agents to AHR in 10:1 ratio led to a reduction in setting time by 8.9-31.6%, and at a 5:1 ratio, the reduction ranged from 8.1 to 31.5%. However, regarding solubility, the addition of natural agents did not induce any significant alterations.
CONCLUSION
Based on the results of this study, it can be concluded that all tested root canal sealers exhibited properties that met the acceptable criteria outlined in the ISO 6876:2012 standardization.
Topics: Humans; Root Canal Filling Materials; Curcumin; Epoxy Resins; Materials Testing; Silicates; Calcium Compounds; Minerals; Resins, Plant; Sesquiterpenes; Triterpenes
PubMed: 38504287
DOI: 10.1186/s12903-024-04108-w -
Dental Research Journal 2024The aim of the study was to investigate the morphometric parameters of dental pulp in open apices immature teeth in a sheep model after mechanical pulp exposure and...
BACKGROUND
The aim of the study was to investigate the morphometric parameters of dental pulp in open apices immature teeth in a sheep model after mechanical pulp exposure and restoration with reinforced zinc oxide-eugenol.
MATERIALS AND METHODS
In this experimental study, a total of 12 immature mandibular central incisors from six adult male sheep, weighing 30-40 kg and with the age of 1 year old with Merino race were examined. After anesthesia, the pulps of the teeth in the case group were mechanically exposed and then were restored with reinforced zinc oxide-eugenol and amalgam. In the control group, the teeth remained intact. The animals were sacrificed at intervals of 2, 4, 6, and 8 weeks (E2, E4, E6, and E8) in the case and 2 and 8 weeks (C2 and C8) in the control groups. Then, their teeth were removed with the surrounding supporting tissues and alveolar bones. Tissue processing and staining were done, and the sections were examined under a light microscope. The Kruskal-Wallis and Mann-Whitney tests were used to analyze the data and compare the changes between the two groups. < 0.05 was considered statistically significant.
RESULTS
In response to mechanical exposure, reparative or tertiary dentin was formed, and its thickness increased during the time of the study. The thickness of the odontoblastic layer in the E4 group was the highest amount. The pulp chamber diameter in the C2 group was significantly larger than the other groups, and the diameter of the apical foramen in the E8 was decreased significantly compared to the controls ( < 0.05).
CONCLUSION
In response to mechanical exposure and restoration with reinforced zinc oxide-eugenol, some morphometric parameters of the dental pulp changed significantly in the sheep model compared to the controls.
PubMed: 38476710
DOI: No ID Found -
Journal of Conservative Dentistry and... Feb 2024During endodontic treatment, sealers seal off dentinal tubules and prevent microbial attack. Bioceramic sealers have excellent bioactivity, but its high alkalinity is...
CONTEXT
During endodontic treatment, sealers seal off dentinal tubules and prevent microbial attack. Bioceramic sealers have excellent bioactivity, but its high alkalinity is found to have detrimental effects on radicular collagen. Collagen cross linkers have the ability to chemically modify collagen and can prevent the detrimental effects of the sealer.
AIM
This research was aimed to assess the effect of collagen cross-linking agents on the integrity of radicular collagen matrix and depth of penetration of sealer.
MATERIALS AND METHODS
Mandibular premolars ( = 48) were taken. Teeth were decoronated; canals were prepared till ProTaper size F2 and were irrigated with 5 mL of 2.5% NaOCl, followed by 3 mL of 17% ethylenediaminetetraacetic acid between instrumentation and finally rinsed with saline following which teeth were divided into three groups based on the surface treatments: Group 1: 6.5% proanthocyanin (PA), Group 2: chlorhexidine (CHX), and Group 3: saline. Teeth were obturated using gutta-percha and bioceramic sealer and stored in artificial saliva. Hydroxyproline (HYP) release was assessed after 14 and 21 days using spectrophotometer. Sealer penetration was assessed using the scanning electron microscope.
STATISTICAL ANALYSIS
Wilcoxon signed-rank test and Kruskal-Wallis test for release of HYP and paired -test and ANOVA for sealer penetration were performed.
RESULTS
Significantly lower release of HYP was seen in proanthocyanin-treated group. Sealer penetration was better for both the proanthocyanin- and CHX-treated groups when compared to saline.
CONCLUSION
Surface treatment with collagen cross-linkers caused a decrease in the amount of HYP released, indicating lesser degradation of collagen. Sealer penetration was better due to the removal of smear layer following the surface treatments.
PubMed: 38463481
DOI: 10.4103/jcd.jcd_309_23 -
Dental Materials : Official Publication... May 2024To evaluate the effects of an ammonia-based and a water-based silver-containing solutions on bonding performance and matrix-metalloproteinases (MMPs) activity of a... (Comparative Study)
Comparative Study
OBJECTIVE
To evaluate the effects of an ammonia-based and a water-based silver-containing solutions on bonding performance and matrix-metalloproteinases (MMPs) activity of a universal adhesive to dentin after 1 year of artificial aging.
METHODS
Mid-coronal dentin surfaces of 60 sound human molars were exposed and the following groups were formed according to the surface pre-treatment and etching mode of the universal adhesive (Zipbond Universal, SDI) (n = 10): G1) Zipbond in the self-etch mode (ZSE); G2) Riva Star (SDI) applied before ZSE; G3) Riva Star Aqua (SDI) applied before ZSE; G4) Zipbond in the etch-and-rinse mode (ZER); G5) Riva Star applied before ZER; G6) Riva Star Aqua applied before ZER. The specimens were sectioned and subjected to microtensile bond strength (µTBS) test at baseline (T) and after 12 months (T) of artificial storage. Scanning electron microscope (SEM) and energy dispersive spectroscopy analysis (EDS) were also conducted. Three additional molars per group were processed for the in situ zymography analysis at T and T. Data were statistically analyzed (p < 0.05).
RESULTS
Dentin pre-treatments and aging decreased bonding values, regardless of the etching mode (p < 0.05). No differences in µTBS were observed between the two silver-containing solutions, both at T and T. Riva Star Aqua and etching significantly increased the MMPs activity, independent of the storage period (p < 0.05).
SIGNIFICANCE
Dentin surface pre-treatment with silver-containing solutions negatively affects the bonding performances of resin composite restorations placed with a universal adhesive. However, the ammonia-based product Riva Star might show better stability in the long term, due to lower activation of MMPs.
Topics: Humans; Water; Dental Bonding; Dentin-Bonding Agents; Materials Testing; Silver; Ammonia; Microscopy, Electron, Scanning; Tensile Strength; Surface Properties; Dentin; In Vitro Techniques; Matrix Metalloproteinases; Resin Cements; Molar; Acid Etching, Dental; Spectrometry, X-Ray Emission; Dental Stress Analysis
PubMed: 38458917
DOI: 10.1016/j.dental.2024.03.003 -
European Endodontic Journal Mar 2024The aim of this study was to investigate the bactericidal effect of various concentrations of triple antibiotic paste (TAP) against Enterococcus faecalis (E. faecalis)...
OBJECTIVE
The aim of this study was to investigate the bactericidal effect of various concentrations of triple antibiotic paste (TAP) against Enterococcus faecalis (E. faecalis) in dentinal tubules using a bacterial culture assay and confocal laser scanning microscope (CLSM).
METHODS
Ninety human teeth were contaminated with E. faecalis (ATCC 29212) and randomly allocated into 5 groups; the negative control (without TAP), 1 mg/ml, 5 mg/ml, 7.5 mg/ml and 10 mg/ml TAP (n=18). After a 3-week TAP treatment, samples were collected from the root canal space, root dentin at 100-μm and 200-μm depth. The collected samples were subjected to a bacterial culture assay (n=10). Eight roots from each group underwent CLSM analysis to determine the live/dead bacterial cells.
RESULTS
The bacterial culture assay results indicated that the negative control samples were all culturable. The number of culture-positive samples decreased after TAP treatment at 1, 5, 7.5 and 10 mg/ml, with 2, 2, 1 and 0 culturable samples, respectively. However, there was no significant difference among the TAP treatments. Surprisingly, the CLSM analysis demonstrated live bacteria in the dentinal tubules in all samples. The negative control had 52.36%+-3.24 live bacteria. TAP treatment at 10 mg/ml had the lowest percentage of live bacterial cells (40.58%+-5.40), followed by 7.5 mg/ml (44.14%+-6.03), 5 mg/ml (46.31%+-5.32) and 1 mg/ml (52.55%+-8.82). The percentage of live cells in the 10 mg/ml, 7.5 mg/ml and 5 mg/ml TAP groups were significantly lower than the 1 mg/ml TAP and negative control groups.
CONCLUSION
TAP treatment significantly decreased the percentage of viable E. faecalis cells in the dentinal tubules and its bactericidal effect was dose-dependent.
Topics: Humans; Anti-Bacterial Agents; Enterococcus faecalis; Random Allocation
PubMed: 38456464
DOI: 10.14744/eej.2023.78942 -
Dental and Medical Problems 2024The progression of non-carious cervical lesions (NCCLs) leads to gingival recession (GR), which is restored with restorative materials, using different periodontal... (Meta-Analysis)
Meta-Analysis Review
The progression of non-carious cervical lesions (NCCLs) leads to gingival recession (GR), which is restored with restorative materials, using different periodontal plastic surgery procedures. There is no consensus on which technique is superior to others. Therefore, the present systematic review aimed to assess the effectiveness of root coverage (RC) procedures in the restored and unrestored NCCLs in terms of clinical and patient-centered outcomes.We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) while searching 5 databases in addition to the gray literature. The Medical Subject Headings (MeSH) terms and keywords in the title and abstract fields, as well as in headings, were used to search the existing literature for the relevant publications on the effectiveness of RC procedures with the restoration of NCCLs over the past 3 decades (January 1990-July 2021). After applying the inclusion and exclusion criteria, 13 articles were read in full and critically analyzed. The quality analysis was performed using the Cochrane RevMan software.A total of 222 potentially relevant titles and abstracts were found after the initial electronic and manual search, and after removing duplicates. Applying the inclusion and exclusion criteria yielded 23 publications that were further analyzed for relevance and applicability. Following critical analysis, 13 publications were used for validity assessment and data extraction.In the teeth with NCCLs and GR, the restoration of NCCLs does not affect the percentage RC. However, it significantly decreases dentin hypersensitivity, and the patients' perception of esthetics and satisfaction.
Topics: Humans; Esthetics, Dental; Databases, Factual; Dental Materials
PubMed: 38445442
DOI: 10.17219/dmp/155338 -
The Saudi Dental Journal Feb 2024This study evaluated the influence of traumatic occlusion in the dentin-pulp complex a molar teeth submitted to subluxation.
BACKGROUND
This study evaluated the influence of traumatic occlusion in the dentin-pulp complex a molar teeth submitted to subluxation.
MATERIAL AND METHODS
Ninety Wistar rats were divided into groups Naïve (N), Subluxation (S) and Subluxation with traumatic occlusion (STO) and submitted to histological analysis after 7 and 21 days. A quantitative analysis was submitted to one-way ANOVA and Tukey's post-hoc test, and Chi-square and Bonferronís post-hoc test.
RESULTS
S and STO showed a significant increase in blood vessels area (p < 0.0005), amorphous fundamental substance (p < 0.0005) and reactionary dentin formation (p < 0.0005), as well as a decrease in the nuclear profile (p < 0.0005), odontoblast layer (p = 0.013 and p < 0.0005) by day 7 when compared with N. These changes normalized by day 21, except for the reactionary dentin (p < 0.0005) in both S and STO groups. Interestingly, the STO group exhibited significant changes in the increase of pulp calcification (p < 0.0005), presence of tubules with nuclei (p < 0.0005), and inflammatory infiltrate (p < 0.0005), as well reduction of nuclear profile (p < 0.0005), odontoblast layer (p < 0.0005) compared with N and S at day 21.
CONCLUSIONS
STO impaired the defence response and decreased pulp regeneration capacity by increasing the inflammatory infiltrate and pulp calcification, and decreasing the nucleated cell number in the odontoblast layer and central pulp.
PubMed: 38420008
DOI: 10.1016/j.sdentj.2023.11.012 -
The Saudi Dental Journal Feb 2024Although medical pulse oximeters are considered effective for endodontic diagnoses, the method remains uncommon in current dental practice. The aim of the present... (Review)
Review
BACKGROUND AND OBJECTIVE
Although medical pulse oximeters are considered effective for endodontic diagnoses, the method remains uncommon in current dental practice. The aim of the present scoping review was to investigate clinical factors that exert a negative impact on the use of pulse oximeters in dental practice.
METHODS
This study followed the PRISMA-ScR guidelines and the protocol was prospectively registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/3GQCE). A comprehensive search of the MEDLINE (via PubMed), Cochrane Library, and Web of Science databases was performed in December 2022 for articles published in English or Spanish. All types of clinical studies were included, except comments, letters to the editor, and abstracts. Two independent investigators analyzed 45 full-text articles. Data extraction included general characteristics, oxygen saturation levels, and limiting factors/barriers to the use of oximeters as pulp testers.
RESULTS
The search of the databases yielded 1,300 records and 38 were included (quantitative data extraction was performed for 35 and three articles were systematic reviews). Publications were highest in number between 2016 and 2017, with an evident reduction occurring after 2021. The oxygen saturation level for sound/vital maxillary anterior teeth was 84.99% (overall mean). The main limiting factors/barriers were i) the difficulty in maintaining the two light-emitting diodes parallel during pulp tests, ii) infrared light diffraction by enamel/dentin/gingiva, and iii) the diversity of patient ages in studies.
CONCLUSION
This scoping review encountered noteworthy findings associated with the impracticability of using medical pulse oximeters as dental pulp testers. The recent decrease in the frequency of published studies compared to approximately seven years ago may imply a negative trend in the use of the method.
PubMed: 38419999
DOI: 10.1016/j.sdentj.2023.11.006