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Scientific Reports Jun 2024The aim of this study is to introduce a dental capping agent for the treatment of pulp inflammation (pulpitis). Nanohydroxyapatite with Elaeagnus angustifolia L. extract...
The aim of this study is to introduce a dental capping agent for the treatment of pulp inflammation (pulpitis). Nanohydroxyapatite with Elaeagnus angustifolia L. extract (nHAEA) loaded with metronidazole (nHAEA@MTZ) was synthesized and evaluated using a lipopolysaccharide (LPS) in vitro model of pulpitis. nHAEA was synthesized through sol-gel method and analyzed using Scanning Electron Microscopy, Transmission Electron Microscopy, and Brunauer Emmett Teller. Inflammation in human dental pulp stem cells (HDPSCs) induced by LPS. A scratch test assessed cell migration, RT PCR measured cytokines levels, and Alizarin red staining quantified odontogenesis. The nHAEA nanorods were 17-23 nm wide and 93-146 nm length, with an average pore diameter of 27/312 nm, and a surface area of 210.89 m/g. MTZ loading content with controlled release, suggesting suitability for therapeutic applications. nHAEA@MTZ did not affect the odontogenic abilities of HDPSCs more than nHAEA. However, it was observed that nHAEA@MTZ demonstrated a more pronounced anti-inflammatory effect. HDPSCs treated with nanoparticles exhibited improved migration compared to other groups. These findings demonstrated that nHAEA@MTZ could be an effective material for pulp capping and may be more effective than nHAEA in reducing inflammation and activating HDPSCs to enhance pulp repair after pulp damage.
Topics: Plant Extracts; Humans; Pulpitis; Metronidazole; Dental Pulp; Durapatite; Nanoparticles; Green Chemistry Technology; Drug Carriers; Stem Cells; Cell Movement; Cells, Cultured
PubMed: 38926433
DOI: 10.1038/s41598-024-65582-4 -
Brazilian Oral Research 2024This prospective study aims to evaluate dental pain, anxiety, and catastrophizing levels in pregnant women undergoing root canal treatment. Sixty pregnant and...
This prospective study aims to evaluate dental pain, anxiety, and catastrophizing levels in pregnant women undergoing root canal treatment. Sixty pregnant and non-pregnant women presenting dental pain and an indication for root canal treatment were included in the study. Dental anxiety and catastrophizing were investigated using validated questionnaires. The endodontic intervention was performed, and a numerical scale measured preoperative and postoperative dental pain. The results were analyzed using STATA software 12.0. Unadjusted analyses assessed the association between pregnancy and pain, anxiety, and catastrophizing levels. Multiple linear regression models using 'forward stepwise' entry procedures were used to assess the independent effects of variables on pain scores. The significance level was set at 0.05. Initially, most patients experienced intense dental pain. The levels of dental pain, dental anxiety, and catastrophizing did not differ between pregnant and non-pregnant women. Logistic regression showed that postoperative pain was associated with irreversible pulpitis diagnosis (OR = 4.78; 95%CI 1.55-13.55) and high catastrophizing levels (OR = 1.96; 95%CI 1.01-3.84). Preoperative and postoperative pain rates and anxiety and catastrophizing were similar between pregnant and non-pregnant patients. Postoperative pain was associated with irreversible pulpitis diagnosis and high catastrophizing levels. The similarity between pregnant and non-pregnant women regarding preoperative and postoperative dental pain and catastrophizing and anxiety levels supports the indication of root canal treatment during the gestational period whenever necessary.
Topics: Humans; Female; Root Canal Therapy; Pregnancy; Adult; Prospective Studies; Dental Anxiety; Pain Measurement; Pain, Postoperative; Catastrophization; Young Adult; Toothache; Surveys and Questionnaires; Pregnancy Complications; Logistic Models; Pulpitis; Statistics, Nonparametric
PubMed: 38922214
DOI: 10.1590/1807-3107bor-2024.vol38.0054 -
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 -
Diagnostics (Basel, Switzerland) May 2024The severity of pulpitis is a crucial factor in determining the suitable treatment. There are no clear objective indicators to assess the stage of pulp inflammation that...
The severity of pulpitis is a crucial factor in determining the suitable treatment. There are no clear objective indicators to assess the stage of pulp inflammation that could be used in clinical practice. The change in blood pH of the pulp during the inflammatory phase could hypothetically serve as an indicator of the pulp inflammation severity. The aim of this study was to assess the pH values in the pulpal blood of mature teeth in patients with symptomatic pulpitis, in comparison with the healthy controls. The study included patients with symptoms of pulpitis in premolar or molar teeth (Test group; = 24, mean age 36.04, SD 7.10), and healthy controls (Control group, = 6, mean age 24.5, SD 5.94) referred for extraction of premolars or third molars, for orthodontic reasons. The pulpal blood was taken at the opening of the endodontic access cavity, and the pH value was measured in both groups. Statistical analysis was performed using the SPSS 27.0 program with a significance level of ≤ 0.05. The Mann-Whitney test for dependent samples was performed to evaluate the statistical difference between the groups. The patients with symptomatic pulpitis had significantly decreased pulpal blood pH compared to the healthy controls ( ≤ 0.05). The mean pulpal blood pH was 7.27 (SD 0.06) and 7.40 (SD 0.02) in Test and Control groups, respectively. In the Test group, the pulpal blood pH values were significantly lower in the patients who had symptoms for 3 days or more (7.25, SD 0.05) than in those who had symptoms for up to 3 days (7.33, SD 0.03) ( < 0.001). The pH value of the pulpal blood gradually declines in cases of symptomatic pulpitis, along with increasing duration of the symptoms.
PubMed: 38893654
DOI: 10.3390/diagnostics14111128 -
Journal of Pharmacy & Bioallied Sciences Apr 2024Carious exposure of an irreversibly inflamed vital pulp in a young permanent tooth presents a significant clinical challenge to clinicians to maintain the vitality....
Carious exposure of an irreversibly inflamed vital pulp in a young permanent tooth presents a significant clinical challenge to clinicians to maintain the vitality. Direct pulp capping, partial pulpotomy, and complete pulpotomy are the available procedures to treat young permanent tooth. Mineral trioxide aggregate and biodentine are currently the material of choice for these procedures. The present case report describes the successful apexogenesis of mandibular left first permanent molar using mineral trioxide aggregate. The 18-month follow-up of the case demonstrated clinical and radiographic success with absence of any signs and symptoms and continued root formation.
PubMed: 38882828
DOI: 10.4103/jpbs.jpbs_1109_23 -
Journal of Pharmacy & Bioallied Sciences Apr 2024This study aimed to conduct a human study to determine the incidence of postobturation pain using different parameters. In this cross-sectional study, 240 patients were...
Incidence of Postoperative Pain After Single- and Multiple-Visit Root Canal Treatment in Patients Reporting in the Conservative Dentistry and Endodontics Outpatient Department of a Tertiary Care Hospital: A Cross-Sectional Study.
This study aimed to conduct a human study to determine the incidence of postobturation pain using different parameters. In this cross-sectional study, 240 patients were included, which were equally allocated into two groups: single visit and multiple visit, 120 in each. Patients in both the single and multiple visits were further categorized into two subgroups, subgroup 1-no occlusal reduction and subgroup 2-occlusion reduction each having 60 patients. Corresponding to the type of visit, patients were followed by the role of medication into two groups, subgroup 1-both analgesics and antibiotics, subgroup 2-only analgesics, and subgroup 3-no medication. Following this approach and the criteria of the study, patients' performa was made, and based on this performa, the intensity of subjective symptoms, particularly postobturation pain, was determined using the visual analog scale (VAS). The data were then analyzed using the Chi-square test. Results were such that a single visit, no occlusal reduction, and only analgesics will be better for patients with irreversible pulpitis as chosen in the present study. Within the limitations of the present study, it can be concluded that single-sitting root canal treatment should be preferred over multiple sitting where there is no periapical inflammation; also, the occlusal reduction could be exempted from the same. To relieve the patient from postoperative pain where complete debridement is possible, antibiotics can be excluded from the regimen and only analgesics could be prescribed.
PubMed: 38882820
DOI: 10.4103/jpbs.jpbs_524_23 -
BMC Oral Health May 2024Pulpectomy continues to be the standard treatment recommendation for management of vital primary molars diagnosed with symptomatic irreversible pulpitis. The recent... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
Treatment outcomes of pulpotomy versus pulpectomy in vital primary molars diagnosed with symptomatic irreversible pulpitis: protocol for a non-inferiority randomised controlled trial.
BACKGROUND
Pulpectomy continues to be the standard treatment recommendation for management of vital primary molars diagnosed with symptomatic irreversible pulpitis. The recent decade has seen a paradigm shift in the treatment concepts of how vital mature permanent molars diagnosed with irreversible pulpitis can be more conservatively managed using vital pulp therapy techniques like pulpotomy. However, despite emerging evidence indicating similarities between primary and permanent tooth pulp response to dental caries, there is limited research on whether pulpotomy can be similarly used as a definitive treatment modality for vital primary teeth with irreversible pulpitis. This randomised controlled trial (RCT) aims to compare the treatment effectiveness of pulpotomy versus pulpectomy in management of vital primary molars diagnosed with symptomatic irreversible pulpitis over a two-year period.
METHODS/DESIGN
This clinical study is a parallel, two-armed, open label, non-inferiority RCT with a 1:1 allocation ratio between the experimental intervention arm (pulpotomy) and the active comparator arm (pulpectomy). Healthy cooperative children, between 4-9 years of age, who have painful primary molars with clinical symptoms typical of irreversible pulpitis will be recruited after obtaining informed consent from their parents/legal guardians. 50 vital primary molars clinically diagnosed with symptomatic irreversible pulpitis will be randomly distributed between the two treatment arms. The primary outcomes that will be assessed are clinical and radiographic success after six-months, one-year and two-years of the trial interventions. The influence of baseline pre-operative variables (age; gender; tooth type; site of caries; pre-operative furcal radiolucency; pre-operative pain intensity) and intra-operative factors (time taken to achieve haemostasis) on treatment outcomes will also be assessed. The secondary outcome evaluated will be the immediate (24 h and 7 d) post-operative pain relief afforded by the two treatment interventions.
DISCUSSION
This trial seeks to provide evidence on whether pulpotomy treatment can be no worse than the standard pulpectomy treatment for the management of symptomatic irreversible pulpitis in vital primary molars.
TRIAL REGISTRATION
ClinicalTrials.gov (NCT06183203). Registered on 30 January 2024.
Topics: Humans; Pulpotomy; Pulpectomy; Pulpitis; Tooth, Deciduous; Molar; Child; Child, Preschool; Treatment Outcome; Equivalence Trials as Topic; Female; Male
PubMed: 38807160
DOI: 10.1186/s12903-024-04411-6 -
International Dental Journal May 2024This research seeks to analyse the immunomodulatory impacts of adrenomedullin (ADM) on macrophages induced by bacterial lipopolysaccharide and to investigate the...
OBJECTIVE
This research seeks to analyse the immunomodulatory impacts of adrenomedullin (ADM) on macrophages induced by bacterial lipopolysaccharide and to investigate the influence of macrophage-conditioned media from various stimulating factors on the biological activity of dental pulp stem cells (DPSCs) in vitro.
METHODS
The polarisation effect of ADM on macrophages was analysed through cell immunofluorescence staining and flow cytometry. Potential mechanisms were explored through transcriptomics and metabolomics. The impact of different macrophage-conditioned media on the biological activity of DPSCs was evaluated through western blotting, Realtime fluorescence quantitative, alkaline phosphatase activity assay, and eosin red staining. Each experiment was performed with 3 biological and 3 technical duplicate measurements. Statistical analysis was performed with t test and one-way ANOVA, and mathematical significance defined as P < .05.
RESULTS
ADM can reverse polarisation of macrophages towards M2 phenotype by Lipopolysaccharide and the conditioned media of ADM-induced M2 polarised macrophages significantly enhances the proliferation and differentiation of DPSCs. The mechanism may involve the metabolic reprogramming of macrophages by ADM, specifically promoting the metabolic shift from glycolysis to mitochondrial oxidative phosphorylation in Lipopolysaccharide-induced macrophages.
CONCLUSION
These results indicate that ADM is involved in suppressing inflammation and enhancing the proliferation and differentiation of DPSCs by reprogramming macrophage metabolism.
PubMed: 38806333
DOI: 10.1016/j.identj.2024.04.022 -
Journal of Oral and Maxillofacial... 2024Autophagy is an evolutionarily conserved intracellular catabolic process that recycles and degrades proteins, organelles and pathogens. It is an endogenous defence...
Autophagy is an evolutionarily conserved intracellular catabolic process that recycles and degrades proteins, organelles and pathogens. It is an endogenous defence mechanism regulating multiple cellular pathways like apoptosis, inflammation, immune response and pathogen clearance and acts as a modulator of pathogenesis. This article highlights the emerging role of autophagy in inflammation and regeneration of human dental pulp. It emphasizes exploring autophagy and autophagy agonists as potential targets for the development of novel therapeutic interventions.
PubMed: 38800427
DOI: 10.4103/jomfp.jomfp_197_23 -
Children (Basel, Switzerland) May 2024This systematic review and meta-analysis aimed to evaluate the success rates of pulpotomy treatment for irreversible pulpitis in primary teeth. (Review)
Review
AIM
This systematic review and meta-analysis aimed to evaluate the success rates of pulpotomy treatment for irreversible pulpitis in primary teeth.
METHODS
This study was registered and conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Relevant studies published between January 1980 and April 2023 were identified across eight online databases and two paediatric dentistry textbooks. Study selection, data extraction, and quality assessment were conducted by multiple investigators independently. Data analysis involved single-arm and two-arm meta-analyses, leave-one-out sensitivity analysis, meta-regression, and assessment of publication bias. The risks of bias were evaluated using the Cochrane Collaboration's assessment tools. The levels of evidence were determined using the Oxford Centre for Evidence-Based Medicine (OCEBM) tool.
RESULTS
Five primary studies were included. The weighted mean overall success rates at 6-month and 12-month follow-ups were 97.2% and 94.4%, respectively. Two-arm meta-analysis revealed no significant difference ( > 0.05) between the use of mineral trioxide aggregate (MTA) and non-MTA bioceramic-based materials as pulpotomy medicaments. The sample size of each study did not affect the degree of data heterogeneity. Egger's test revealed no significant publication bias.
CONCLUSIONS
Pulpotomy may be regarded as an alternative modality for treating primary teeth with irreversible pulpitis. Nevertheless, future well-designed trials and extended follow-up periods are warranted.
PubMed: 38790569
DOI: 10.3390/children11050574