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Journal of Dentistry Mar 2024The aim of this review was to analyze the clinical treatment outcomes of cracked teeth (CT) retaining vital dental pulp (CT-VDP) or undergoing root canal treatment... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The aim of this review was to analyze the clinical treatment outcomes of cracked teeth (CT) retaining vital dental pulp (CT-VDP) or undergoing root canal treatment (CT-RCT).
SOURCES
A systematic search was conducted in Medline, Embase, PubMed, and Cochrane Library databases.
STUDY SELECTION
Studies evaluating tooth survival rate (TSR), pulp survival rate (PSR), and success rate (SR) with at least a one-year follow-up were included. The risk of bias was evaluated with the Newcastle-Ottawa scale.
DATA
Twenty-seven studies underwent qualitative analysis, 26 of which were included in the meta-analysis. SR of monitoring without restorative treatments was 80 % at three years. TSR of CT-VDP was 92.8-97.8 % at 1‒6 years, PSR of CT-VDP was 85.6‒90.4 % at 1‒3 years, and SR of CT-VDP was 80.6‒89.9 % at 1‒3 years; TSR of CT-RCT was 90.5‒91.1 % at 1‒2 years, and SR of CT-RCT was 83.0‒91.2 % at 1‒4 years. Direct restorations without cuspal coverage for CT-VDP increased the risk ratio (RR) of pulpal complications (RR=3.2, 95 % CI: 1.51-6.82, p = 0.002) and tooth extraction (RR=8.1, 95 % CI: 1.05-62.5, p = 0.045) compared with full-crown restorations. The CT-RCT without full-crown restorations had an 11.3-fold higher risk of tooth extraction than the CT-RCT with full-crown restorations (p < 0.001).
CONCLUSIONS
Monitoring without restorative treatments might be an option for the CT without any symptoms. Direct restorations without cuspal coverage for the CT-VDP could significantly increase the RR of pulpal complications and tooth extraction compared with full-crown restorations. Full-crown restorations are strongly recommended for the CT-RCT.
CLINICAL SIGNIFICANCE
Monitoring without restorative treatments could be a viable option for the CT without any symptoms. Full-crown restorations are strongly recommended for the CT with any symptoms and the CT-RCT.
Topics: Humans; Dental Restoration, Permanent; Crowns; Treatment Outcome; Root Canal Therapy; Cracked Tooth Syndrome
PubMed: 38272437
DOI: 10.1016/j.jdent.2024.104843 -
Dentistry Journal Dec 2023This systematic review evaluated the potential clinical use of microfluidic lab-on-a-chip (LOC) technology in the identification and antibiotic susceptibility testing of... (Review)
Review
The Potential Clinical Applications of a Microfluidic Lab-on-a-Chip for the Identification and Antibiotic Susceptibility Testing of -Associated Endodontic Infections: A Systematic Review.
This systematic review evaluated the potential clinical use of microfluidic lab-on-a-chip (LOC) technology in the identification and antibiotic susceptibility testing of in endodontic infections. The search methodology employed in this review adhered to the PRISMA guidelines. Multiple scientific databases, including PubMed/MEDLINE, SCOPUS, and SCIELO, were utilized, along with exploration of grey literature sources. Up to September 2023, these resources were searched using specific keywords and MeSH terms. An initial comprehensive search yielded 202 articles. Ultimately, this systematic review incorporated 12 studies. Out of these, seven aimed to identify , while the remaining five evaluated its susceptibility to different antibiotics. All studies observed that the newly developed microfluidic chip significantly reduces detection time compared to traditional methods. This enhanced speed is accompanied by a high degree of accuracy, efficiency, and sensitivity. Most research findings indicated that the entire process took anywhere from less than an hour to five hours. It is important to note that this approach bypasses the need for minimum inhibitory concentration measurements, as it does not rely on traditional methodologies. Microfluidic devices enable the rapid identification and accurate antimicrobial susceptibility testing of , which are crucial for timely diagnosis and treatment in endodontic infections.
PubMed: 38248213
DOI: 10.3390/dj12010005 -
Cell Journal Dec 2023Neural cells are the most important components of the nervous system and have the duty of electrical signal transmission. Damage to these cells can lead to neurological...
Neural cells are the most important components of the nervous system and have the duty of electrical signal transmission. Damage to these cells can lead to neurological disorders. Scientists have discovered different methods, such as stem cell therapy, to heal or regenerate damaged neural cells. Dental stem cells are among the different cells used in this method. This review attempts to evaluate the effect of biomaterials mentioned in the cited papers on differentiation of human dental pulp stem cells (hDPSCs) into neural cells for use in stem cell therapy of neurological disorders. We searched international databases for articles about the effect of biomaterials on neuronal differentiation of hDPSCs. The relevant articles were screened by title, abstract, and full text, followed by selection and data extraction. Totally, we identified 731 articles and chose 18 for inclusion in the study. A total of four studies employed polymeric scaffolds, four assessed chitosan scaffolds (CS), two utilised hydrogel scaffolds, one investigation utilised decellularised extracellular matrix (ECM), and six studies applied the floating sphere technique. hDPSCs could heal nerve damage in regenerative medicine. In the third iteration of nerve conduits, scaffolds, stem cells, regulated growth factor release, and ECM proteins restore major nerve damage. hDPSCs must differentiate into neural cells or neuron-like cells to regenerate nerves. Plastic-adherent cultures, floating dentosphere cultures, CS, polymeric scaffolds, hydrogels, and ECM mimics have been used to differentiate hDPSCs. According to our findings, the floating dentosphere technique and 3D-PLAS are currently the two best techniques since they result in neuroprogenitor cells, which are the starting point of differentiation and they can turn into any desired neural cell.
PubMed: 38192251
DOI: 10.22074/cellj.2023.2007711.1375 -
BMC Oral Health Jan 2024Mandibular first premolars are familiar with their varied root canal morphology, causing difficulties and challenges for successful endodontic procedures. This... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Mandibular first premolars are familiar with their varied root canal morphology, causing difficulties and challenges for successful endodontic procedures. This systematic review and meta-analysis aim to study the characterization of root and canal morphology of the first mandibular premolar using micro-computed tomography.
METHODOLOGY
The literature search was conducted using electronic web databases like PubMed, Scopus, ScienceDirect and Cochrane with the chosen MeSH key words and data was retrieved until May 2023. Further to perform the statistical analysis, R v 4.3.1 software with "meta", 'metafor" "metaviz" " ggplot2" package was used, and results were represented by odds ratios (OR) and the percentage of forest plots along a 95 per cent confidence interval (CI).
RESULTS
The total number of studies meeting the inclusion criteria was 13; these studies were conducted on mandibular first premolar using Micro-CT; the total sample size was 1817. To scan the sample, an X-ray micro-focus CT system (Siemens Inveon CT, Erlangen, Germany) was used in four studies and seven different machines were used in the respective studies. Mimics 10.01 software (Materialize, Leuven, Belgium) and NRecon v.1.6.9 software (Bruker, Kontich, Belgium) were commonly operated. The minimum and maximum voxel size ranges between 11.94 and 50 μm. Vertucci's classification was frequently used (9), while one study applied Ahmed et al. and Vertucci's classification.
CONCLUSION
This systematic review provides essential information about the root and canal configurations, radicular grooves, accessory canals, and apical foramina through Micro-CT, aiming to improve the accuracy of endodontic treatment and help practitioners.
Topics: Humans; Dental Pulp Cavity; X-Ray Microtomography; Bicuspid; Tooth Root; Mandible
PubMed: 38167114
DOI: 10.1186/s12903-023-03624-5 -
Journal of Dentistry Mar 2024The present systematic review and meta-analysis aimed to evaluate the success rate of root canal retreatment filled with gutta-percha and the variables related to... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The present systematic review and meta-analysis aimed to evaluate the success rate of root canal retreatment filled with gutta-percha and the variables related to retreatment success.
DATA
The PRISMA guidelines were followed for the present review. The study protocol was registered in the International Prospective Database of Systematic Reviews (PROSPERO CRD42021283134). Risk assessment was performed using the Newcastle-Ottawa scale. Funnel plots were used to detect publication bias and asymmetry was assessed using Egger's tests.
SOURCES
PubMed, Scopus, ScienceDirect, Cochrane, and additional sources were searched.
STUDY SELECTION
Studies published until 10 December 2022. Clinical studies evaluating the success of root canal retreatment filled with gutta-percha with at least a 1-year follow-up were selected.
RESULTS
Ten studies and one unpublished study fulfilled the inclusion criteria for quantitative analysis. The success rate of non-surgical root canal retreatment was 71% (95% CI: 66%-76%) with strict criteria and 87% (79% - 93%) with loose criteria for 1-3 years of follow-up, and 77% (66% - 86%) with strict criteria for a 4-5 years of follow-up. Endodontically retreated teeth with periapical lesions had a lower success rate under strict criteria. The tooth type, dental arch, initial periapical index (PAI) score, and the number of visits also affected the treatment success rate under strict criteria. For the loose criteria, teeth with larger periapical lesions and higher initial PAI scores had a lower success rate.
CONCLUSIONS
According to the present systematic review and meta-analysis, non-surgical root canal retreatment results in favourable outcomes. The presence of a periapical radiolucency, periapical lesions >5mm, a higher initial PAI score, multiple-visit retreatments, and mandibular and molar teeth resulted in a lower success rate.
CLINICAL SIGNIFICANCE
Non-surgical root canal retreatment filled with gutta-percha techniques is a relatively predictable procedure with a high success rate. Several variables can affect retreatment success, mainly the presence and size of a periapical lesion and the type of tooth.
Topics: Dental Pulp Cavity; Gutta-Percha; Retreatment; Root Canal Filling Materials; Root Canal Preparation; Root Canal Therapy; Treatment Outcome; Humans
PubMed: 38145805
DOI: 10.1016/j.jdent.2023.104809 -
Pediatric Dentistry Nov 2023to update the 2016 systematic review evidence for vital pulp therapy (VPT) for primary teeth affected by caries or trauma. The population, intervention, comparison,... (Meta-Analysis)
Meta-Analysis
to update the 2016 systematic review evidence for vital pulp therapy (VPT) for primary teeth affected by caries or trauma. The population, intervention, comparison, outcomes, and study (PICOS) design inclusion/exclusion was used for multiple databases. Risk of bias, meta-analyses using RevMan, and certainty of evidence was created. A total of 299 studies were included; no trauma was found. Indirect pulp treatment (IPT) resulted in 97 percent success. Two calcium silicate cement (CSC) pulpotomies' success using mineral trioxide aggregate (MTA) and Biodentine were 94 percent and 90 percent, respectively, greater than for direct pulp capping (DPC; 86 percent) and other pulpotomies (moderate certainty). The success of IPT versus pulpotomy at 24 months showed no significant difference (P=0.31). Different liners or capping agents did not affect the success of IPT (P=0.79) or DPC at 24 months (P=0.24). The two CSC pulpotomies were not significantly different based on 24-month success (P=0.34). The formocresol pulpotomy success at 24 months was significantly lower than for MTA (P=0.02). Ferric sulfate had a significant lower success at 24 months than MTA pulpotomy (69 percent versus 92 percent; P=0.03). Zinc oxide eugenol, as a singular pulpotomy, had low success (65 percent). Selective/stepwise caries removal did significantly better at avoiding pulp exposures than complete excavation (P<0.001). Complete, selective, and no caries removal (Hall technique [HT], steel crown placement with no caries removal) had no significant difference in pulp vitality success for deep caries at 24 months (P=0.29). For deep caries affecting vital incisors, pulpotomy had significantly greater success than pulpectomy (P=0.002). The following had no significant effect on MTA pulpotomy success: coronal pulp removal methods; irrigation solution; method to control hemorrhage; base over MTA; treatment in one or two visits; and anterior or posterior teeth. Vital pulp therapy success of indirect pulp treatment or two calcium silicate cement pulpotomies demonstrated improved success over direct pulp capping and other pulpotomies based on 24-month evidence with moderate certainty. The Hall technique did not significantly reduce pulp vitality success versus caries removal.
Topics: Humans; Calcium Compounds; Silicates; Dental Care; Dental Cements; Zinc Oxide-Eugenol Cement; Dental Pulp Capping; Pulpotomy; Glass Ionomer Cements; Tooth, Deciduous; Oxides; Drug Combinations; Treatment Outcome; Aluminum Compounds
PubMed: 38129755
DOI: No ID Found -
The Saudi Dental Journal Nov 2023This Systematic Review (SR) was to report on the prevalence of pulp stones in the Saudi Arabian (KSA) population. The electronic databases were searched for scientific... (Review)
Review
This Systematic Review (SR) was to report on the prevalence of pulp stones in the Saudi Arabian (KSA) population. The electronic databases were searched for scientific research articles during May 2021. The data search was performed in electronic search engines like PubMed, Scopus, Web of science, and Saudi Digital Library, and 6 original research articles which fulfilled the eligibility criteria were assessed for qualitative data. The prevalence of pulp stones among the KSA population ranged from 4.6% to 50.93% among the study participants and it ranged between 10.2%-13.34% in the teeth assessed. The pulp stones were more frequently reported in decayed teeth, periodontal diseases, attrition, teeth with dental restorations, and higher in the molar teeth in comparison with the premolar teeth. The data on the prevalence of pulp stones among the Saudi population will be helpful for clinicians in planning endodontic procedures.
PubMed: 38077230
DOI: 10.1016/j.sdentj.2023.07.012 -
Restorative Dentistry & Endodontics Nov 2023This study aimed to investigate the effectiveness of different topical/systemic agents in reducing the damage caused by bleaching gel to pulp tissue or cells.
OBJECTIVES
This study aimed to investigate the effectiveness of different topical/systemic agents in reducing the damage caused by bleaching gel to pulp tissue or cells.
MATERIALS AND METHODS
Electronic searches were performed in July 2023. and studies evaluating the effects of different topical or systemic agents on pulp inflammation or cytotoxicity after exposure to bleaching agents were included. The risk of bias was assessed.
RESULTS
Out of 1,112 articles, 27 were included. Nine animal studies evaluated remineralizing/anti-inflammatories agents in rat molars subjected to bleaching with 35%-38% hydrogen peroxide (HP). Five of these studies demonstrated a significant reduction in inflammation caused by HP when combined with bioglass or MI Paste Plus (GC America), or following KF-desensitizing or Otosporin treatment ( = 3). However, orally administered drugs did not reduce pulp inflammation ( = 4). Cytotoxicity ( = 17) was primarily assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay on human dental pulp cells and mouse dental papilla Cell-23 cells. Certain substances, including sodium ascorbate, butein, manganese chloride, and peroxidase, were found to reduce cytotoxicity, particularly when applied prior to bleaching. The risk of bias was high in animal studies and low in laboratory studies.
CONCLUSIONS
Few studies have evaluated agents to reduce the damage caused by bleaching gel to pulp tissue. Within the limitations of these studies, it was found that topical agents were effective in reducing pulp inflammation in animals and cytotoxicity. Further analyses with human pulp are required to substantiate these findings.
TRIAL REGISTRATION
PROSPERO Identifier: CRD42022337192.
PubMed: 38053785
DOI: 10.5395/rde.2023.48.e39 -
Journal of Lasers in Medical Sciences 2023Considering the positive impact of laser treatment on the proliferation of certain cell types, we opted to perform a systematic review aimed at evaluating the effects... (Review)
Review
Considering the positive impact of laser treatment on the proliferation of certain cell types, we opted to perform a systematic review aimed at evaluating the effects of laser therapy and photobiomodulation on the proliferation and differentiation of human dental pulp stem cells (hDPSCs). We included all research studies examining the impact of laser therapy on hDPSCs, without limitations on publication dates or article languages. The major international databases, including PubMed, ISI Web of Science, and Scopus, were searched from inception to April 2022 by the relevant keywords. In total, 1886 studies were identified in the initial search from the mentioned databases and other sources. Finally, 17 relevant studies were included in the present systematic review after removing duplicates and non-relevant articles. The results indicated the useful effect of low-level laser therapy (LLLT) on the hDPSCs. The findings of this systematic review indicate the useful role of LLLT in cell therapy, proliferation, and differentiation associated with hDPSCs.
PubMed: 38028866
DOI: 10.34172/jlms.2023.47 -
European Journal of Dentistry Nov 2023Recent evidence suggests the immense potential of human mesenchymal stem cell (hMSC) secretome conditioned medium-mediated augmentation of angiogenesis. However,...
Recent evidence suggests the immense potential of human mesenchymal stem cell (hMSC) secretome conditioned medium-mediated augmentation of angiogenesis. However, angiogenesis potential varies from source and origin. The hMSCs derived from the oral cavity share an exceptional quality due to their origin from a hypoxic environment. Our systematic review aimed to compare the mesenchymal stem cells (MSCs) derived from various oral cavity sources and cell-derived secretomes, and evaluate their angiogenic potential. A literature search was conducted using PubMed and Scopus from January 2000 to September 2020. Source-wise outcomes were systematically analyzed using , , and studies, emphasizing endothelial cell migration, tube formation, and blood vessel formation. Ninety-four studies were included in the systematic review, out of which 4 studies were subsequently included in the meta-analysis. Prominent growth factors and other bioactive components implicated in improving angiogenesis were included in the respective studies. The findings suggest that oral tissues are a rich source of hMSCs. The meta-analysis revealed a positive correlation between dental pulp-derived MSCs (DPMSCs) and stem cells derived from apical papilla (SCAP) compared to human umbilical cord-derived endothelial cell lines as a control. It shows a statistically significant positive correlation between the co-culture of human umbilical vein endothelial cells (HUVECs) and DPMSCs with tubule length formation and total branching points. Our meta-analysis revealed that oral-derived MSCs (dental pulp stem cells and SCAP) carry a better angiogenic potential than endothelial cell lines alone. The reviewed literature illustrates that oral cavity-derived MSCs (OC-MSCs) increased angiogenesis. The present literature reveals a dearth of investigations involving sources other than dental pulp. Even though OC-MSCs have revealed more significant potential than other MSCs, more comprehensive, target-oriented interinstitutional prospective studies are warranted to determine whether oral cavity-derived stem cells are the most excellent sources of significant angiogenic potential.
PubMed: 37995732
DOI: 10.1055/s-0043-1776315