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Asgary S, Shamszadeh S, Shirvani A. Management strategies for pulpitis in vital permanent teeth in children and adolescents: a systematic review and meta-analysis of randomized clinical trials. Eur Arch Paediatr Dent 2025:10.1007/s40368-025-01021-w. [PMID: 40117109 DOI: 10.1007/s40368-025-01021-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2024] [Accepted: 02/24/2025] [Indexed: 03/23/2025]
Abstract
PURPOSE Vital pulp treatment (VPT), including pulp capping and pulpotomy, is a conservative approach designed to maintain pulp vitality and health in reversible and partially irreversible pulpitis cases, particularly in children and adolescents with immature or mature permanent teeth. Despite extensive research, the comparation of various VPTs remains uncertain. This study evaluated the efficacy of different VPT techniques and capping materials, including calcium hydroxide (CH), mineral trioxide aggregate (MTA), and other pulp-protecting agents (PPA), and explored heterogeneity across trials, particularly with respect to pulp status (reversible vs. irreversible) and coronal restorations, using meta-regression analysis. METHODS A systematic review and meta-analysis, adhering to PRISMA guidelines, was conducted through a comprehensive search in PubMed and Scopus up to August 2024. The PICO framework was used to define the inclusion criteria: Population (children/adolescents with vital permanent teeth diagnosed with pulp inflammation), Intervention (various VPTs), Comparison (different PPAs and restoration types), and Outcome (success rates based on clinical/radiographic criteria). Odd ratios (ORs) were calculated using random-effects models. Statistical heterogeneity was assessed using the I2 test. Meta-regression analysis was performed to explore the influence of co-interventions on the success rate (P < 0.05). RESULTS Nineteen randomized controlled trials involving 1183 participants were included. The meta-analysis revealed no significant difference between CH and MTA/PPA at 6 months (OR = -0.62; P = 0.26); however, at 12 months, CH demonstrated a significantly lower success rate compared to MTA/PPA (OR = -1.34; P = 0.01). Meta-regression analysis indicated that factors such as pulp status, restoration type, and VPT techniques did not significantly predict treatment success. CONCLUSIONS The findings suggest that various VPT techniques utilising MTA/PPA are effective for managing reversible/irreversible pulpitis in mature/immature permanent teeth in children/adolescents. In contrast, CH is less favourable and not recommended for VPT. These results reinforce the growing evidence supporting the use of MTA and other evidence-supported PPAs over CH for long-term success in VPTs.
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Affiliation(s)
- S Asgary
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - S Shamszadeh
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A Shirvani
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Deputy of Training Affairs, Ministry of Health and Medical Education, Tehran, Iran
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Kwon D, Yoo DS, Kang SS, Jang K, Kim SE. Outcomes of root canal treatments with three different sealers for 120 fractured maxillary fourth premolar teeth in small-to medium-sized dogs. Front Vet Sci 2024; 11:1382645. [PMID: 38784660 PMCID: PMC11112409 DOI: 10.3389/fvets.2024.1382645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction Tooth fracture is one of the most common traumatic maxillofacial injuries in dogs and cats. For fractures with pulp exposure occurring in functionally important teeth, the literature indicates that root canal treatment (RCT) is an effective therapy option that may be the remedy of choice before extraction. The most commonly reported fractures in the United States involve canine teeth; however, fractures of the maxillary fourth premolars are more common in Korea, where there are many small-and medium-sized dogs. RCT mechanically and chemically removes pulp tissue and bacteria (cleaning and shaping) from the infected root canal, and obturates the root canal with filling material to restore tooth functionality without inflammation. Various techniques, instruments, and materials used in humans have been modified for application in veterinary dentistry. Methods This study analyzed the results of RCT of the maxillary fourth premolar in 120 small-and medium-sized dogs (weighing less than 25 kg) using three different sealers (silicone-based sealer, bioceramic sealer, and calcium hydroxide-based sealer) through a simple application of the single-cone technique. Results The overall success rate of RCT in maxillary fourth premolars was 90.83%, with 8.33% no evidence of failure (NEF) and 0.83% failure. Discussion There were no significant differences between the three different sealers. Furthermore, preexisting periapical lesion (PAL) was reconfirmed as a factor in reducing the success rate of RCT. In addition, the working length and master apical file of each root were analyzed in our study as a novel reference for endodontic veterinarians.
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Affiliation(s)
- Daehyun Kwon
- MAY Veterinary Dental Hospital, Seoul, Republic of Korea
- Department of Veterinary Surgery, College of Veterinary Medicine and BK21 Plus Project Team, Chonnam National University, Gwangju, Republic of Korea
| | - Dae Sung Yoo
- Department of Veterinary Public Health, College of Veterinary Medicine, Chonnam National University, Gwangju, Republic of Korea
| | - Seong Soo Kang
- Department of Veterinary Surgery, College of Veterinary Medicine and BK21 Plus Project Team, Chonnam National University, Gwangju, Republic of Korea
- Biomaterial R&BD Center, Chonnam National University, Gwangju, Republic of Korea
| | - Kwangsik Jang
- Department of Veterinary Surgery, College of Veterinary Medicine and BK21 Plus Project Team, Chonnam National University, Gwangju, Republic of Korea
- Biomaterial R&BD Center, Chonnam National University, Gwangju, Republic of Korea
| | - Se Eun Kim
- Department of Veterinary Surgery, College of Veterinary Medicine and BK21 Plus Project Team, Chonnam National University, Gwangju, Republic of Korea
- Biomaterial R&BD Center, Chonnam National University, Gwangju, Republic of Korea
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Uçar AY, Kölüş T, Bozkurt DA, Neelakantan P, Ali IAA, Belli S. A laboratory investigation on the effect of biguanide- and pyridine-derived antiseptics on the adhesion of resin composites to dentin. AUST ENDOD J 2023; 49:599-605. [PMID: 37602727 DOI: 10.1111/aej.12791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 08/06/2023] [Accepted: 08/13/2023] [Indexed: 08/22/2023]
Abstract
Optimal bonding of adhesive restorations to dentin is crucial to prevent microleakage and enhance the survival of root-filled teeth. The aim of this study was to investigate the effect of chlorhexidine (CHX), alexidine (ALX) and octenidine dihydrochloride (OCT) on the bond strength of resin composites to coronal dentin. Human coronal dentin specimens were treated with 2% CHX, 0.1% ALX, 0.1% OCT or saline then restored with traditional or bulk-fill resin composites. The adhesion strength between the resin and dentin was measured using the microtensile bond strength and failure mode was determined using a stereomicroscope. Treatment with ALX and OCT resulted in significantly greater μTBS compared with CHX and saline, irrespective of the resin composite used. Alexidine treatment predominantly resulted in mixed failure, while adhesive failures were frequently observed in CHX and saline-treated dentin. In conclusion, final irrigation with ALX or OCT improved the bonding of resin composites to dentin.
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Affiliation(s)
- Arzu Yağmur Uçar
- Department of Endodontics, Faculty of Dentistry, Selçuk University, Konya, Turkey
| | - Türkay Kölüş
- Department of Restorative Dentistry, Faculty of Dentistry, Karamanoğlu Mehmetbey University Ahmet Keleşoğlu, Karaman, Turkey
| | - D Alperen Bozkurt
- Department of Endodontics, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Prasanna Neelakantan
- Divison of Restorative Dental Sciences, Discipline of Endodontology, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Islam A A Ali
- School of Dentistry, Oregon Health & Science University, Portland, Oregon, USA
| | - Sema Belli
- Department of Endodontics, Faculty of Dentistry, Selçuk University, Konya, Turkey
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Durmazpinar PM, Recen D, Çeliksöz Ö, Yazkan B. Micro shear bond strength of mineral trioxide aggregate to different innovative dental restorative materials. Proc Inst Mech Eng H 2023; 237:762-769. [PMID: 37171056 DOI: 10.1177/09544119231173506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The objective of this in vitro study was to investigate the micro shear bond strength (µSBS) of mineral trioxide aggregate to four different restorative materials. Sixty mineral trioxide aggregate (MTA) samples were randomly assigned into four experimental groups based on the restorative materials used: nanohybrid resin composite as a control, giomer, alkasite and ormocer. µSBS samples were prepared for each group (n = 15). These samples were then submitted to a µSBS test (crosshead speed, 0.5 mm/min). The resulting data were statistically analyzed by one-way analysis of variance (ANOVA), Levene, and Bonferroni tests (α = 0.05). The bond strength of the alkasite group was statistically significantly higher than all the tested groups (p<0.05), while there were no significant differences between the nanohybrid resin composite, giomer, or ormocer groups (p > 0.05). Within the limitations of this study, alkasite restorative material could be a promising material when placed over MTA.
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Affiliation(s)
| | - Duygu Recen
- Department of Restorative Dentistry, Faculty of Dentistry, Izmir Democracy University, Istanbul, Turkey
| | - Özge Çeliksöz
- Department of Restorative Dentistry, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Başak Yazkan
- Department of Restorative Dentistry, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
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Paulo S, Abrantes AM, Xavier M, Brito AF, Teixo R, Coelho AS, Paula A, Carrilho E, Botelho MF, Marto CM, Ferreira MM. Microleakage Evaluation of Temporary Restorations Used in Endodontic Treatment-An Ex Vivo Study. J Funct Biomater 2023; 14:jfb14050264. [PMID: 37233374 DOI: 10.3390/jfb14050264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 05/27/2023] Open
Abstract
(1) Background: Coronal microleakage can lead to endodontic treatment failure. This study aimed to compare the sealing ability of different temporary restorative materials used during endodontic treatment. (2) Methods: Eighty sheep incisors were collected, uniformized in length, and access cavities were performed, except for in the negative control group, where the teeth were left intact. The teeth were divided into six different groups. In the positive control group, the access cavity was made and left empty. In the experimental groups, access cavities were restored with three different temporary materials (IRM®, Ketac™ Silver, and Cavit™) and with a definitive restorative material (Filtek Supreme™). The teeth were submitted to thermocycling, and two and four weeks later, they were infiltrated with 99mTcNaO4, and nuclear medicine imaging was performed. (3) Results: Filtek Supreme™ obtained the lowest infiltration values. Regarding the temporary materials, at two weeks, Ketac™ Silver presented the lowest infiltration, followed by IRM®, whereas Cavit™ presented the highest infiltration. At four weeks, Ketac™ Silver remained with the lowest values, whereas Cavit™ decreased the infiltration, comparable to IRM®. (4) Conclusion: Regarding temporary materials, Ketac™ Silver had the lowest infiltration at 2 and 4 weeks, whereas the highest infiltration was found in the Cavit™ group at two weeks and in the IRM® group at 4 weeks.
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Affiliation(s)
- Siri Paulo
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Ana Margarida Abrantes
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
- Institute of Biophysics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Mariana Xavier
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Ana Filipa Brito
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Institute of Biophysics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Ricardo Teixo
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Institute of Biophysics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Ana Sofia Coelho
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
| | - Anabela Paula
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
| | - Eunice Carrilho
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
| | - Maria Filomena Botelho
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
- Institute of Biophysics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Carlos Miguel Marto
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
- Institute of Biophysics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
- Institute of Experimental Pathology, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Manuel Marques Ferreira
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
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Pushout Bond Strength of Root Fillings after Irrigation of Root Canals Utilizing Sodium Hypochlorite, Chlorhexidine, and Homeopathic Mother Tincture ( Arnica Montana). Clin Pract 2023; 13:305-314. [PMID: 36826170 PMCID: PMC9954886 DOI: 10.3390/clinpract13010028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/03/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
The pushout bond strength of root fillings at radicular dentin was investigated employing NaOCl, CHX, and homoeopathic mother tincture (Arnica montana) as an irrigant. Sixty human permanent single-rooted extracted teeth were decoronated. The root canals were instrumented using Pro taper universal rotary system (Dentsply Tulsa Dental; Tulsa, Oklahoma) and were prepared up to F3 apical size. The roots were then randomly divided into three groups according to irrigation solution (n = 20) according to the final irrigation regimen: Group I: 3 mL 5.25% NaOCl followed by 3 mL Saline (control); Group II: 3 mL Arnica montana (10%, w/v) followed by 3 mL Saline; Group III: 3 mL CHX followed by 3 mL Saline. The canals were dried using paper points. The canals were coated with AH Plus sealer (Dentsply DeTey, Konstaz, Germany) with the aid of a Lentulo spiral (Dentsply DeTey, Konstaz, Germany) and obturated with #F3 gutta-percha. Each root was then horizontally sliced into three slices, labelled coronal, middle, and apical, each measuring 2 mm thick. Furthermore, at a crosshead speed of 2 mm/min, the test was carried out using the universal testing apparatus. The 5.25% NaOCl significantly decreased the bond strength of AH Plus to dentin. Both CHX and Arnica montana were capable of reversing the compromised pushout of AH Plus to NaOCl-treated dentin. After using NaOCl as an irrigant, the danger of diminished binding capacity of AH Plus to root canal walls arises. Final irrigation with Arnica montana and CHX reduces this risk.
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Apical periodontitis and associated factors in a rural population of southern Brazil: a multilevel analysis. Clin Oral Investig 2023:10.1007/s00784-023-04886-7. [PMID: 36746818 DOI: 10.1007/s00784-023-04886-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 01/26/2023] [Indexed: 02/08/2023]
Abstract
OBJECTIVES This study aims to evaluate the association between apical periodontitis (AP) and sociodemographic/clinical factors in a probability sample of individuals living in a rural area of southern Brazilian. MATERIALS AND METHODS A cross-sectional study was conducted involving 584 non-edentulous adult individuals who had undergone a full-mouth radiographic survey. Periapical status was analysed using the periapical index (PAI). Endodontic status was evaluated considering the occurrence of voids in the filling material and the root filling length. Crown status was classified based on the presence of caries, restorations, and prosthetic crowns. Sociodemographic variables, frequency of dental care, and periodontal disease were also registered. The data were analysed using hierarchical multilevel Poisson regression analysis. The multilevel structure was composed of three models: sociodemographic variables, clinical variables, and clinical variables adjusted by sociodemographic variables (α = 5%). RESULTS The prevalence of AP in the sample was 60.45%. AP was significantly associated with age, skin colour, schooling, periodontal disease, and frequency of dental care (P < 0.005). Among the 10,396 teeth evaluated, 868 (8.35%) had AP, which was significantly associated with tooth group, dental arch, crown status, and endodontic treatment (P < 0.005). CONCLUSIONS The prevalence of AP was high in the population studied. An older age, black/brown skin colour, low level of schooling, infrequent dental care, severe periodontal disease, mandibular teeth, posterior teeth, inadequate crown status, and having undergone endodontic treatment were significantly associated with the outcome. Clinical relevance This study about a rural probability sample reinforces that AP is still a recurrent oral health problem.
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Kwon W, Kim IH, Kang CM, Kim B, Shin Y, Song JS. Comparative study of pulpal responses to ProRoot MTA, Vitapex, and Metapex in canine teeth. J Dent Sci 2021; 16:1274-1280. [PMID: 34484596 PMCID: PMC8403786 DOI: 10.1016/j.jds.2020.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/25/2020] [Indexed: 11/29/2022] Open
Abstract
Background/purpose ProRoot MTA, Vitapex, and Metapex are widely used for pulp treatment of primary tooth. The aim of this study was to compare the pulpal responses to ProRoot MTA, Vitapex, and Metapex in a canine model of pulpotomy. Materials and methods Pulpotomy procedure was performed to 34 teeth (21 incisors and 13 premolars) and ProRoot MTA, Vitapex or Metapex was applicated to artificially exposed pulp tissues. After 13 weeks, the teeth were extracted and processed with hematoxylin-eosin staining for histologic evaluation. All specimens were evaluated in several categorys related to calcific barrier, inflammatory responses and the area of calcific barrier formation was measured. Results Most of the specimens in the ProRoot MTA group developed a calcific barrier at the pulp amputation site and showed a low level of inflammatory response. However, in comparison to ProRoot MTA group, a small amount of calcific barrier formed in Vitapex and Metapex groups. Conclusion This in vivo study found that Vitapex and Metapex induced similar pulpal responses but showed poor outcomes compared with using ProRoot MTA. Vitapex and Metapex are therefore not good substitutes for ProRoot MTA in direct pulp capping and pulpotomy.
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Affiliation(s)
- Woojin Kwon
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Ik-Hwan Kim
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Chung-Min Kang
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Byurira Kim
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Yooseok Shin
- Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Republic of Korea.,Department of Conservative Dentistry, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Je Seon Song
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, Republic of Korea.,Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Republic of Korea
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Malagnino VA, Pappalardo A, Plotino G, Carlesi T. The fate of overfilling in root canal treatments with long-term follow-up: a case series. Restor Dent Endod 2021; 46:e27. [PMID: 34123763 PMCID: PMC8170384 DOI: 10.5395/rde.2021.46.e27] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 01/09/2021] [Accepted: 02/08/2021] [Indexed: 11/30/2022] Open
Abstract
This study describes 6 cases of endodontic overfilling with successful clinical outcomes during long-term (up to 35 years) radiographic follow-up. Successful endodontic treatment depends on proper shaping, disinfection, and obturation of root canals. Filling materials should completely fill the root canal space without exceeding the anatomical apex. Overfilling may occur when the filling material extrudes into the periapical tissues beyond the apex. The present case series describes 6 root canal treatments in which overfilling of root canal sealer and gutta-percha accidentally occurred. Patients’ teeth were periodically checked with periapical radiographs in order to evaluate the outcomes during long-term follow-up. All cases showed healing and progressive resorption of the extruded materials in the periapex. The present cases showed that if a 3-dimensional seal was present at the apical level, overfilling did not negatively affect the long-term outcomes of root canal treatment.
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Affiliation(s)
- Vito Antonio Malagnino
- Unit of Endodontic, Department of Oral Science, Nano and Biotechnology, University "G. D'Annunzio" of Chieti, Chieti, Italy
| | - Alfio Pappalardo
- Department of General Surgery and Medical-Surgical, University of Catania, Catania, Italy
| | | | - Teocrito Carlesi
- Unit of Endodontic, Department of Oral Science, Nano and Biotechnology, University "G. D'Annunzio" of Chieti, Chieti, Italy
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Alshawwa H, Wang JF, Liu M, Sun SF. Successful management of a tooth with endodontic-periodontal lesion: A case report. World J Clin Cases 2020; 8:5049-5056. [PMID: 33195681 PMCID: PMC7642532 DOI: 10.12998/wjcc.v8.i20.5049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/01/2020] [Accepted: 08/29/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Endodontic-periodontal lesion is a commonly encountered dental condition. However, the prognosis of the condition varies from good to poor. Some cases are associated with a poor prognosis that requires tooth extraction. This report presents a case of an endodontic-periodontal lesion in a tooth that was successfully treated by root canal treatment.
CASE SUMMARY A 51-year-old female patient with no medical history complained about persistent pain and discomfort in her left mandibular first molar. Clinical examination showed the left mandibular first molar with poor restoration. It was also associated with underlying necrotic pulp and periodontal involvement. Radiographic examination revealed visible bone defects in the apical and periodontal areas. Based on the findings, the patient was diagnosed with a primary endodontic lesion. A root canal treatment for the endodontic lesion was performed. The patient received a coronal all-ceramic endocrown restoration. A follow-up was arranged to check the prognosis. At the 3 mo follow-up, the clinical and radiography evaluations showed complete disappearance of signs and symptoms and an increase in the radiopacity of the root area.
CONCLUSION Despite the poor prognosis associated with many endodontic lesions, this case report highlights that a good prognosis is still possible for an endodontic lesion with apical and periodontal bone loss. In this case, it was achieved via successful root canal treatment without the need for periodontal or surgical intervention.
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Affiliation(s)
- Hamed Alshawwa
- Department of Endodontics, Hospital of Stomatology, Jilin University, Changchun 130021, Jilin Province, China
| | - Jia-Feng Wang
- Department of Endodontics, Hospital of Stomatology, Jilin University, Changchun 130021, Jilin Province, China
| | - Min Liu
- Department of Periodontics, Hospital of Stomatology, Jilin University, Changchun 130021, Jilin Province, China
| | - Shu-Fen Sun
- Department of Endodontics, Hospital of Stomatology, Jilin University, Changchun 130021, Jilin Province, China
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Physicochemical and Antibacterial Properties of Novel, Premixed Calcium Silicate-Based Sealer Compared to Powder-Liquid Bioceramic Sealer. J Clin Med 2020; 9:jcm9103096. [PMID: 32992852 PMCID: PMC7600315 DOI: 10.3390/jcm9103096] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/11/2020] [Accepted: 09/24/2020] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to compare the physicochemical properties, filling ability, and antibacterial activity of a premixed calcium silicate-based sealer to those of a powder–liquid bioceramic sealer. Ceraseal (CS) and BioRoot (BR) materials were analyzed using scanning electron microscopy and energy-dispersive X-ray spectroscopy at 7 and 14 d of immersion in distilled water. The filling ability of the two sealers as well as the water contact angle, solubility, flow, roughness, crystalline microstructure, pH, and compressive strength were also evaluated. The antibacterial activity was assessed through an agar diffusion as well as through direct tests. All the results were statistically analyzed using one-way or two-way analysis of variance tests. Statistically significant lower void percentages were observed for CS at 2 and 8 mm from the working length (WL) compared to those for the BR group, whilst no significant difference was observed at 5 mm from the WL. BR sealer showed higher alkaline pH, rougher surface, lower water contact angle values, lower flowability, and higher solubility compared to CS. BR showed globular and needle-like crystalline microstructure, whilst CS had globular and flower-like crystalline microstructure up to 72 h. No statistical difference was found for the compressive strength between the two sealers. BR and CS showed no antibacterial effect against Enterococcus faecalis after 3 h, whilst both sealers showed antibacterial capacity after 24 and 72 h. BR demonstrated higher antibacterial activity after 24 h. In conclusion, the use of bioceramic sealers may play an important role in controlling bacterial growth. Moreover, CS may have superior filling ability and lower solubility than the BioRoot sealer due to its specific chemical composition and mixing method.
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Strøm PC, Arzi B, Lommer MJ, Kuntsi H, Fulton Scanlan AJ, Kass PH, Verstraete FJM. Radiographic outcome of root canal treatment of canine teeth in cats: 32 cases (1998–2016). J Am Vet Med Assoc 2018; 252:572-580. [DOI: 10.2460/javma.252.5.572] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Presence of Voids after Continuous Wave of Condensation and Single-cone Obturation in Mandibular Molars: A Micro-computed Tomography Analysis. J Endod 2017; 43:638-642. [DOI: 10.1016/j.joen.2016.11.027] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 11/30/2016] [Accepted: 11/30/2016] [Indexed: 11/18/2022]
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Moosavi H, Afshari S, Manari F. Fracture resistance of endodontically treated teeth with different direct corono-radicular restoration methods. J Clin Exp Dent 2017; 9:e454-e459. [PMID: 28298991 PMCID: PMC5347298 DOI: 10.4317/jced.53160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 07/18/2016] [Indexed: 11/24/2022] Open
Abstract
Background Endodontically treated teeth are widely considered to be more susceptible to fracture than vital teeth. Obturation procedures and post placement have been a main cause of vertical root fracture. Material and Methods Forty-eight human premolars with standardized weakened roots were endodontically treated and allocated to four experimental groups (n=12). After root canal treatment, in group 1, fiber posts #1 were cemented in root canals using Estelite Core Quick, and the crowns were restored with resin composite. For group 2 and 3, the roots and crowns were restored using a light-cured and self-cured adhesive and resin composites respectively. In group 4, it was used the Panavia F 2.0 resin cement and resin composite for corono-radicular reconstruction. In group 5, the teeth remained untouched. After 24 hours storage and 1000 thermocycles, samples were loaded at a cross head speed of 1 mm per minute. Results A significant difference was observed in fracture resistance among groups 4 and 5 compared to other groups. Conclusions Root reconstruction with fiber post and Panavia resin cement, and crown building using light-cured resin composite resulted in increased fracture resistance equal to that of intact teeth. Key words:Fracture resistance, fiber post, resin cement, resin composite.
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Affiliation(s)
- Horieh Moosavi
- Associate Professor of Dental Materials Research Center and Department of Operative Dentistry, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Safora Afshari
- Assistant Professor of Dental Materials Research Center and Department of Operative Dentistry, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Manari
- DDS, Dentist, Mashhad University of Medical Sciences, Mashhad, Iran
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Nakashima M, Iohara K, Murakami M, Nakamura H, Sato Y, Ariji Y, Matsushita K. Pulp regeneration by transplantation of dental pulp stem cells in pulpitis: a pilot clinical study. Stem Cell Res Ther 2017; 8:61. [PMID: 28279187 PMCID: PMC5345141 DOI: 10.1186/s13287-017-0506-5] [Citation(s) in RCA: 264] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 01/05/2017] [Accepted: 02/10/2017] [Indexed: 02/06/2023] Open
Abstract
Background Experiments have previously demonstrated the therapeutic potential of mobilized dental pulp stem cells (MDPSCs) for complete pulp regeneration. The aim of the present pilot clinical study is to assess the safety, potential efficacy, and feasibility of autologous transplantation of MDPSCs in pulpectomized teeth. Methods Five patients with irreversible pulpitis were enrolled and monitored for up to 24 weeks following MDPSC transplantation. The MDPSCs were isolated from discarded teeth and expanded based on good manufacturing practice (GMP). The quality of the MDPSCs at passages 9 or 10 was ascertained by karyotype analyses. The MDPSCs were transplanted with granulocyte colony-stimulating factor (G-CSF) in atelocollagen into pulpectomized teeth. Results The clinical and laboratory evaluations demonstrated no adverse events or toxicity. The electric pulp test (EPT) of the pulp at 4 weeks demonstrated a robust positive response. The signal intensity of magnetic resonance imaging (MRI) of the regenerated tissue in the root canal after 24 weeks was similar to that of normal dental pulp in the untreated control. Finally, cone beam computed tomography demonstrated functional dentin formation in three of the five patients. Conclusions Human MDPSCs are safe and efficacious for complete pulp regeneration in humans in this pilot clinical study.
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Affiliation(s)
- Misako Nakashima
- Department of Stem Cell Biology and Regenerative Medicine, National Center for Geriatrics and Gerontology, Obu, Japan.
| | - Koichiro Iohara
- Department of Stem Cell Biology and Regenerative Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Masashi Murakami
- Department of Stem Cell Biology and Regenerative Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hiroshi Nakamura
- Department of Endodontics, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Yayoi Sato
- Innovation Center for Clinical Research, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yoshiko Ariji
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Kenji Matsushita
- Department of Dental and Oral Infrastructure Development, Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology, Obu, Japan
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Association of Quality of Coronal Filling with the Outcome of Endodontic Treatment: A Follow-up Study. Dent J (Basel) 2017; 5:dj5010005. [PMID: 29563411 PMCID: PMC5806991 DOI: 10.3390/dj5010005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/22/2016] [Accepted: 01/06/2017] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to assess the effect of the quality of the coronal restoration and the root filling on the success of endodontic treatment. Patients treated at Kuwait University Dental Clinics (KUDC) from 2003 to 2014 were contacted by telephone calls. Demographic data and clinical records of patients, including age, gender, the tooth number, and medical history were recorded. Each patient received clinical examination for all teeth, including assessment of the coronal filling (type, quality), root- and/or coronal fracture, and the periodontal condition around the tooth (e.g., probing depth, gingival recession); percussion and mobility tests. A periapical radiograph of the endodontic treated tooth was taken to determine the health of the periapical tissues using the periapical index. The quality of the root filling was assessed by length and density of the root filling. The mean follow-up period was 4.8 years. The overall success rate of endodontic treatment was 86%; teeth without any initial periapical lesion had a success of 93%, whereas those with such lesion had a success rate of 80%. Periapical healing was not significantly associated with either the length of root filling (p = 0.40) or the density of root filling (p = 0.099), but was statistically significantly associated with the presence of coronal filling defects (p = 0.001). This study demonstrated that inadequate coronal filling but not the quality of root filling was associated with a higher prevalence of periapical lesions.
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Al-Maswary AA, Alhadainy HAH, Al-Maweri SA. Coronal Microleakage of the Resilon and Gutta-Percha Obturation Materials with Epiphany SE Sealer: An in-vitro Study. J Clin Diagn Res 2016; 10:ZC39-42. [PMID: 27437358 DOI: 10.7860/jcdr/2016/17545.7750] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/18/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The coronal leakage of bacteria and other irritants to the root canal system is one of the main factors that may result in clinical failure and affect the long term success of endodontic treatment. The Resilon/Epiphany obturation system has been developed as an alternative to gutta-percha and traditional sealers. AIM This study aimed to evaluate and compare the coronal leakage between Resilon obturation material and gutta-percha using the same sealer. MATERIALS AND METHODS In this in-vitro study, 72 freshly extracted single-rooted human teeth were used, and were sectioned at CEJ with 13mm length. The roots were randomly divided into four groups. In Group I, 30 roots were obturated using Resilon and Epiphany SE sealer, Group II, 30 roots were obturated using gutta-percha and Epiphany SE. Group III and Group IV, 12 roots were used as control groups (positive and negative). The coronal leakage was measured using the dye penetration technique. Data were statistically analysed by a One-Way ANOVA test. RESULTS There was a significant difference between the two experimental groups where Resilon revealed less microleakage than gutta-percha group (p <0.05). CONCLUSION Resilon is a suitable replacement for gutta-percha on the basis of its increased resistance to microleakage, but it failed to provide complete hermetic coronal sealing.
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Affiliation(s)
| | | | - Sadeq Ali Al-Maweri
- Assistant Professor, Department of Oral and Maxillofacial Sciences, Al-Farabi Colleges , Saudi Arabia; Department of Oral Medicine and Diagnosis, Sana'a University, Yemen
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Moradi S, Disfani R, Baziar H, Daneshvar F, Jafarzadeh H. Use of fluid filtration method to evaluate the effect of master cone size on the apical seal of severely curved root canals. J Oral Sci 2014; 55:93-8. [PMID: 23748447 DOI: 10.2334/josnusd.55.93] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The apical third of most root canals shows some degree of curvature, which is important in cleaning/shaping and obturation during root canal treatment. The present study evaluated the effect of master cone size on the apical seal of severely curved root canals. Thirty-eight mesial roots of human mandibular first molars were prepared using the crown-down technique. All samples were mature roots with closed apices, had no carious lesions or resorption, and had a canal curvature of > 45º to 60º. Two samples were used as a negative and positive control to evaluate the fluid filtration equipment, and the remaining 36 samples were equally divided into groups A, B, and C based on master cone size, namely, gutta-percha #20, #25, and #30, respectively. The fluid filtration method was used to evaluate microleakage. No significant difference in microleakage was observed among groups (P = 0.31). In conclusion, an increase in master cone size up to #30 does not significantly influence apical microleakage.
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Affiliation(s)
- Saeed Moradi
- Dental Material Research Center, Department of Endodontics, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Gillen BM, Looney SW, Gu LS, Loushine BA, Weller RN, Loushine RJ, Pashley DH, Tay FR. Impact of the quality of coronal restoration versus the quality of root canal fillings on success of root canal treatment: a systematic review and meta-analysis. J Endod 2011; 37:895-902. [PMID: 21689541 DOI: 10.1016/j.joen.2011.04.002] [Citation(s) in RCA: 219] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 03/31/2011] [Accepted: 04/02/2011] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Thorough cleaning and shaping of root canals are essential for periapical healing. Restoration of endodontically treated teeth is also required for them to function and prevent coronal leakage. This study compared the impact of the quality of root canal treatment versus the quality of coronal restoration in treatment outcomes. METHODS Literature search was conducted using the search terms "coronal restoration," "root canal," "periapical status," and "quality." Articles that evaluated the effect of the quality of root filling and coronal restoration or both on the success of root canal treatment were selected. Nine articles were identified and were reviewed by 3 investigators. Data were collected based on predetermined criteria. Percentages of teeth without apical periodontitis were recorded for each category: adequate root canal treatment (AE), inadequate root canal treatment (IE), adequate restoration (AR), and inadequate restoration (IR). Data were analyzed using meta-analysis for odds ratios (ORs). RESULTS After adjusting for significant covariates to reduce heterogeneity, the results were combined to obtain pooled estimates of the common OR for the comparison of AR/AE versus AR/IE (OR = 2.734; 95% confidence interval [CI], 2.61-2.88; P < .001) and AR/AE versus IR/AE (OR = 2.808; 95% CI, 2.64-2.97; P < .001). CONCLUSIONS On the basis of the current best available evidence, the odds for healing of apical periodontitis increase with both adequate root canal treatment and adequate restorative treatment. Although poorer clinical outcomes may be expected with adequate root filling-inadequate coronal restoration and inadequate root filling-adequate coronal restoration, there is no significant difference in the odds of healing between these 2 combinations.
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Affiliation(s)
- Brian M Gillen
- Department of Endodontics, Georgia Health Sciences University, Augusta, GA 30912-1129, USA
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Affiliation(s)
- Roy George
- Griffith University School of Dentistry and Oral Health, Southport, Queensland, Australia
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Tickle M, Milsom K, Qualtrough A, Blinkhorn F, Aggarwal VR. The failure rate of NHS funded molar endodontic treatment delivered in general dental practice. Br Dent J 2008; 204:E8; discussion 254-5. [DOI: 10.1038/bdj.2008.133] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2007] [Indexed: 12/14/2022]
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Torabinejad M, Kutsenko D, Machnick TK, Ismail A, Newton CW. Levels of Evidence for the Outcome of Nonsurgical Endodontic Treatment. J Endod 2005; 31:637-46. [PMID: 16123698 DOI: 10.1097/01.don.0000153593.64951.14] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The purpose of this systematic review was (a) to search for clinical articles pertaining to success and failure of nonsurgical root canal therapy, and (b) to assign levels of evidence to these studies. Electronic and manual searches were conducted to identify studies published between January 1966 and September 2004 with information on the success and failure of nonsurgical root canal therapy. Articles were reviewed and graded for strength of level of evidence (LOE) from one (highest level) to five (lowest level). This review resulted in the identification of 306 clinical studies related to this topic area. Six articles were randomized controlled trials (RCTs, LOE 1). This search also identified 12 low-quality RCTs (LOE 2), 14 cohort studies (LOE 2), five case-control and eight cross sectional studies (LOE 3), four low-quality cohort studies (LOE 4), and five low-quality case-control studies (LOE 4). The majority (73) of the often-quoted "success and failure" studies were case series (LOE 4). The rest of the articles were descriptive epidemiological studies (42), case reports (114), expert opinions (18), literature reviews (4), and one meta-analysis. Based on these findings, it appears that a few high-level studies have been published in the past four decades related to the success and failure of nonsurgical root canal therapy. The data generated by this search can be used in future studies to specifically answer questions and test hypotheses relevant to the outcome of nonsurgical root canal treatment.
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Affiliation(s)
- Mahmoud Torabinejad
- Department of Endodontics of the School of Dentistry, Loma Linda University, Loma Linda, California 92350, USA.
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