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The Journal of Clinical Pediatric... 2014Root canal revascularization attempts to make necrotic tooth alive by the use of certain simple clinical protocols. Earlier apexification was the treatment of choice for... (Review)
Review
Root canal revascularization attempts to make necrotic tooth alive by the use of certain simple clinical protocols. Earlier apexification was the treatment of choice for treating and preserving immature permanent teeth that have lost pulp vitality. This procedure promoted the formation of apical barrier to seal the root canal of immature teeth and nonvital filling materials contained within root canal space. However with the success of root canal revascularization to regenerate the pulp dentin complex of necrotic immature tooth has made us to rethink if apexification is at the beginning of its end. The objective of this review is to discuss the new concepts of tissue engineering in endodontics and the clinical steps of root canal revascularization.
Topics: Apexification; Dental Pulp Cavity; Dentin; Humans; Neovascularization, Physiologic; Regeneration; Root Canal Therapy; Stem Cells; Tissue Engineering
PubMed: 25571677
DOI: 10.17796/jcpd.38.4.j5285857278615r1 -
Virulence 2015Infections of the root canal space and their sequelae can be extremely painful and potentially dangerous, yet they do not necessarily have to be. Chronic, asymptomatic... (Review)
Review
Infections of the root canal space and their sequelae can be extremely painful and potentially dangerous, yet they do not necessarily have to be. Chronic, asymptomatic inflammatory lesions around the apex of a tooth with a necrotic dental pulp or an insufficient root canal treatment can develop unnoticed by the patient, and remain so for years. The course of disease is modulated by both the virulence of the microbiota established in the root canal space and the capacity of the immune system to curb the infection. To both ends, highly convincing investigations to help us understand when and why the tissues around an endodontically involved tooth become acutely inflamed are missing. We will discuss how recent advances in molecular identification of microorganisms have altered our understanding of root canal infections, and which information is currently missing to link clinical experience with observations from experimental research.
Topics: Bacterial Infections; Dental Pulp Cavity; Dental Pulp Necrosis; Humans; Metagenomics; Microbiota; Root Canal Therapy
PubMed: 25654162
DOI: 10.4161/21505594.2014.984567 -
Clinical and Experimental Dental... Dec 2023This bibliometric analysis aimed to evaluate the leading nations, authors, journals, institutes, highly cited publications, and most commonly used keywords concerning... (Review)
Review
OBJECTIVES
This bibliometric analysis aimed to evaluate the leading nations, authors, journals, institutes, highly cited publications, and most commonly used keywords concerning scientific publications based on root and root canal morphology using the CBCT.
MATERIAL AND METHODS
For this bibliometric analysis, an extensive search was carried out on September 25, 2023 using the Scopus database. Pertinent articles in the field were scrutinized after applying inclusion and exclusion criteria. Data were evaluated using Vosviewer and Microsoft Excel.
RESULTS
A literature search revealed the initiation of scientific publication in 2008. Significant contributions made by Saudi Arabia, India, and China concerning the number of publications were seen. Similarly, Jazan University from SA was recognized as the leading institute. The Journal of Endodontics was the leading journal, while authors JNR Martins and G Gambarini produced the highest number of papers.
CONCLUSIONS
This bibliometric analysis demonstrated that scientific publications have increased tremendously since 2008. Significant contributions have been made by developing and developed nations. The Journal of Endodontics and Jazan University have been identified as the leading journal and institute.
Topics: Humans; Dental Pulp Cavity; Endodontics; Bibliometrics; Cone-Beam Computed Tomography; Databases, Factual
PubMed: 37877522
DOI: 10.1002/cre2.801 -
Brazilian Oral Research Oct 2018Pulp canal obliteration (PCO) is a frequent finding associated with pulpal revascularization after luxation injuries of young permanent teeth. The underlying mechanisms... (Review)
Review
Pulp canal obliteration (PCO) is a frequent finding associated with pulpal revascularization after luxation injuries of young permanent teeth. The underlying mechanisms of PCO are still unclear, and no experimental scientific evidence is available, except the results of a single histopathological study. The lack of sound knowledge concerning this process gives rise to controversies, including the most suitable denomination. More than a mere semantic question, the denomination is an important issue, because it reflects the nature of this process, and directly impacts the treatment plan decision. The hypothesis that accelerated dentin deposition is related to the loss of neural control over odontoblastic secretory activity is well accepted, but demands further supportive studies. PCO is seen radiographically as a rapid narrowing of pulp canal space, whereas common clinical features are yellow crown discoloration and a lower or non-response to sensibility tests. Late development of pulp necrosis and periapical disease are rare complications after PCO, rendering prophylactic endodontic intervention useless. Indeed, yellowish or gray crown discoloration may pose a challenge to clinicians, and may demand endodontic intervention to help restore aesthetics. This literature review was conducted to discuss currently available information concerning PCO after traumatic dental injuries (TDI), and was gathered according to three topics: I) physiopathology of PCO after TDI; II) frequency and predictors of pulpal healing induced by PCO; and III) clinical findings related to PCO. Review articles, original studies and case reports were included aiming to support clinical decisions during the follow-up of teeth with PCO, and highlight future research strategies.
Topics: Dental Pulp Cavity; Dental Pulp Diseases; Dentition, Permanent; Humans; Radiography, Dental; Tooth Avulsion; Tooth Crown; Tooth Discoloration; Tooth Fractures
PubMed: 30365616
DOI: 10.1590/1807-3107bor-2018.vol32.0075 -
Advances in Dental Research Jul 2011Pulp regeneration is considered in cases where the dental pulp has been destroyed because of microbial irritation. Diverse oral and food-borne micro-organisms are able... (Review)
Review
Pulp regeneration is considered in cases where the dental pulp has been destroyed because of microbial irritation. Diverse oral and food-borne micro-organisms are able to invade the pulp space, form biofilm on canal walls, and infiltrate dentinal tubules. Prior to pulp regeneration procedures, the pulp space and dentinal walls need to be sufficiently disinfected to allow for and promote regeneration. The necessary level of disinfection is likely higher than that accepted for traditional endodontic therapy, because in traditional techniques the mere lowering of bacterial loads and prevention of bacterial access to periapical tissues is conducive to healing. Moreover, several of the non-specific antimicrobials used in traditional endodontic therapy may cause significant changes in remaining dentin that interfere with its inherent potential to mediate regeneration. Non-specific antimicrobials also suppress all microbial taxa, which may allow residual virulent micro-organisms to preferentially repopulate the pulp space. Therefore, it is important for endodontic pathogens to be studied by molecular methods that allow for a broad depth of coverage. It is then essential to determine the most effective protocols to disinfect the pulp space, with minimal disruption of remaining dentin. These protocols include the topical use of effective antibiotics, including newer agents that have demonstrated efficacy against endodontic pathogens.
Topics: Anti-Bacterial Agents; Dental Disinfectants; Dental Pulp; Dental Pulp Cavity; Dental Pulp Diseases; Dentin; Humans; Regeneration; Root Canal Preparation
PubMed: 21677080
DOI: 10.1177/0022034511405388 -
Medical Science Monitor : International... Jan 2021BACKGROUND We investigated the root canal curvature and morphology of maxillary posterior teeth in Guizhou, China, to provide references for clinical practice. MATERIAL...
BACKGROUND We investigated the root canal curvature and morphology of maxillary posterior teeth in Guizhou, China, to provide references for clinical practice. MATERIAL AND METHODS We collected 274 maxillary posterior teeth in Guizhou Province, China. The root canal curvature was observed by X-ray film measurement. Two hundred teeth were selected to make transparent tooth models, and root canal configuration was recorded according to Vertucci classification criteria. The position of the MB2 root canal orifice and the mesiobuccal root canal configuration were observed by micro-computed tomographic (micro-CT) scanning. The t test and the chi-square test were used for statistical analysis. RESULTS The root canals of the maxillary posterior teeth showed more significant curvature in the mesiodistal direction than in the buccolingual direction (P<0.05). The MB2 root canal of maxillary molars showed severe bending in the mesiodistal direction: 25.16±6.6 degrees and 28.05±8.65 degrees in first and second molars, respectively. The detection rate of MB2 was 48% in maxillary first molars and 32% in maxillary second molars. The results of micro-CT showed that the vertical distances between the MB2 and MB-P line were 0.64±0.34 mm and 0.57±0.28 mm in first and second molars, respectively. CONCLUSIONS The root canal morphology and curvature of maxillary posterior teeth varied greatly in the Guizhou population, which increases the difficulty of treatment. It is necessary for clinicians to gain understanding of the root canal and to improve the success rate of root canal therapy.
Topics: Anatomic Variation; Bicuspid; Dental Pulp Cavity; Humans; Maxilla; Molar; X-Ray Microtomography
PubMed: 33439855
DOI: 10.12659/MSM.928758 -
Medicina (Kaunas, Lithuania) Nov 2021: This systematic review aimed to assess the literature focusing on the clinical management of traumatized teeth with Pulp Canal Obliteration (PCO) and propose an...
: This systematic review aimed to assess the literature focusing on the clinical management of traumatized teeth with Pulp Canal Obliteration (PCO) and propose an updated clinical decision-making algorithm. The present review follows the PRISMA guidelines and was registered on PROSPERO database (CRD42020200656). : An electronic search strategy was performed in Pubmed, EBSCOhost and LILACS from inception to March 2021. Only anterior permanent teeth with PCO due to dental trauma were included. Regarding clinical approaches, only teeth managed with a "watchful waiting" approach, tooth bleaching or root canal treatment (RCT) were included. Quality assessment was performed using the JBI Critical Appraisal Tool for Case Reports. : Twenty case reports were selected, resulting in a total of 27 patients. The number of traumatized teeth diagnosed with PCO was 33. The "watchful waiting" approach was the most implemented clinical strategy. Discolored non-symptomatic PCO teeth were mostly managed with external bleaching. The prevalence of pulp necrosis (PN) was 36.4%. For teeth diagnosed with PN, non-surgical RCT was performed in 10 teeth and surgical RCT in one tooth. Guided endodontic technique was performed in six of those teeth. : For discolored non-symptomatic PCO teeth, external bleaching is advocated and the RCT approach should not be implemented as a preventive intervention strategy. Symptomatic PCO teeth should follow regular endodontic treatment pathways. Clinical approach of teeth with PCO should follow a decision-making algorithm incorporating clinical and radiographic signs and patient-reported symptoms.
Topics: Dental Pulp Cavity; Dentition, Permanent; Humans; Tooth Discoloration
PubMed: 34833455
DOI: 10.3390/medicina57111237 -
Brazilian Dental Journal 2022This study aimed to analyze the root and root canal morphology of mandibular first and second molars using CBCT images. A total of 2,400 mandibular molars exams were...
This study aimed to analyze the root and root canal morphology of mandibular first and second molars using CBCT images. A total of 2,400 mandibular molars exams were selected from 600 patients aged between 18 and 75 years. The number of roots, number of root canals, and root canal configuration according to the Vertucci classification were verified. Overall, 94.92% of mandibular first molars and 90.17% of mandibular second molars had two separate roots. Among the biradicular molars, the first molars showed a greater incidence of type IV canals in the mesial root and type I in the distal root. In the second molars, the most common canal form was type IV in the mesial root and type I in the distal root. In the triradicular molars, the type IV and type I configurations were the most common in the mesial root of the first molar and second molar, respectively. In both triradicular molars, there was a prevalence of type I canal in the distal and DL roots. Statistical analysis was performed at a significance level of 0.05. The number of roots was correlated with gender (Spearman test), and the canal's configuration with gender and bilaterality (Wilcoxon test). The subpopulation studied has a high incidence of bilateral symmetry and mandibular molars with two roots with two distinct mesial canals and one distal canal. The bilateral configuration is possible to estimate the number of canals, especially in images that are difficult to visualize, such as atresic canals.
Topics: Adolescent; Adult; Aged; Humans; Middle Aged; Young Adult; Cone-Beam Computed Tomography; Dental Pulp Cavity; Mandible; Molar; Tooth Root
PubMed: 36287490
DOI: 10.1590/0103-6440202205105 -
Journal of Endodontics Dec 2023Innovative file systems have been recently introduced, claiming improved effectiveness and superior ability to preserve the tooth structure, still allowing an efficient...
Comparative Evaluation of the Canal Shaping Ability, Pericervical Dentin Preservation, and Smear Layer Removal of TruNatomy, WaveOne Gold, and ProTaper Ultimate-An Ex Vivo Study in Human Teeth.
INTRODUCTION
Innovative file systems have been recently introduced, claiming improved effectiveness and superior ability to preserve the tooth structure, still allowing an efficient preparation and disinfection up to the apical region. Regardless, few data are available on the comparative effectiveness of the most recently developed systems. Thus, this ex vivo study aimed to comparatively evaluate, for the first time, the functionality of WaveOne Gold (WOG), TruNatomy (TN), and ProTaper Ultimate (PU) file systems regarding canal shaping, dentin preservation, and smear layer removal ability.
METHODS
Human maxillary incisors were randomly divided for instrumentation with one of the assayed systems. Canal shaping ability and pericervical dentin preservation were characterized through microtomographic evaluation and morphometric assessment (n = 15). Smear layer removal ability was evaluated by scanning electron microscopy (SEM) (n = 6).
RESULTS
TN and PU presented the lowest canal volume variation upon instrumentation, found to be significantly lower than that attained with WOG (P < .05). Pericervical dentin was reduced in all groups upon instrumentation, with TN evidencing the highest preservation, quantitatively similar to PU, and significantly higher than that attained with WOG (P < .05). SEM imaging revealed the presence of scattered remnants of the smear layer and partially opened dentinal tubules at the apical portion, with no significant differences between systems.
CONCLUSIONS
TN and PU allowed for the highest tissue preservation, reporting the lowest volume variation and the highest preservation of the pericervical dentin. None of the assessed systems provided a complete removal of the smear layer in the apical region.
Topics: Humans; Smear Layer; Dentin; Dental Pulp Cavity; Gold; Root Canal Preparation; Root Canal Irrigants
PubMed: 37717909
DOI: 10.1016/j.joen.2023.09.002 -
Journal of Oral Science Jun 2021This study investigated root number and canal configurations, including morphological variations, of mandibular first molars in a subpopulation of South Africans.
PURPOSE
This study investigated root number and canal configurations, including morphological variations, of mandibular first molars in a subpopulation of South Africans.
METHODS
Two calibrated examiners retrospectively evaluated 371 mandibular first molars by using high-resolution cone-beam CT images and the Vertucci classification system with the additions of Sert and Bayirli. Internal and external configurations were recorded, and correlations of sex and age with root number and canal configuration were determined with the chi-square and Fisher exact tests (P < 0.05).
RESULTS
Among mandibular first molars, 0.3% were single-rooted, 98.7% were two-rooted, and 1% were three-rooted. The most frequent configuration was Vertucci Type IV in mesial roots and Vertucci Type I in distal roots. Middle mesial canals were found in 20% and middle-distal canals in 7% of samples. The prevalence of third canals increased in mesial and distal roots as age increased (P > 0.05). Canal configuration and sex were not correlated (P > 0.05).
CONCLUSION
Mandibular first molars exhibited diverse anatomic characteristics in this subpopulation. Clinicians should be aware of the possibility of additional canals in mandibular first molars, as treatment outcomes may be worse if canals are left untreated.
Topics: Cone-Beam Computed Tomography; Dental Pulp Cavity; Humans; Mandible; Molar; Retrospective Studies; Tooth Root
PubMed: 34039829
DOI: 10.2334/josnusd.20-0651