Ricardo Machado;Daniel Comparin;Sergio Aparecido Ignacio;Ulisses Xavier da Silva Neto
Restorative Dentistry and Endodontics
/
v.46
no.3
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pp.31.1-31.13
/
2021
Objectives: To evaluate postoperative pain after endodontic treatment of necrotic teeth using large intentional foraminal enlargement (LIFE). Materials and Methods: The sample included 60 asymptomatic necrotic teeth (with or without chronic apical periodontitis), and a periodontal probing depth of 3 mm, previously accessed and referred to perform endodontic treatment. After previous procedures, the position and approximate size of the apical foramen (AF) were determined by using an apex locator and K flexo-files, respectively. The chemomechanical preparation was performed with Profile 04 files 2 mm beyond the AF to achieve the LIFE, using 2.5 mL of 2.5% NaOCl at each file change. The filling was performed by Tagger's hybrid technique and EndoFill sealer. Phone calls were made to all the patients at 24, 48 and 72 hours after treatment, to classify postoperative pain. Statistical analysis was performed by different tests with a significance level of 5%. Results: Age, gender, periradicular status and tooth type did not influence postoperative pain (p > 0.05). Only 1 patient (1.66%) reported severe pain after 72 hours. Moderate pain was reported by 7, 4 and 3 patients after 24, 48 and 72 hours, respectively (p = 0.0001). However, paired analyses showed a statistically significant difference only between 24 and 72 hours (p = 0.04). Sealer extrusion did not influence the postoperative pain (p > 0.05). Conclusions: Acute or moderate postoperative pain was uncommon after endodontic treatment of necrotic teeth with LIFE.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.49
no.5
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pp.262-269
/
2023
Objectives: Anterior maxillary sinus wall fractures are common in all types of maxillofacial trauma. They can result in various complications, including injury to the surrounding nerves. Owing to its anatomy, trauma to the maxillary antrum can result in injury to the middle superior alveolar nerve (MSAN) and the anterior superior alveolar nerve (ASAN). The purpose of this study is to evaluate neurosensory deficits (NSD) present in maxillary gingiva, incisors, and premolars after injury to the anterior wall of the maxillary antrum. Materials and Methods: This prospective study was conducted among 39 patients sustaining unilateral fractures of the anterior maxillary sinus wall. Clinical neurosensory tests including two-point discrimination and fine touch discrimination were performed to classify the extent of nerve injuries as mild, moderate, severe, or anesthetic. Additional temperature discrimination and pulpal sensibility tests (electric pulp testing and cold testing) were carried out. A comparison of radiographic fracture patterns and severity of nerve injury was done. Testing was carried out immediately after trauma and at 2-month follow-up. Results: More than half of the patients assessed in the study group presented with NSD of the teeth and gingiva after trauma. The incidence of deficits varied with the type of test used to measure them. Most frequently, patients presented with both loss of two point as well as fine touch discrimination thresholds. Severe nerve injuries were associated with loss of temperature discrimination clinically and displaced fractures radiographically. There was no significant relationship between the recovery of pulpal and gingival sensation. The patterns of injury and recovery in ASAN and MSAN were similar. Conclusion: NSD after trauma to the maxillary antrum is relatively common. Clinical loss of temperature discrimination and radiographic signs of fracture lines passing through the canalis sinuosus are predictors of persistent and severe oral NSD.
This study was designed to evaluate the expression of non-collagenous protein in periodontal tissue during the experimental movement of rat incisors, by LSAB(labelled streptavidine biotin) immunohistochemical staining for osteonectin and osteocalcin. Twenty seven Sprague-Dawley rats were divided into a control group(3 rats) and 6 experimental groups(24 rats) where 75g of force was applied from helical springs across the maxillary incisors. Rats of experimental groups were sacrificed at 12 hours, 1, 4, 7, 14 and 28 days after force application, respectively. And the tissues of a control group and experimental groups were studied immunohistochemically and histologically. The results were as follows : 1. Until 28 days after force application, periodontal fibers had been strectched on tension side and compressed in pressure side of all the experimental groups, and the arrangement of periodontal fibers had not been recovered yet. 2. The expression of osteonectin in control group was rare in dentin, cementum and osteocyte, and was mild in odontoblasts and matrix of alveolar bone. 3. The expression of osteocalcin in control group was negative in gingiva, osteoblasts, osteocyte and cementum, and was rare in predentin, capillaries in pulp and periodontal ligament and the matrix of alveolar bone. 4. There was no difference in the expression of osteocalcin or osteonectin in dentin, cementum, pulp, odontoblasts, between of control and of experimental groups. 5. The expression of osteonectin in intermaxillary suture got the peak in 7-day and was declined after 14-day. The expression of osteocalcin remained in a same degree since it became mild in 14-day. 6. The expression of osteonectin in pressure side of periodontal ligament of experimental group was rare, which was similar to control group. But in tension side, it was increased until 14-day aftrer which it was declined. 7. The expression of osteocalcin in periodntal ligament was rare in 12-hour to 14-day, but became severe in 28-day, which was greater in tension side than in pressure side, and in the periodontal fiber next to alveolar bone than to tooth surface. 8. The expression of osteocalcin in alveolar bone was rare until 14-day in pressure side, but became moderate in 28-day. The expression of osteonectin was increased from 7-day by time dependency, which was greater in tension side than in pressure side.
Suebin Choi;Chankue Park;Jonghyun Shin;Taesung Jeong;Eungyung Lee
Journal of the korean academy of Pediatric Dentistry
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v.50
no.3
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pp.318-333
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2023
The purpose of this study is to analyze changes in dental trauma in children under the age of 12 during the period of Coronavirus Disease 2019 (COVID-19). March 2020, when COVID-19 was officially declared a pandemic by the World Health Organization, was set as the starting point for COVID-19. From March 2018 to February 2020, subjects in the pre-COVID-19 period were classified as the Pre-COVID-19 group, and from March 2020 to March 2022, subjects in the post-COVID-19 period were classified as the COVID-19 group. Information related to trauma was collected through electronic medical records. The number of trauma patients before and after the outbreak of COVID-19 decreased significantly. During the COVID-19 period, there was no significant difference in the male-female ratio or the distribution order of age groups. In the COVID-19 group of permanent teeth, the ratio of trauma caused by personal mobility was higher than trauma caused by sports. In the COVID-19 group of permanent teeth, the ratio of crown fracture with pulp involvement was significantly higher than the ratio of crown fracture without pulp involvement. Changes in trauma patterns caused by COVID-19 were observed more clearly in school-aged children than in preschool children. In a pandemic situation such as COVID-19, it is expected to be used as a good educational basis for knowing that frequent diagnoses can change due to changes in the environment.
The purpose of our study was to investigate whether the intrapulpal temperature during cavity preparation of enamel or dentin with Er:YAG laser still remained in range of safety for dental pulp protection when combined with appropriate water flow rate. The effect of different pulse repetition rates at the same pulse energy during ablation was evaluated as well. Caries-free, restoration-free extracted human molar teeth were prepared for the specimen and divided two experimental groups of enamel and dentin. Each group comprised 5 specimens and each of tooth specimens were embedded into a resin block each and measuring probe was placed on the irradiated pulpal walls. For experiments of dentin ablation, enamel layers were prepared to produce dentin specimen with a same dentin thickness of 2 mm. A pulse energy of Er:YAG laser was set to 300 mJ and three different pulse repetition rates of 20 Hz, 15 Hz and 10 Hz were employed. Laser beam was delivered with 3 seconds and less per application over enamel and dentin surfaces constant sized by $3\;mm{\times}2\;mm$ and water spray added during irradiation was a rate of 1.6 ml/min. Temperature change induced by Er:YAG laser irradiation was monitored and recorded While enamel was ablated, there was no significant difference of temperature related to pulse repetition rates(p=0.358) and temperature change at any pulse repetition rate was negligible. Significant statistical difference in temperature changes during cavity preparation in dentin existed among three different pulse groups(p=0.001). While temperature rise was noticeable when the dentinal wall was perforated, actual change of temperature due to Er:YAG laser irradiation was not enough to compromise safety of dental pulp when irradiation was conjugated with appropriate water spray. Conclusively, it can be said that cavity preparation on enamel or dentin with an Er:YAG laser is performed safely without pulp damage if appropriate volume of water is sprayed properly over the irradiated site.
The purpose of this study was to examine the effect of hydrogen peroxide at different application time and concentrations on the microtensile bond strength of resin restorations to the deep and the pulp chamber dentin. A conventional endodontic access cavity was prepared in each tooth, and then the teeth were randomly divided into 1 control group and 4 experimental groups as follows: Group 1, non treated; Group 2, with 20% Hydrogen peroxide ($H_2O_2$); Group 3, with 10% $H_2O_2$; Group 4, with 5% $H_2O_2$; Group 5, with 2.5% $H_2O_2$; the teeth of all groups except group 1 were treated for 20, 10, and 5min. The treated teeth were filled using a Superbond C&B (Sun medical Co., Shiga, Japan). Thereafter, the specimens were stored in distilled water at $37^{\circ}C$ for 24-hours and then sectioned into the deep and the chamber dentin. The microtensile bond strength values of each group were analyzed by 3-way ANOVA and Tukey post hoc test(p < 0.05). In this study, the microtensile bond strength of the deep dentin (D1) was significantly greater than that of the pulp chamber dentin (D2) in the all groups tested. The average of microtensile bond strength was decreased as the concentration and the application time of $H_2O_2$ were increased. Analysis showed significant correlation effect not only between the depth of the dentin and the concentration of $H_2O_2$ but also between the concentration of H202 and the application time(p < 0.05), while no significant difference existed among these three variables(p > 0.05). The higher $H_2O_2$ concentration, the more opened dentinal tubules under a scanning electron microscope(SEM) examination.
This study was designed to evaluate the expression of heat shock protein in tooth and surrounding tissue during the experimental movement of rat incisors, by LSAB(labelled streptavidine biotin) immunohistochemical staining for heat shock protein. Twenty seven Sprague-Dawley rats were divided into a control group(3 rats), and 6 experimental groups(24 rats), to which 75g of force was applied from helical springs across the maxillary incisors. Rats of experimental groups were sacrificed at 0.5, 1, 4, 7, 14 and 28 days after force application, respectively. And the periodontal tissues of a control group and experimental groups were studied immunohistochemically. The results were as follows : 1. In control group, the expression of HSP47 was rare in gingiva, dentin and cementum, and mild in periodontal ligament and alveolar bone. But it was more evident than that of HSP70. 2. The expression of HSP47 or HSP70 was rare or mild in dentin, cementum and odontoblast of experimental group, regardless of the duration of force application, which was not different from that of control group. 3. In experimental group, the expression of HSP47 got to the highest degree in periodontal ligament and alveolar bone at 4 days after force application, and then decreased. And the expression was more evident in the pressure side than in the tension side of periodontal ligament 4. The expression of HSP70 began to increase at 12 hours after force application and got to the highest degree at 4 days, in the capillary of pulp and periodontal ligament. And the expression was more evident in the pressure side than in the tension side of periodontal ligament 5. The expression of HSP70 in alveolar bone of experimental group was rare, which was similar to that of control group.
Journal of the korean academy of Pediatric Dentistry
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v.44
no.1
/
pp.28-37
/
2017
Mineral trioxide aggregate have been used for many years as a pulp therapy material. The most widely used product, Proroot white $MTA^{(R)}$ has a major drawback that it causes tooth discoloration. This study assessed discoloration of crown when various MTA-based materials were placed in the coronal aspect of the root canal. Seventy-five single-rooted, unrestored premolar teeth were selected. The teeth were randomly assigned to four experimental groups, each of $Biodentine^{(R)}$, Proroot $wMTA^{(R)}$, $Endocem^{(R)}$, $RetroMTA^{(R)}$ and one negative control groups. Color measurements were utilized by the Commission International de I'Eclairage's L*a*b* system with spectrophotometer. The color was assessed eight times : initial, 1 day, 1 week, 2 weeks, 4 weeks, 8 weeks, 12 weeks, and 16 weeks after the placement. Statistical analysis was performed using the 2-way repeated analysis of variance and Bonferroni's method with p < 0.05. Proroot $wMTA^{(R)}$ induced significant decreases in $L^*$ values during experiment period. Tooth samples from the $Endocem^{(R)}$ group presented indistinct grayish color changes. The $Biodentine^{(R)}$ and $RetroMTA^{(R)}$ showed color stability. Consequently, while Proroot $wMTA^{(R)}$ and $Endocem^{(R)}$ that contain bismuth oxide as a radiopacifier showed tooth discoloration, displayed no sign of discoloration $Biodentine^{(R)}$ and $RetroMTA^{(R)}$ that contain zirconium oxide as a radiopacifier.
This study was conducted to provide baseline data which could suggest a direction of role based efficient integrated clinical education by avoiding duplicate of contents through analyzing clinical courses. Among the 7 clinical courses, orthodontics and periodontology were the most published subjects which were published in 5 kinds of books and dental materials was the least published subject which was published in 2 kinds of books on investigation of overlapping contents based on titles that appeared on chapters and verses of all textbooks for clinical courses. Dental implant was covered in 4 subjects such as oral maxillofacial surgery, prosthodontics, periodontology and dental materials which was the most number. Other overlapping contents were restoration treatment, occlusion and malocclusion, temporomandibular joint diseases, anesthesia sedation, tooth trauma, systemic disease and dental treatment, dental casting, isolation techniques, tooth bleaching, pulp protection, gingivitis periodontitis, tooth development, etc. Reviews of textbooks of clinical courses should be conducted in a detailed manner by systematic, various studies in order to improve quality of the textbooks.
Nitric oxide(NO) has been reported to be one of the mediators relating to bone remodelling. Nitric oxide is synthesized from L-arguinine by nitric oxide synthetase(NOS), which is largely divided Into two groups. One group which is composed of $NOS_1\;and\;NOS_3$, is dependent of calcium or calmodulin. The other consisted of $NOS_2$, which is independent of calcium or calmodulin. NOS is thought to be a possible intermediate affecting in the course of tooth movement. This study was designed to evaluate the expression of nitrous oxide synthetase(NOS) in periodontal tissue during the experimental movement of rat incisors, by LSAB(labelled streptavidine biotin) immunohistochemical staining for $NOS_2\;and\;NOS_3$. Twenty seven Sprague-Dawley rats were divided into a control group(3 rats), and 6 experimental groups(24 rats), to which 75g of force was applied, with helical springs across the maxillary incisors. Rats of experimental groups were sacrificed at 12 hours, 1, 4, 7, 14 and 28 days after force application, respectively. After that, the tissues of the control group and experimental groups were studied immunohistochemically. The results were as follows: 1. In control group, the expression of $NOS_3$ was rare in gingiva, dentin, periodontal ligament and alveolar bone, and was mild in the capillaries of pulp and intermaxillary suture. And the expression of $NOS_2$ showed similar pattern to that of $NOS_3$. 2. There were no differences in the expression of $NOS_2\;or\;NOS_3$ in dentin, gingiva, cementum, cementoblast and odontoblast, between control and experimental groups, regardless of the duration of the force application. 3. The expression of $NOS_3$ began to increase at 4 days and showed to the highest degree at 7 days after force application, in the apical region of pressure side of periodontal ligament in experimental groups. 4. The expression of $NOS_3$ in alveolar bone was rare until 7 days, after which it increased to mild degree at 14 days through 28 days in experimental group. But there was no difference between pressure and tension side of periodontal ligament. 5. The expression of $NOS_2$ in periodontal ligament was mild from 7 days after force application, regardless of the side of periodontium, which was generally more evident than that of $NOS_3$. 6. The expression of $NOS_2$ in alveolar bone increased to mild degree at 14 days after force application, and it was evident in osteoblasts, osteoclasts and osteocytes. And the expression of $NOS_2$ was little more stronger in the tension side than that of pressure side of alveolar bone.
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