-
Scientific Reports Jun 2024For successful root canal treatment, adequate chemomechanical instrumentation to eliminate microorganisms and pulp tissue is crucial. This study aims to assess the...
For successful root canal treatment, adequate chemomechanical instrumentation to eliminate microorganisms and pulp tissue is crucial. This study aims to assess the organic tissue dissolving activity of various irrigation solutions on bovine tooth pulp tissue. 40 extracted bovine mandibular anterior teeth (n = 10) were used for the study. Bovine pulp pieces (25 ± 5 mg) were placed in 1.5 ml Eppendorf tubes. Each tooth pulp sample was then covered with 1.5 ml of different irrigation solutions, dividing them into four groups: Group 1 with freshly prepared 5% Boric acid, Group 2 with 5% NaOCl, Group 3 with Irritrol, and Group 4 with Saline. Samples were left at room temperature for 30 min, then dried and reweighed. The efficacy of tissue dissolution ranked from highest to lowest was found to be NaOCl, Boric Acid, Irritrol, and saline (p < 0.05). It was observed that the decrease in the NaOCl group was greater than the decrease in the Irritrol and saline groups, and the decrease in the Boric acid group was significantly greater than the decrease in the saline group (p < 0.05). It also emphasizes the need for future studies to further investigate the effects of Irritrol and Boric Acid on tissue dissolution.
Topics: Animals; Cattle; Boric Acids; Root Canal Irrigants; Dental Pulp; Sodium Hypochlorite; Therapeutic Irrigation
PubMed: 38879635
DOI: 10.1038/s41598-024-64904-w -
Medicine Jun 2024To investigate the efficacy of 3 root canal sealants such as AH Plus, GuttaFlow and iRoot SP combined with warm gutta-percha vertical compression technique in the...
To investigate the efficacy of 3 root canal sealants such as AH Plus, GuttaFlow and iRoot SP combined with warm gutta-percha vertical compression technique in the treatment of dental pulp disease. This was a single-center retrospective study. 180 patients with dental pulp disease were divided into AH Plus group (n = 60), GuttaFlow group (n = 60) and iRoot SP group (n = 60) according to the different treatment methods. Patients in different groups were treated with corresponding root canal sealant combined with warm gutta-percha vertical compression technique. The quality of root canal filling, filling time, filling area ratio, the incidence of pain after operation, serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) and efficacy at 6 months after operation were compared among the 3 groups, respectively. The filling time in the GuttaFlow group and the iRoot SP group was significantly shorter than that in the AH Plus group (P < .001). There were significant differences in pain grade (P = .015) and pain rate (P = .016) among the 3 groups, and the pain rate in the GuttaFlow group and the iRoot SP group was significantly lower than that in the AH Plus group (P = .016). The time-point effect, intergroup effect and time-groups effect of serum TNF-α and IL-6 were significantly different (P < .001), and the levels of the 3 groups after treatment were significantly lower than those before treatment (P < .05), and the levels were significantly lower in the GuttaFlow group and the iRoot SP group (P < .05). There were significant differences in efficacy grading and effective rate among the 3 groups (P = .028), and the effective rate of iRoot SP group was significantly higher than that of AH Plus group (P < .05). The iRoot SP or GuttaFlow as root canal sealant combined with warm gutta-percha vertical compression technique in the treatment of dental pulp disease is better than AH Plus, and the former one can shorten the filling time, relieve the postoperative pain and improve the inflammatory response, but the long-term apical sealing effect of iRoot SP is better than GuttaFlow.
Topics: Humans; Female; Male; Retrospective Studies; Adult; Root Canal Filling Materials; Gutta-Percha; Dental Pulp Diseases; Interleukin-6; Middle Aged; Tumor Necrosis Factor-alpha; Treatment Outcome; Young Adult; Drug Combinations; Dimethylpolysiloxanes
PubMed: 38875398
DOI: 10.1097/MD.0000000000038414 -
Cureus May 2024Traditionally, radiographs were used to assess the working length of root canals. However, the use of Electronic Apex Locators (EAL) may be a non-invasive alternative....
INTRODUCTION
Traditionally, radiographs were used to assess the working length of root canals. However, the use of Electronic Apex Locators (EAL) may be a non-invasive alternative. This study aimed to evaluate the accuracy of the electronic apex locator (EAL) compared to radiographic measurements in determining the working length of root canals.
METHOD
The study assessed the performance of EALs in different scenarios, including the presence of blood and pulp tissue, the use of ethylenediaminetetraacetic acid (EDTA), sodium hypochlorite (NaOCl) as an irrigant, and post-instrumentation with normal saline. An electronic apex locator (DTE DPEX-V; Woodpecker, China) was used alongside traditional radiographs to measure the working length in 144 root canal treatments. Bland-Altman analysis was used to compare the measurements between EAL and radiographs using Jamovi software, v2.4.8 (https://www.jamovi.org/).
RESULT
The findings revealed strong correlations between EAL and radiographic measurements across all testing environments, with Pearson's correlation coefficients ranging from 0.944 to 0.998. The Bland-Altman analysis suggests bias; the average difference was negative and close to zero (Pulp: -0.354, EDTA: -0.0972, NaOCl: -0.0382, Saline: -0.0139) when EAL measurements were compared to radiographic measurements.
CONCLUSION
The working length measurement of root canals using an electronic apex locator such as DTE DPEX-V is comparable to traditional radiographic measurements. The use of irrigants improves the measurement. The EAL has the potential to be an alternative to the invasive radiograph for root canal length measurement.
PubMed: 38872664
DOI: 10.7759/cureus.60283 -
Clinical Case Reports Jun 2024The main objective of root canal therapy is to locate all the canals, cleaning, and shaping, and obturation to obtain fluid tight seal and to heal the periapical lesion...
KEY CLINICAL MESSAGE
The main objective of root canal therapy is to locate all the canals, cleaning, and shaping, and obturation to obtain fluid tight seal and to heal the periapical lesion if present.
ABSTRACT
The proper cleaning, shaping, and disinfection of the pulp chambers, as well as the filling of the canals, are critical to the efficacy of treatment with root canals. The success of an endodontically treated tooth is dependent on the accuracy of the diagnosis, disinfection, cleaning and shaping, obturation, and finally, the prosthetic rehabilitation management. Root canal therapy should provide a hermatic as well as fluid impenetrable seal which prevents the progression of periapical infection. There are two ways to treat such lesions: surgical and nonsurgical methods. If the root canal is cleaned, shaped, and sealed properly and adequately without the use of a surgical procedure, these lesions will recover during nonsurgical root canal therapy. This case series focuses primarily on the nonsurgical treatment of an enormous periapical lesion and provides evidence that these lesions respond well without surgery.
PubMed: 38863866
DOI: 10.1002/ccr3.9074 -
BMC Oral Health Jun 2024The efficacy of root canal treatment is greatly impacted by a thorough understanding of root canal anatomy. This systematic review and meta-analysis aim to thoroughly... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
The efficacy of root canal treatment is greatly impacted by a thorough understanding of root canal anatomy. This systematic review and meta-analysis aim to thoroughly investigate the root morphology and canal configuration (RMCC) of permanent premolars (PMs).
METHODOLOGY
A comprehensive analysis was conducted following the PRISMA guidelines. Literature exploration was carried out across four electronic databases (PubMed, Embase, Cochrane, and Web of Science). The risk of bias assessment was conducted for the included studies utilizing the Anatomical Quality Assessment (AQUA) tool. Data analysis was performed utilizing SPSS and RevMAN5.3.3. The meta-analysis was applied with a 95% confidence interval to calculate odds ratios (OR).
RESULTS
Among the 82 selected studies, 59 studies exhibited potential bias in domain one (objective(s) and subject characteristics), followed by domain three (methodology characterization). The majority of maxillary PM1s had either single root (46.7%) or double roots (51.9%), while three-rooted variants were uncommon (1.4%). Conversely, most other PMs exhibited a single root. In terms of canal configuration, maxillary PM1s predominantly featured double distinct canals (87.2%), with the majority of maxillary PM2s displaying either a single canal (51.4%) or double canals (48.3%). Mandibular PMs were primarily characterized by single canals, accounting for 78.3% of mandibular PM1s and 90.3% of mandibular PM2s. Subgroup analyses revealed higher incidences of single-rooted and single-canalled PMs among Asians compared to Caucasians. Additionally, women exhibited a higher incidence of single-rooted PMs, while men showed a greater frequency of double-rooted PMs.
CONCLUSIONS
The comprehensive analysis indicated that maxillary PM1s predominantly possess double roots and double canals, whereas maxillary PM2s and mandibular PMs were primarily characterized by single-rooted with a single canal. Notably, single root and single canal were more prevalent among women and Asian samples.
Topics: Humans; Cone-Beam Computed Tomography; Bicuspid; Tooth Root; Dental Pulp Cavity
PubMed: 38835024
DOI: 10.1186/s12903-024-04419-y -
Heliyon May 2024Cemental tears are often misdiagnosed due to their scarcity. In this study, we reported the second largest cohort of cemental tears thus far. By reviewing the...
Cemental tears are often misdiagnosed due to their scarcity. In this study, we reported the second largest cohort of cemental tears thus far. By reviewing the radiographic data and medical records of 63 cemental tear teeth, we found that periapical periodontitis was the most frequent diagnosis, followed by cracked tooth/root fracture and periodontitis. Most of the cemental tear teeth that did not have root canal treatment had vital pulp. The apical third of the root was the most prominent site of cemental tears. Cemental tears occurred more frequently in the palatal root of the maxillary molars and in the mesial root of the two-root mandibular molars. Uncontrollable bone loss and tooth mobility were the two main reasons for the extraction of teeth with cemental tears. We suggest that cemental tears should be included in the differential diagnosis of periapical periodontitis, cracked tooth, vertical root fracture and periodontitis, especially for teeth with periapical radiolucency and vital pulp. We believe our study could provide more insights into cemental tears, which will aid clinicians in the early diagnosis and proper treatment of cemental tears.
PubMed: 38826719
DOI: 10.1016/j.heliyon.2024.e30999 -
BMC Oral Health Jun 2024Immature teeth with necrotic pulps present multiple challenges to clinicians. In such cases, regenerative endodontic procedures (REPs) may be a favorable strategy....
BACKGROUND
Immature teeth with necrotic pulps present multiple challenges to clinicians. In such cases, regenerative endodontic procedures (REPs) may be a favorable strategy. Cells, biomaterial scaffolds, and signaling molecules are three key elements of REPs. Autologous human dental pulp cells (hDPCs) play an important role in pulp regeneration. In addition, autologous platelet concentrates (APCs) have recently been demonstrated as effective biomaterial scaffolds in regenerative dentistry, whereas the latest generation of APCs-concentrated growth factor (CGF), especially liquid phase CGF (LPCGF)-has rarely been reported in REPs.
CASE PRESENTATION
A 31-year-old woman presented to our clinic with the chief complaint of occlusion discomfort in the left mandibular posterior region for the past 5 years. Tooth #35 showed no pulp vitality and had a periodontal lesion, and radiographic examination revealed that the tooth exhibited extensive periapical radiolucency with an immature apex and thin dentin walls. REP was implemented via transplantation of autologous hDPCs with the aid of LPCGF. The periodontal lesion was managed with simultaneous periodontal surgery. After the treatment, the tooth was free of any clinical symptoms and showed positive results in thermal and electric pulp tests at 6- and 12-month follow-ups. At 12-month follow-up, radiographic evidence and three-dimensional models, which were reconstructed using Mimics software based on cone-beam computed tomography, synergistically confirmed bone augmentation and continued root development, indicating complete disappearance of the periapical radiolucency, slight lengthening of the root, evident thickening of the canal walls, and closure of the apex.
CONCLUSION
hDPCs combined with LPCGF represents an innovative and effective strategy for cell-based regenerative endodontics.
Topics: Humans; Female; Adult; Dental Pulp; Regenerative Endodontics; Dental Pulp Necrosis; Cell Transplantation; Transplantation, Autologous
PubMed: 38824565
DOI: 10.1186/s12903-024-04410-7 -
Journal of Endodontics May 2024Automated segmentation of three-dimensional pulp space on cone-beam computed tomography (CBCT) images presents a significant opportunity for enhancing diagnosis,... (Review)
Review
INTRODUCTION
Automated segmentation of three-dimensional pulp space on cone-beam computed tomography (CBCT) images presents a significant opportunity for enhancing diagnosis, treatment planning, and clinical education in endodontics. The aim of this systematic review was to investigate the performance of AI-driven automated pulp space segmentation on CBCT images.
METHODS
A comprehensive electronic search was performed using PubMed, Web of Science, and Cochrane databases, up until February 2024. Two independent reviewers participated in the selection of studies, data extraction, and evaluation of the included studies. Any disagreements were resolved by a third reviewer. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the risk of bias.
RESULTS
Thirteen studies that met the eligibility criteria were included. Most studies demonstrated high accuracy in their respective segmentation methods, although there was some variation across different structures (pulp chamber, root canal) and tooth types (single-rooted, multi-rooted). Automated segmentation showed slightly superior performance for segmenting the pulp chamber compared to the root canal and single-rooted teeth compared to multi-rooted ones. Furthermore, second mesiobuccal (MB2) canal segmentation also demonstrated high performance. In terms of time efficiency, the minimum time required for segmentation was 13 seconds.
CONCLUSION
AI-driven models demonstrated outstanding performance in pulp space segmentation. Nevertheless, these findings warrant careful interpretation, and their generalizability is limited due to the potential risk and low evidence level arising from inadequately detailed methodologies and inconsistent assessment techniques. In addition, there is room for further improvement, specifically for root canal segmentation and testing of AI performance in artifact-induced images.
PubMed: 38821262
DOI: 10.1016/j.joen.2024.05.012 -
Dental Research Journal 2024The presence of treatment-resistant microorganisms is known as the main cause of pulpectomy failure in the endodontic treatment of deciduous teeth. The usage of lasers...
BACKGROUND
The presence of treatment-resistant microorganisms is known as the main cause of pulpectomy failure in the endodontic treatment of deciduous teeth. The usage of lasers can contribute to reducing these microorganisms. This study aimed to compare the effect of three disinfection methods for deciduous teeth canals using laser diode 810 nm, photodynamic therapy with laser 660 nm and methylene blue, and sodium hypochlorite.
MATERIALS AND METHODS
In this experimental study, 58 single-root deciduous teeth with no root resorption were investigated in four groups, including one control group of 10 and three intervention groups of 16. Preparation of the samples was done using manual files up to three numbers after the initial file. After sterilizing the samples in an autoclave, bacteria were cultured in the canals. In the first group, irrigating with hypochlorite 2.5% was done; in the second group, photodynamic therapy was performed using a laser diode and 0.1 mg/mL methylene solution; and in the third group, high-intensity laser 810 nm direct radiation was done into the canal. Next, samples were taken from all canals. The colony formation unit (CFU) of the bacteria was counted in the blood agar culture medium. The data were analyzed using Kruskal-Wallis and negative binomial regression test (α =0.05).
RESULTS
The mean CFU differed significantly between the four groups. The rate of incidence of colonies showed a reduction in all three intervention groups compared to the negative control. In the high-intensity laser 810 nm group, there was 68.4%; in the photodynamic therapy with diode 660 nm and methylene blue, there was 88%; and in the hypochlorite group, 98.3% reduction was observed compared to the negative control group.
CONCLUSION
Based on the results of this study, to compare three disinfection methods of the deciduous teeth canals without preparation of canals, sodium hypochlorite had greater efficiency. All three groups of laser, photodynamic therapy, and sodium hypochlorite showed reductions of bacterial colony compared to the control group. The reductive effects of CFU were greater in the hypochlorite sodium group, followed by photodynamic and direct laser radiation groups.
PubMed: 38807661
DOI: No ID Found -
BMC Oral Health May 2024Growth factors embedded in the extracellular matrix of the dentin play an important role in the migration, proliferation, and differentiation of dental pulp stem cells... (Comparative Study)
Comparative Study
Comparative effects of 17% ethylenediaminetetraacetic acid and 9% etidronic acid applied with different irrigant activation techniques on the release of growth factors from dentin: in vitro study.
BACKGROUND
Growth factors embedded in the extracellular matrix of the dentin play an important role in the migration, proliferation, and differentiation of dental pulp stem cells in regenerative endodontics. In regenerative endodontic treatments, the type of irrigation solution used is crucial for the release of growth factors (GFs) from the dentin matrix. This study evaluated the effectiveness of different irrigant activation techniques (IAT) using two different chelating agents, 17% ethylenediaminetetraacetic acid (EDTA) and 9% etidronic acid (HEDP), in terms of their GF release.
METHODS
Seventy-two mandibular premolar teeth were prepared to simulate an open apex. The root fragments were irrigated with 20 ml of 1.5% sodium hypochlorite and 20 ml of saline solution. Eight root fragments were randomly separated for the control group, and the remaining 64 fragments were randomly separated into eight groups based on two different chelating agents (17% EDTA and 9% HEDP) and four different IAT ((conventional needle irrigation (CNI), passive ultrasonic irrigation (PUI), sonic activation with EDDY, and XP-endo Finisher (XPF)). TGF-β1, VEGF-A, BMP-7 and IGF-1 release levels were determined using an ELISA, and statistical analysis was performed using the Kolmogorov-Smirnov test, ANOVA, and the Tukey test (p < .05).
RESULTS
Compared to the control group, the experimental groups showed significantly higher GF release when using EDTA or HEDP. Among the activation groups, the EDDY group triggered the highest GF release, and the CNI group triggered the lowest.
CONCLUSIONS
IAT with EDTA and HEDP can increase GF release, with EDDY being the most effective IAT method. Using chelating agents with IAT may be beneficial in regenerative endodontic treatments.
Topics: Edetic Acid; Humans; Root Canal Irrigants; Dentin; Etidronic Acid; Chelating Agents; In Vitro Techniques; Intercellular Signaling Peptides and Proteins; Regenerative Endodontics; Bicuspid; Root Canal Preparation
PubMed: 38802852
DOI: 10.1186/s12903-024-04336-0