The management of deep carious lesions and the exposed pulp in fully developed and immature teeth with irreversible pulpitis: a questionnaire-based study among Greek dentists.

OBJECTIVES: The study aimed to identify the preferred management techniques used by dentists in Greece for treating deep carious lesions or pulp exposure during the removal of carious tissue in teeth with irreversible pulpitis. Additionally, the study sought to explore how patient-related factors (such as age and symptoms) and operator-related factors (like material choice and the use of antibiotics) influence these management decisions. MATERIALS AND METHODS: The questionnaire, developed by five investigators, was divided into two parts: the first gathered respondent demographics, and the second presented clinical scenarios of deep carious lesions, requesting treatment strategies, materials used, and antibiotic prescription practices. The scenarios described patients with intense spontaneous pain and very deep carious lesions, differentiated by age and tooth development status.Data collection was via Google Drive, with analysis performed using SPSS 28, Chi-square, and Fisher's exact tests, with significance set at p < 0.05. RESULTS: The study polled 453 Greek dentists about their treatment choices, for deep carious lesions in mature and immature teeth with irreversible pulpitis The majority favored root canal treatment for mature teeth, however quite a few opted for partial or cervical pulpotomy. MTA emerged as the preferred capping material, emphasizing its biocompatibility. Hemostasis management varied, with saline and sodium hypochlorite as popular choices. In cases of immature teeth, a shift towards vital pulp therapy was evident, reflecting a preference for preserving healthy pulp to avoid complex procedures. CONCLUSIONS: Challenges identified include varying treatment preferences, the significance of bleeding control in vital pulp therapy, and the limited use of antibiotics for irreversible pulpitis. While the study has limitations, including sample size and potential biases, its findings offer valuable insights into the decision-making processes of Greek dentists. CLINICAL RELEVANCE: Future research and ongoing education within the dental community could contribute to standardizing treatment approaches and optimizing outcomes for patients with deep carious lesions and irreversible pulpitis.

A scientometric, bibliometric, and thematic map analysis of hydraulic calcium silicate root canal sealers.

Objectives: This scientometric and bibliometric analysis explored scientific publications related to hydraulic calcium silicate-based (HCSB) sealers used in endodontology, aiming to describe basic bibliometric indicators and analyze current research trends. Materials and Methods: A comprehensive search was conducted in Web of Science and Scopus using specific HCSB sealer and general endodontic-related terms. Basic research parameters were collected, including publication year, authorship, countries, institutions, journals, level of evidence, study design and topic of interest, title terms, author keywords, citation counts, and density. Results: In total, 498 articles published in 136 journals were retrieved for the period 2008-2023. Brazil was the leading country, and the universities of Bologna in Italy and Sao Paolo in Brazil were represented equally as leading institutions. The most frequently occurring keywords were "calcium silicate," "root canal sealer MTA-Fillapex," and "biocompatibility," while title terms such as "calcium," "sealers," "root," "canal," "silicate based," and "endodontic" occurred most often. According to the thematic map analysis, "solubility" appeared as a basic theme of concentrated research interest, and "single-cone technique" was identified as an emerging, inadequately developed theme. The co-occurrence analysis revealed 4 major clusters centered on sealers' biological and physicochemical properties, obturation techniques, retreatability, and adhesion. Conclusions: This analysis presents bibliographic features and outlines changing trends in HCSB sealer research. The research output is dominated by basic science articles scrutinizing the biological and specific physicochemical properties of commonly used HCSB sealers. Future research needs to be guided by studies with a high level of evidence that utilize innovative, sophisticated technologies.

A Bibliometric Analysis of Platelet Derivate Uses in Oral and Maxillofacial Surgery.

PURPOSE: Concentrated platelet derivatives (PDs) such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) have been extensively applied in tissue engineering, and particularly in various fields of regenerative dentistry. The purpose of the present citation analysis was to compile the 100 top-cited articles on the PDs uses in oral and maxillofacial surgery. METHODS: A cross-sectional search of the relevant studies in the Web of Science citation database was conducted to identify the 100 most-cited articles. All the included papers consisted of independent variables of this analysis. Covariates that were further considered were basic bibliometric indexes, such as publication year, publishing journal, authorship, institution and country of origin, study design, and field of study. The primary outcome variables were citation counts and citation density. A descriptive analysis of secondary outcome variables, namely bibliographic data such as keyword, abstract, title term co-occurrence analysis, thematic map and wordcloud analysis, was performed using the bibliometrix R and VOSviewer software. RESULTS: The total citation count for the 100 most-cited articles ranged from 85 to 1821, with 2002 being the most productive year. With 15 articles, the Journal of Periodontology was the most represented journal, followed closely by the Journal of Oral and Maxillofacial Surgery and Clinical Oral Implants Research. The United States published the largest number of papers. Original basic science research studies on implantology and biology dominated the top-cited list. Randomized clinical trials and systematic reviews were adequately represented in the top-cited list. Platelet-derived growth factor and osteoprotegerin represented emerging minimally developed themes, while PRP, growth factors and fibrin, along with the applications of PRF in gingival recession and intra bony defects, were considered important motor themes. CONCLUSIONS: The current study provides a complete list and in-depth analysis of the 100 most-cited publications relevant to PDs use in oral and maxillofacial surgery, identifying the most important research topics, most impactful authors, institutions, and countries. Though PRP studies were leading the top-cited list, publications focusing on PRF pesented higher citation density values, indicating a continuously increasing citation rate.

Shear Bond Strength of Ah26 to Human Dentin Treated with Dimethyl Sulfoxide (Dmso).

The purpose of this study was to examine the bond strength of AH26 to human coronal dentin exposed to DMSO. A total of 70 dentin specimens were equally divided into two groups. Each dentin surface was pre-treated with 2 mL of 2.5% NaOCl, 3 mL of EDTA 17%, and distilled water. One group was finally rinsed with 50% DMSO. Following the AH26 application, the bond strength was tested by subjecting the samples to a shear load at a crosshead speed of 0.5 mm/min using universal testing equipment. The results according to paired samples t-test indicated that there was a statistically insignificant difference between the two groups. Therefore, DMSO had no effect on the bond strength of AH26 root sealer to dentin.

YouTube as a source of information about pulpotomy and pulp capping: a cross sectional reliability analysis.

OBJECTIVES: The purpose of this study was to critically evaluate the quality, reliability and educational content of the information of vital pulp treatment videos available on YouTube. MATERIALS AND METHODS: The keywords "pulpotomy" and "pulp capping" were searched on YouTube on 5th July 2020, until 60 English language videos of each search term with a duration shorter than 15 minutes were acquired. Video characteristics were recorded and Video Power Index (VPI) was calculated. Reliability and educational quality of videos were evaluated using the Modified DISCERN score, the Journal of American Medical Association (JAMA) benchmark criteria and Global Quality Scores (GQS). Videos were categorized by uploading source. RESULTS: Regarding pulpotomy, 31.7% of the videos were uploaded by specialists and 68.3% were directed by non-specialists. In the case of pulp capping, the corresponding percentages were 45% and 55%, respectively. Videos uploaded by specialists had significantly higher modified DISCERN, JAMA and GQS scores compared to those uploaded by non-specialists. Endodontists tended to have the highest reliability and VPI scores. CONCLUSIONS: YouTube videos on vital pulp treatment contain low educational quality or incomplete information. Low popularity of dental pulp capping and pulpotomy videos may be attributed to the specialized nature of these procedures. As YouTube represents an important source for patient information about different health topics, reliable informative videos should be uploaded by specialized dental professionals.

Top 50 cited articles on dental stem cell research.

OBJECTIVES: Citation analysis provides a unique insight into how scientific interests and research trends have changed over time. The aim of this study was to report on the 50 top-cited papers in dental stem cell research using the Science Citation Index Expanded provided by the Web of Science database to determine the academic importance of each contribution. MATERIALS AND METHODS: After the screening, article title and type, total citations and citations per year, publication journal, publication year, first and senior authors, country of origin, institution, and university of reprint author were documented for the 50 top-cited articles in dental stem cell research. Keyword analysis was performed to determine which keywords were most/least popular. RESULTS: Top 50-cited articles were cited between 179 to 2,275 times. The majority of papers were published in 2008 and originated from the United States with the highest contribution from the National Institute of Dental & Craniofacial Research. Journal of Dental Research published the highest number of top-cited articles, followed by Stem Cells and Journal of Endodontics. The greatest number of articles was published by two individual authors, Shi and Gronthos. Among 197 unique keywords, dental pulp stem cells and mesenchymal stem cells were the most frequently used. Thirty-eight of the 50 most cited articles were original articles, and 37 of them were in the field of basic science. CONCLUSIONS: Basic science studies in dental stem cell research published in high impact factor journals had the highest citation rates.

Top 100 cited systematic reviews and meta-analyses in dentistry.

Objective: The purpose of the present study was to identify the 100 top cited systematic reviews and meta-analyses on dental journals so as to gain insight into the influential publications in dentistry.Material and methods: The Web of Science was used to comprehensively identify the 100 most cited papers without year and language restriction. Specific parameters regarding the title, journal, publication year, authors, country of origin, institution and university, collaborations, keyword analysis and field of study of each manuscript were retrieved.Results: The citations ranged from 642 to 140. The most productive years were 2008 and 2009. The majority of top cited papers were published in Clinical Oral Implants Research and Journal of Clinical Periodontology. The leading countries were United States, followed by Switzerland. The University of Zurich was the most productive institution with 8 articles. Major topics of interest in the top 100 most-cited papers were dental implants and periodontology. The most frequently occurring keywords were systematic review, dental implants and meta-analyses.Conclusions: Systematic reviews published in high impact factor Dental journals focused on implantology and periodontology had the highest citation rates. Obviously, the top cited list is dynamic, as scientific interests and research tendencies evolve over the years.

Top-Cited Articles in Implant Dentistry.

PURPOSE: Citation analysis is the field of bibliometrics that uses citation data to evaluate the scientific recognition and the influential performance of a research article in the scientific community. The aim of this study was to conduct a bibliometric analysis of the top-cited articles pertaining to implant dentistry, to analyze the main characteristics, and to display the most interesting topics and evolutionary trends. MATERIALS AND METHODS: The 100 top-cited articles published in "Dentistry, Oral Surgery, and Medicine" journals were identified using the Science Citation Index Database. The articles were further reviewed, and basic information was collected, including the number of citations, journals, authors, publication year, study design, level of evidence, and field of study. RESULTS: The highly cited articles in implant dentistry were cited between 199 and 2,229 times. The majority of them were published in four major journals: Clinical Oral Implants Research, International Journal of Oral & Maxillofacial Implants, Journal of Clinical Periodontology, and Journal of Periodontology. The publication year ranged from 1981 to 2009, with 45% published in a nine-year period (2001 to 2009). Publications from the United States (29%) were the most heavily cited, followed by those from Sweden (23%) and Switzerland (17%). The University of Göteborg from Sweden produced the highest number of publications (n = 19), followed by the University of Bern in Switzerland (n = 13). There was a predominance of clinical papers (n = 42), followed by reviews (n = 25), basic science research (n = 21), and proceedings papers (n = 12). Peri-implant tissue healing and health (24%), implant success/failures (19.2%), and biomechanical topics (16.8%) were the most common fields of study. CONCLUSION: Citation analysis in the field of implant dentistry reveals interesting information about the topics and trends negotiated by researchers and elucidates which characteristics are required for a paper to attain a "classic" status. Clinical science articles published in high-impact specialized journals are most likely to be cited in the field of implant dentistry.

Dentine-pulp tissue engineering in miniature swine teeth by set calcium silicate containing bioactive molecules.

OBJECTIVE: The present study aims to investigate whether reparative dentinogenesis could be guided at central pulpal sites or at a distance from the amputated pulp of miniature pig teeth, by using set calcium silicate-based carriers containing human recombinant bioactive molecules. DESIGN: Pulp exposures were performed in 72 permanent teeth of 4 healthy miniature swine. The teeth were capped with pre-manufactured implants of set calcium silicate-based material containing BMP-7, TGFß1 or WnT-1, for 3 weeks. Conical-shaped intrapulpal implants were exposed in the central pulp core, while disc-shaped extrapulpal implants were placed at a distance from the amputated pulp. Implants without bioactive molecules were used as controls. Thickness and forms of new matrix mineralized deposition were assessed histologically at post-operative periods of 3 weeks by light microscopy. RESULTS: Intrapulpal applications: Calcified structures composed of osteodentine were found in contact with the BMP-7 implants. An inhomogeneous calcified tissue matrix was found around the WnT-1 carriers. A two-zone calcified structure composed of osteodentine and a thicker tubular matrix zone was seen at the TGFß1 carrier-pulp interface. Extrapulpal applications: The space between WnT-1 implants and pulp periphery had been invaded by soft tissue with traces of calcified foci. Thick calcified structures composed of osteodentine were found surrounding pulp exposure sites in response to application of BMP-7. Spindle-shaped cells associated with atubular calcified matrix or elongated polarized cells associated with tubular dentine-like matrix were found along the cut dentinal walls of the TGFß1 group. CONCLUSION: The present experiments indicated that set calcium silicate could be used as carrier for biologically active molecules. TGFß1 was shown to be an effective bioactive molecule in guiding tertiary dentine formation.

Dentinogenic Specificity in the Preclinical Evaluation of Vital Pulp Treatment Strategies: A Critical Review.

Reviews on the clinical performance of vital pulp treatment strategies and capping materials repeatedly showed an insufficient grade of evidence concerning their therapeutic validity. The biological mechanisms underlying the regenerative potential of pulp-dentin complex have attracted much attention during the last two decades, since new pulp treatment modalities have been designed and tested at the preclinical level. It has been recognized that evaluation should be based on the specific ability of therapeutic interventions to signal recruitment and differentiation of odontoblast-like cells forming a matrix in a predentin-like pattern, rather than uncontrolled hard tissue deposition in a scar-like form. The aim of the present article was to critically review data from histological experimental studies on pulp capping, published during the last 7 decades. A comprehensive literature search covering the period from 1949 to 2015 was done using the Medline/Pubmed database. Inclusion of a study was dependent on having sufficient data regarding the type of capping material used and the unit of observation (human permanent tooth in vivo or animal permanent dentition; primary teeth were excluded). The post-operatively deposited matrix was categorized into three types: unspecified, osteotypic, or dentin-like matrix. One hundred fifty-two studies were included in the final evaluation. Data from the present systematic review have shown that only 30.2% of the 152 experimental histological pulp capping studies described the heterogenic nature of the hard tissue bridge formation, including osteotypic and tubular mineralized tissue. Structural characteristics of the new matrix and the associated formative cells were not provided by the remaining 106 studies. Analysis showed that more careful preclinical evaluation with emphasis on the evidence regarding the dentinogenic specificity of pulp therapies is required. It seems that selection of appropriate vital pulp treatment strategies and pulp capping materials would be further facilitated in terms of their therapeutic validity if international consensus could be reached on a select number of mandatory criteria for tissue-specific dentinogenic events.

An ex vivo comparison of the push-out bond strength of a new endodontic filling system (Smartseal) and various gutta-percha filling techniques.

The purpose of this study was to evaluate, ex vivo, the push-out bond strength of a new filling material (Smartseal) compared with gutta-percha/AH-26. A total of 40 extracted single-rooted human teeth were used. After instrumentation using the ProTaper rotary system, the root canals were filled as follows: Group 1, Smartseal sealer and a 0.06 taper Smartpoint calibrated to apical tip size 30; Group 2, Smartseal sealer and an F3 SmartpointPT; Group 3, AH-26 sealer and a single F3 ProTaper gutta-percha cone and Group 4, AH-26 sealer and gutta-percha using the cold lateral condensation technique. Two successive disk shaped slices were cut from each root sample and the bond strength was measured using the push-out test. Two-way analysis of variance was used for data analysis with the level of significance set at 0.05. Statistical analysis revealed no significant differences (p > 0.05) between the mean bond strengths of the various groups; thus indicating there was no difference in adhesion to dentine between the Smartseal system and gutta-percha/AH-26 applied using either the single cone or lateral condensation technique.

Top-cited articles in endodontic journals.

INTRODUCTION: The purpose of this study was to identify the 100 top-cited articles published in journals dedicated to endodontology and analyze their characteristics to describe the quality and evolution of research in the field of endodontology. METHODS: The Institute for Scientific Information Web of Knowledge Database and the Journal Citation Report Science Editions were used to retrieve the 100 most cited articles published in journals dedicated to endodontics. The top-cited articles were selected and analyzed with regard to journals, authors, institution, country of origin, publication title and year, number of citations, article type, study design, level of evidence, and field of study. RESULTS: The top 100 articles were cited between 87 and 554 times. These articles appeared in 4 different journals, with more than half in the Journal of Endodontics, followed by the journals Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology, the International Endodontic Journal, and Endodontics & Dental Traumatology. Forty-eight articles were published between 1990 and 1999. All articles were published in English and primarily originated from the United States (n = 52). The majority of articles were basic science articles (n = 55), followed by clinical research studies (n = 28) and nonsystematic reviews (n = 17). Uncontrolled case series with level IV of evidence and narrative reviews with level V of evidence were the most frequent types of study design. The main topics covered by the top-cited articles were microleakage and endodontic microbiology. CONCLUSIONS: This analysis of citation rates reveals useful and interesting information about scientific progress in the field of endodontics. Basic research and observational studies published in high-impact endodontic journals had the highest citation rates.

Differentiation potential of dental papilla, dental pulp, and apical papilla progenitor cells.

INTRODUCTION: Regenerative endodontic procedures use the differentiation potential of embryonic and adult pulp progenitor cell populations to reconstitute dental structures. METHODS: An in-depth search of the literature was accomplished to review biologic knowledge from basic research on tooth morphogenesis and differentiation, root development, dentin-pulp regeneration, pulp revascularization and apexification, experimental and clinical studies on the dentinogenic differentiation potential of progenitor cells in the embryonic dental papilla, dental pulp, and associated mesenchymal tissues of the developing root. RESULTS: Odontogenic potential is determined during early tooth morphogenesis in the odontogenic mesenchyme. Progenitor cells from the odontogenic mesenchyme give rise to primary dentin-forming cells (odontoblasts) in the presence of stage-specific enamel epithelium and/or basement membrane and tertiary dentin-forming cells (odontoblast-like cells) in experimental conditions. The specificity of odontogenic mesenchymal cells to form tertiary dentin might be related to the repertoire of signaling pathways operated by the temporospatial pattern of epithelial-mesenchymal interactions during tooth formation. Dental papilla cells isolated from tooth germs before the onset of odontoblast differentiation have not shown any competence to become odontoblasts in the absence of enamel epithelium. On the other hand, the specificity of progenitor cells in the mesenchymal cell populations of the developing root apex remains to be determined. CONCLUSIONS: It seems evident that the dental pulp might be only used as a source of progenitor cells with dentinogenic competence for the regeneration of the dentin-pulp complex. The nature of dental or apical papilla progenitor cells in terms of their specificity for dentin regeneration has to be first characterized.