Er: YAG laser irradiation utilizing the newly developed RCLase side-firing spiral tip was used for the cleansing of root canals following their bio-mechanical preparation with ProTaper Ni-Ti files. The distal and palatal roots of 20 freshly extracted molar teeth were instrumented to size F3 with ProTaper files. In the experimental group (10 teeth) the pulp chamber and the root canals were filled with EDTA 17% and the root canals were lased for 30 s using the Er: YAG laser irradiation at 600 mJ per pulse and a frequency of 12 Hz. In the control group (10 teeth) the root canals were not lased. Scanning electron microscope analysis showed clean wall surfaces of the lased root canals with open dentinal tubules, free of smear layer and debris. In the scanning electron microscope photographs of the walls of the non-lased root canals a considerable amount of debris could be detected. It appears that an efficient cleansing of the root canal system can be achieved by using the Er: YAG laser irradiation with the RCLase Side-firing Spiral Tip following bio-mechanical preparation of the root canal with Ni-Ti Taper files.
Objectives: The purpose of this study was to evaluate the efficacy of mineral trioxide aggregate (MTA), Biodentine and Propolis as pulpotomy medicaments in primary dentition, both clinically and radiographically. Materials and Methods: A total of 75 healthy 3 to 10 yr old children each having at least one carious primary molar tooth were selected. Random assignment of the pulpotomy medicaments was done as follows: Group I, MTA; Group II, Biodentine; Group III, Propolis. All the pulpotomized teeth were evaluated at 3, 6, and 9 mon clinically and radiographically, based on the scoring criteria system. Results: The clinical success rates were found to be similar among the three groups at 3 and 6 mon where as a significant decrease in success rate was observed in Group III (84%) compared to both Group I (100%) and Group II (100%) at 9 mon. Radiographic success rates over a period of 9 mon in Groups I, II, and III were 92, 80, and 72%, respectively. Conclusions: Teeth treated with MTA and Biodentine showed more favorable clinical and radiographic success as compared to Propolis at 9 mon follow-up.
Purpose: This study was performed to investigate the relationship between sleep bruxism(SB) and pulpal calcifications in young women. Materials and Methods: A total of 100 female participants between 20 and 31 years of age who were referred to our radiology clinic for a dental check-up, including 59 SB and 41 non-SB patients, were sampled for the analysis. SB was diagnosed based on the American Academy of Sleep Medicine criteria. All teeth were evaluated on digital panoramic radiographs to detect pulpal calcifications, except third molars, teeth with root canal treatment, and teeth with root resorption. Binary logistic regression analysis was used to determine the risk factors for pulpal calcifications. The Spearman correlation coefficient was applied and the Pearson chi-square test was used for categorical variables. To test intra-examiner reproducibility, Cohen kappa analysis was applied. P values <.05 were considered to indicate statistical significance. Results: A total of 2800 teeth were evaluated (1652 teeth from SB patients and 1148 from non-SB patients), and 61% of patients had at least 1 dental pulpal calcification. No statistically significant relationship was found between SB and pulpal calcifications (P>0.05). In SB patients, the total number of pulpal calcifications was 129, while in non-SB patients, it was 84. Binary logistic analysis showed that SB was not a risk factor for the presence of pulpal calcifications(odds ratio, 1.19; 95% CI, 0.52-2.69, P>.05). Conclusion: No relationship was found between SB and pulpal calcifications.
George Taccio de Miranda Candeiro;Antonio Sergio Teixeira de Menezes;Ana Carolina Saldanha de Oliveira;Flavio Rodrigues Ferreira Alves
Restorative Dentistry and Endodontics
/
v.48
no.2
/
pp.17.1-17.8
/
2023
The present report describes the endodontic treatment of an Oehlers type II dens invaginatus in a maxillary lateral incisor with 5 root canals, an extremely rare condition. Apical periodontitis and related symptoms were noted. Cone-beam computed tomography was used to aid the diagnosis, reveal tooth morphology, and assist in canal location. The pulp chamber was carefully accessed, and the root canals were explored under magnification. All root canals were prepared with an R25 Reciproc Blue system and sodium hypochlorite (NaOCl) irrigation. After initial preparation, a self-adjusting file (SAF) with NaOCl and ethylenediaminetetraacetic acid was used to complement the disinfection. Additionally, calcium hydroxide medication was applied. Vertical compaction was used to fill the canals with a calcium silicate-based endodontic sealer and gutta-percha. After 12 months, the patient exhibited healing of the periapical region, absence of symptoms, and normal dental function. In conclusion, this nonsurgical treatment protocol was successful in promoting the cure of apical periodontitis. Both complementary disinfection with an SAF and use of calcium hydroxide medication should be considered when choosing the best treatment approach for dens invaginatus with very complex anatomy.
Jaehyun Seung;Seong-Jin Shin;Byounghwa Kim;Ji-Myung Bae;Jiyoung Ra
Journal of Korean Dental Science
/
v.17
no.3
/
pp.112-120
/
2024
Purpose: The objective of this study was to investigate the impact of blood contamination on the compressive strength and surface morphology of both conventional and newly developed calcium silicate cements (CSCs). Materials and Methods: Compressive strengths of Endocem MTA Premixed Regular (EMPR) and ProRoot MTA (PMTA) were assessed after immersion in fetal bovine serum (FBS), saline, and deionized water (DW). Surface morphology was examined using scanning electron microscopy (SEM). Results: The compressive strength of EMPR samples immersed in FBS for both 1 and 7 days was significantly lower compared to those in saline and DW, with no significant differences between the saline and DW groups. The PMTA group exhibited the lowest compressive strength after 1 day in FBS, although it did not significantly differ from that of saline and DW groups. SEM images revealed significant differences in crystalline formation between FBS and the other experimental groups. Conclusion: Minimizing blood contamination during vital pulp therapy (VPT) is crucial to ensure optimal CSC setting. PMTA may be preferred over EMPR for resisting high occlusal forces in the presence of blood contamination.
Journal of the korean academy of Pediatric Dentistry
/
v.41
no.2
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pp.134-144
/
2014
The aim of this study was to investigate changes in treatment patterns within pediatric dentistry departments by analyzing the distribution of patients and treatment trends. To that end, treatment charts based on electronic medical records (EMR) from the Yonsei University Dental Hospital from 2008 to 2012 were collected and analyzed. The results showed a decrease in the number of new patients and patients cared for by non-specialists, while the number of foreign patients has increased. The under 2 years-old group accounted for a large portion of new patients. Dental caries, dental trauma, and malocclusion ranked as the top complaints. In terms of restoration treatment, the proportion of patients receiving composite resin, amalgam, and sealant has decreased, whereas self-curing glass ionomer and preventive resin restoration have increased. Single-visit endodontic treatment has been increasing, with a decreasing trend in multi-visit endodontic treatment. The rate of conservative pulp treatment, such as pulp capping and pulpotomy, has increased. For reducing patient anxiety, treatments under sedation have increased, especially with the use of nitric oxide. This investigation into the latest treatment trends and patient characteristics is expected to help pediatric dentists to make appropriate treatment plans.
The aim of this study was to investigate the effect of low - power laser used in the medical field for various purposes to suppress pain responses evoked by noxious electrical or mechanical stimuli. After both inferior alveolar nerves and the left anterior digastric muscle of cats under general anesthesia were exposed, a recording electrode for the jaw opening reflex was inserted into the anterior digastric muscle. The right inferior alveolar nerve was dissected under a surgical microscope until the response of the functional single nerve could be evoked by the electrical stimulation of the dental pulp or oral mucosa. The electrical stimulus was applied with a rectangular pulse of 10 ms duration for measuring the threshold intensity of a single nerve fiber in the inferior alveolar nerve which responds to stimulation of dental pulp and oral mucosa. Then a pulse of 1 ms duration was applied for determination of conduction velocity. A noxious mechanical stimulus to the oral mucosa was applied by clamping the receptive field with an arterial clamp. The Ga-As diodide laser(wave length, 904 nm ; frequency, 1,000 Hz) was irradiated to the prepared tooth cavity, inferior alveolar nerve and oral mucosa as a pulse wave of 2 mW for 6 minutes. This was followed by a continuous wave of 15 mW for 3 minutes. The action potential of the nerve and EMG of the digastric muscle evoked by the noxious electrical stimulus and nerve response to noxious mechanical stimulus were compared at intervals of before, immediately after, and at 5, 10, 20, 40, 60 minutes after laser irradiation. The results were as follows: The conduction velocity of the intrapulpal $A{\delta}$- nerve fiber recorded from the inferior alveolar nerve before irradiation had a mean value of $6.68{\pm}2.07m/sec$. The laser irradiation did not affect the conduction velocity of the AS - nerve fiber and did not change the threshold intensity or amplitude of the action potential either. The EMG of the digastric muscle evoked by noxious electrical stimulation to the tooth was not changed by the laser irradiation, whether in latency, threshold intensity or amplitude. The laser irradiated to the receptive field of the oral mucosa which was subjected to noxious stimuli did not affect the amplitude of the action potential or the frequency either.
Although it has been reported that lysyl oxidase (LOX) is involved in odontoblastic differentiation, the role of LOX on odontoblastic differentiation by hydrogen peroxide ($H_2O_2$) have not been clarified. In the present study, we investigated whether $H_2O_2$, reactive oxygen species (ROS), is modulated the messenger RNA (mRNA) expression and activity of LOX during odontoblastic differentiation of human dental pulp (HDP) cells. The mRNA expression was quantified by reverse transcriptase polymerase chain reaction (RT-PCR) analysis, and LOX enzyme activity was measured by high sensitive fluorescent assay. Expression of the odontoblastic differentiation marker genes were assessed in the presence and absence of specific small interfering RNAs (siRNAs) of the LOX and LOXL. The $H_2O_2$-induced mRNA expression of LOX family was significant reduction of LOX, LOXL, and LOXL3 mRNA levels in HDP cells. LOX enzyme activity was increased at $H_2O_2$ 0.3 mM for 24 hours. The mRNA expression of alkaline phosphatase (ALP), osteopontin (OPN), and osteocalcin (OCN) was inhibited by LOX- and LOXL-specific siRNAs whereas the mRNA expression of dentin matrix protein1 (DMP1), and dentin sialophosphoprotein (DSPP) was inhibited by LOX-specific siRNA. In LOX enzyme activity, siRNA-induced knockdown of both LOX and LOXL inhibited the total amine oxidase activity in HDP cells, as in the case of mRNA expression. In conclusion, the essential role of $H_2O_2$ on odontoblastic differentiation suggests that its regulation by LOX may have pharmacologic importance in HDP cells.
Background: This study aimed to evaluate and compare the efficacy of oral premedication with ibuprofen on the anesthetic efficacy of inferior alveolar nerve block (IANB) using 2% lignocaine and 1:100000 epinephrine in tobacco-chewing (TC) and non-tobacco-chewing (NTC) patients with symptomatic irreversible pulpitis (SIP) during nonsurgical endodontic intervention (NEI). Methods: This multicenter, prospective, double-blind, two-arm parallel-group randomized controlled trial involving 160 patients was conducted for a period of 9 months. The patients were classified into the study (TC patients) and control (NTC patients) groups, which were subdivided into two subgroups 1 hour before the procedure based on oral premedication with tab ibuprofen 600 mg. Nicotine dependence was assessed using the Modified Fagerstrom Tolerance Nicotine Scale. Patients were administered an IANB injection of 2% lignocaine containing epinephrine 1:100000 after premedication. Pulpal anesthesia before NEI was confirmed using electric pulp testing and cold spraying. Patients rated their pain on the 10-point visual analog scale (VAS) during NEI thrice at the dentin, pulp, and instrumentation levels. No pain at each level indicated the success of anesthesia. Results: The success and failure rates did not differ between the premedication and non-premedication subgroups in the TC or NTC groups (P > 0.05). However, the success rate was higher in the premedication subgroup of the NTC group (52.5%) than in the TC group (45%). Most patients with premedication experienced failure at the instrumentation level, whereas patients in the non-premedication group experienced pain at the dentin level. Failure rates of IANB did not differ significantly at different levels between the groups (P > 0.05). The mean VAS scores differed significantly at the dentin level in both groups, with lower values in the premedication group (P < 0.05). Conclusions: The efficacy of ibuprofen premedication with IANB during NEI did not differ significantly between the TC and NTC patients with SIP. The effect of premedication was more significant in the NTC group than in the TC group. A causal relationship between nicotine consumption and the success of premedication could not be established, and further studies are required to validate the results of the present study.
Journal of the korean academy of Pediatric Dentistry
/
v.10
no.1
/
pp.35-45
/
1983
This study was undertaken to evaluate the pulpal responses to the intermediate restorative materials such as Zinc phosphate cement, Polycarboxylate cement, IRM (zinc oxide eugenol cement), Dycal, Life, Cresatin, and Fluoride in caivties which were cut with high speed instrument. 5 dogs were used as experimental animals and devided into 8 groups. The intervals of observaobservation ranged 3 days, 1, 3, 4, 8 weeks after experiment respectively. The specimens were fixed with 10% formalin and decalcified in 5% nitric acid. All slides were stained with hemtoxylin-eosin and examined histopathologically. The results were as follows: 1. In control group, severe vacuolar degeneration and atrophy of odontoblasts were seen in 3 days, hemorrhage and congestion continued until 8 weeks. Necrosis of odontoblastic layer was seen in zinc phosphate cement group and polycarboxylate cement group. 2. In dycal group, vacuolar degeneration and atrophy of odontoblast were not seen. but in Life group, these were seen in 3 days and partially continued until 3 weeks. In 4 weeks, regeneration of odontoblast was occured. 3. In Crcsatin group, there was no pathosis except odontoblastic displacement. In Fluoride group, vacuolar degeneration of odontoblast was seen and soon disappeared. As compared with control group, pathological change of the pulp tissue in experimental group were decreased after amalgam restoration.
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