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Compendium of Continuing Education in... Jun 2024According to the American Dental Association Principles of Ethics and Code of Professional Conduct, dental professionals hold a special position of trust and privilege...
According to the American Dental Association Principles of Ethics and Code of Professional Conduct, dental professionals hold a special position of trust and privilege within society, and thus are bound to adhere to the highest standards of conduct. This code of ethics defines key tenets, including veracity, patient autonomy, beneficence, nonmaleficence, and justice. Maintaining these ethical principles goes beyond the competent delivery of operative care and requires up-to-date, evidence-based knowledge and practices on the part of clinicians.1 With pain management being a key component of endodontics practice, clinicians must maintain their knowledge on the most effective evidence-based pain management strategies to ethically care for their patients.
Topics: Humans; Evidence-Based Dentistry; Pain Management; Ethics, Dental
PubMed: 38900449
DOI: No ID Found -
Compendium of Continuing Education in... Jun 2024The use of cone-beam computed tomography (CBCT) imaging often elicits changes in both diagnostics and treatment plans when incorporated into endodontic workups. In...
The use of cone-beam computed tomography (CBCT) imaging often elicits changes in both diagnostics and treatment plans when incorporated into endodontic workups. In endodontic practice, CBCT scans enable detection of periapical pathology before it is apparent on traditional 2-dimensional intraoral radiographs. The visualization provided by CBCT scans can help clinicians confirm suspected diagnoses, including but not limited to periapical pathology, traumatic tooth displacement, and vertical root fracture. This article discusses the use of CBCT imaging in the field of endodontics with an emphasis on its utilization to identify incidental findings, which can introduce complexities to a diagnosis and yield valuable information to enhance the scope of care for the patient.
Topics: Cone-Beam Computed Tomography; Humans; Incidental Findings; Tooth Fractures
PubMed: 38900448
DOI: No ID Found -
Compendium of Continuing Education in... Jun 2024Treatment planning for cracked teeth can be quite challenging for clinicians, as various outcomes-related clinical parameters must be considered. Historically,... (Review)
Review
Treatment planning for cracked teeth can be quite challenging for clinicians, as various outcomes-related clinical parameters must be considered. Historically, extraction was recommended for cracked teeth with radicular extensions due to their poor prognosis. Recent literature, however, suggests that these teeth may be saved with careful case selection and appropriate treatment. This article closely examines Davis and Shariff's 2019 study, which demonstrated a promising prognosis for treating cracked teeth with radicular extensions following a specific treatment protocol. This literature review discusses current findings regarding cracked teeth and suggested treatment modalities to optimize outcomes.
Topics: Humans; Cracked Tooth Syndrome; Tooth Extraction
PubMed: 38900447
DOI: No ID Found -
Compendium of Continuing Education in... Jun 2024The adoption of vital pulp therapy (VPT) is a significant advancement in preserving the longevity of vital mature pulp. VPT represents a potential alternative approach... (Review)
Review
The adoption of vital pulp therapy (VPT) is a significant advancement in preserving the longevity of vital mature pulp. VPT represents a potential alternative approach to nonsurgical root canal therapy in which compromised pulp is treated such that it maintains its vitality and function. With the introduction of novel bioceramic materials, including calcium silicate cements and mineral trioxide aggregate, the prognosis for VPT in mature permanent teeth has greatly increased, and as a result, adaptation of VPT in these teeth has garnered considerable support. This article reviews evidence-based guidance for case selection and procedural methods associated with the adoption of VPT in mature permanent teeth.
Topics: Humans; Calcium Compounds; Dental Caries; Dental Pulp Capping; Dentition, Permanent; Silicates
PubMed: 38900446
DOI: No ID Found -
Compendium of Continuing Education in... Jun 2024Vital pulp therapy (VPT) was once a treatment modality that was only considered for immature permanent teeth to allow for the continued development of the radicular...
Vital pulp therapy (VPT) was once a treatment modality that was only considered for immature permanent teeth to allow for the continued development of the radicular system if the pulp was vital. With the advent of bioceramics and bioactive materials such as calcium silicate cements, the applications for VPT have greatly increased, giving dentists a treatment option other than nonsurgical root canal therapy (RCT) for mature teeth previously diagnosed to have an irreversible pulpitis. This approach can serve as a less invasive, simpler procedure than RCT while allowing for the preservation of natural tooth structure. It also may be a more amenable treatment alternative for patients than RCT. This article outlines and reviews the protocol for VPT with pulp exposure.
Topics: Humans; Calcium Compounds; Dental Pulp Capping; Dental Pulp Exposure; Pulpitis; Pulpotomy
PubMed: 38900418
DOI: No ID Found -
Cureus May 2024This article provides an overview of a biologically based method for restoring damaged tooth structures and pulp tissues known as regenerative endodontics. It explores... (Review)
Review
This article provides an overview of a biologically based method for restoring damaged tooth structures and pulp tissues known as regenerative endodontics. It explores the concept of regenerative endodontics, its tissue engineering approach, and its application in maintaining vitality. The article discusses the significance of the factors affecting growth, scaffolds, and stem cells being the three tissue engineering components involved in the regeneration of pulp tissues. It also delves into the classification of scaffolds and the role of platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) as biological scaffolds. The methodology section details the search process for relevant studies, and the review section presents research findings associated with PRF and its application in regeneration and repair of tissue. The article concludes by highlighting the potential of advanced PRF and injectable PRF in regenerative endodontics, with a focus on their impact on tissue regeneration and healing.
PubMed: 38899240
DOI: 10.7759/cureus.60691 -
Case Reports in Dentistry 2024Hyperplastic pulpitis is an irreversible type of pulpitis that primarily affects young patients. It occurs when an inflamed pulp becomes exposed due to factors such as...
Hyperplastic pulpitis is an irreversible type of pulpitis that primarily affects young patients. It occurs when an inflamed pulp becomes exposed due to factors such as dental caries, dental trauma, or other causes. Root canal treatment is commonly employed to manage hyperplastic pulpitis. However, vital pulp therapy can be considered as a less invasive option. The main objective of this treatment is to preserve the vitality and functionality of the remaining pulp tissue. This case report discusses the potential management of hyperplastic pulpitis in an immature molar using vital pulp therapy instead of a full root canal treatment. The report includes clinical and radiographic follow-up at six and twelve months.
PubMed: 38899006
DOI: 10.1155/2024/5280168 -
Journal of Applied Oral Science :... 2024To investigate iron-deficiency anemia as a risk factor for dental pulp disease in children from the central Peruvian jungle.
AIM
To investigate iron-deficiency anemia as a risk factor for dental pulp disease in children from the central Peruvian jungle.
METHODOLOGY
A case-control study was carried out with 270 children, of which 90 referred to cases and 180, to controls. Patients with pulp disease were diagnosed according to the criteria of the Association of Endodontists and the American Board of Endodontics. A specific questionnaire was used to assess ferrous sulfate consumption, maternal education level, maternal age, occupation, and household income. Data were analyzed using Pearson's correlation coefficient and a binary logistic regression.
RESULTS
Iron deficiency anemia offers a risk factor for pulp disease in children (OR 7.44, IC 95% 4.0-13.8). According to multivariate analysis using binary logistic regression, ferrous sulfate consumption (OR 13.8, IC 95% 5.6.33.9), maternal education level (OR 2.4, IC 95% 1.1-5.3), maternal age (OR 7.5, IC 95% 2.9-19.4), household income (OR 4.0, IC 95% 1.6-9.6), and caries (OR 10.7, IC 95% 4.5-25.7) configured independent factors that were statistically associated with pulp disease.
CONCLUSION
Iron deficiency anemia, ferrous sulfate consumption, maternal education level, maternal age, household income, and dental caries were positively associated with pulp disease in children.
Topics: Humans; Anemia, Iron-Deficiency; Peru; Female; Risk Factors; Case-Control Studies; Male; Child; Socioeconomic Factors; Dental Pulp Diseases; Child, Preschool; Ferrous Compounds; Educational Status; Maternal Age; Adolescent; Income; Dental Caries
PubMed: 38896640
DOI: 10.1590/1678-7757-2024-0014 -
Journal of Applied Oral Science :... 2024To explore the feasibility of injectable platelet-rich fibrin (i-PRF) in regenerative endodontics by comparing the effect of i-PRF and platelet-rich fibrin (PRF) on the... (Comparative Study)
Comparative Study
OBJECTIVE
To explore the feasibility of injectable platelet-rich fibrin (i-PRF) in regenerative endodontics by comparing the effect of i-PRF and platelet-rich fibrin (PRF) on the biological behavior and angiogenesis of human stem cells from the apical papilla (SCAPs).
METHODOLOGY
i-PRF and PRF were obtained from venous blood by two different centrifugation methods, followed by hematoxylin-eosin (HE) staining and scanning electron microscopy (SEM). Enzyme-linked immunosorbent assay (ELISA) was conducted to quantify the growth factors. SCAPs were cultured with different concentrations of i-PRF extract (i-PRFe) and PRF extract (PRFe), and the optimal concentrations were selected using the Cell Counting Kit-8 (CCK-8) assay. The cell proliferation and migration potentials of SCAPs were then observed using the CCK-8 and Transwell assays. Mineralization ability was detected by alizarin red staining (ARS), and angiogenesis ability was detected by tube formation assay. Real-time quantitative polymerase chain reaction (RT-qPCR) was performed to evaluate the expression of genes related to mineralization and angiogenesis. The data were subjected to statistical analysis.
RESULTS
i-PRF and PRF showed a similar three-dimensional fibrin structure, while i-PRF released a higher concentration of growth factors than PRF ( P <.05). 1/4× i-PRFe and 1/4× PRFe were selected as the optimal concentrations. The cell proliferation rate of the i-PRFe group was higher than that of the PRFe group ( P <.05), while no statistical difference was observed between them in terms of cell mitigation ( P >.05). More importantly, our results showed that i-PRFe had a stronger effect on SCAPs than PRFe in facilitating mineralization and angiogenesis, with the consistent result of RT-qPCR ( P <.05).
CONCLUSION
This study revealed that i-PRF released a higher concentration of growth factors and was superior to PRF in promoting proliferation, mineralization and angiogenesis of SCAPs, which indicates that i-PRF could be a promising biological scaffold for application in pulp regeneration.
Topics: Platelet-Rich Fibrin; Humans; Cell Proliferation; Microscopy, Electron, Scanning; Enzyme-Linked Immunosorbent Assay; Neovascularization, Physiologic; Regenerative Endodontics; Cells, Cultured; Real-Time Polymerase Chain Reaction; Intercellular Signaling Peptides and Proteins; Reproducibility of Results; Cell Movement; Stem Cells; Time Factors; Feasibility Studies; Analysis of Variance; Dental Papilla; Reference Values
PubMed: 38896639
DOI: 10.1590/1678-7757-2023-0449 -
Journal of Applied Oral Science :... 2024To evaluate the effect of the labiolingual diameter and construction of an endodontically treated (ET) anterior tooth with crown restoration on stress distribution and...
OBJECTIVE
To evaluate the effect of the labiolingual diameter and construction of an endodontically treated (ET) anterior tooth with crown restoration on stress distribution and biomechanical safety under occlusal loading.
METHODOLOGY
Three-dimensional finite element models were generated for maxillary central incisors with all-ceramic crown restorations. The labiolingual diameters of the tooth, defined as the horizontal distance between the protrusion of the labial and lingual surfaces, were changed as follows: (D1) 6.85 mm, (D2) 6.35 mm, and (D3) 5.85 mm. The model was constructed as follows: (S0) vital pulp tooth; (S1) ET tooth; (S2) ET tooth with a 2 mm ferrule, restored with a fiber post and composite resin core; (S3) ET tooth without a ferrule, restored with a fiber post and composite resin core. A total of 12 models were developed. In total, two force loads (100 N) were applied to the crown's incisal edge and palatal surface at a 45° oblique angle to the longitudinal axis of the teeth. The Von Mises stress distribution and maximum stress of the models were analyzed.
RESULTS
Regardless of the loading location, stress concentration and maximum stress (34.07~66.78MPa) in all models occurred in the labial cervical 1/3 of each root. Both labiolingual diameter and construction influenced the maximum stress of the residual tooth tissue, with the impact of the labiolingual diameter being greater. A reduction in labiolingual diameter led to increased maximum stress throughout the tooth. The ferrule reduced the maximum stress of the core of S2 models (7.15~10.69 MPa), which is lower compared with that of S3 models (19.45~43.67 MPa).
CONCLUSION
The labiolingual diameter exerts a greater impact on the biomechanical characteristics of ET anterior teeth with crown restoration, surpassing the influence of the construction. The ferrule can reduce the maximum stress of the core and maintain the uniformity of stress distribution.
Topics: Finite Element Analysis; Crowns; Tooth, Nonvital; Humans; Biomechanical Phenomena; Incisor; Composite Resins; Dental Stress Analysis; Post and Core Technique; Reproducibility of Results; Stress, Mechanical; Reference Values; Bite Force; Imaging, Three-Dimensional; Dental Prosthesis Design; Materials Testing; Tooth Crown
PubMed: 38896638
DOI: 10.1590/1678-7757-2023-0439