RESUMO
Background: Preservation of necrotic primary teeth is important. Pulpectomy is the gold standard treatment in this situation. Reinfection is the main cause of failure in pulpectomy. The application of regenerative endodontic therapy in mature teeth has the rationale of restoring dental-pulp-like tissue and preventing reinfection. Aims and objectives: The current study was designed to clinically and radiographically assess regenerative endodontics therapy in necrotic primary molars in comparison to zinc oxide eugenol (ZOE) pulpectomy. Materials and methods: A double-blinded randomized controlled trial with three parallel arms and a 1:1:1 allocation ratio was conducted. A total of 54 necrotic primary molars in 39 healthy children aged 4-7 years old were randomly allocated as follows group I-control group, in which ZOE pulpectomy was performed. Group II and III-experimental groups, in which regenerative endodontic therapy (RET) was performed. Modified triple antibiotic paste (mTAP) and Metapex™ were used as intracanal medicaments in groups II and III, respectively. Clinical and radiographic assessments were recorded at baseline, 6 and 12 months. Chi-squared and Fisher's exact tests were used to compare the qualitative data, while Friedman's test was used to study the changes by time within each group. Results: Nonstatistically significant differences were reported between the three groups at the 6 and 12 months follow-ups regarding the clinical or radiographic assessment (p-value = 0.327 and effect size = 0.22), (p-value = 0.055 and effect size = 0.118), respectively. Conclusion: Regenerative endodontic therapy (RET) yielded comparable results to pulpectomy. However, the use of 5 mg/mL mTAP in RET represented the highest level of clinical as well as radiographic insignificant failure. Clinical significance: Regenerative endodontic therapy (RET) provides an acceptable biological alternative to pulpectomy. Trial registration: The protocol was registered at ClinicalTrial.gov with the registration number (NCT04190914). 12/5/2019. How to cite this article: Abdelmoneim DD, Abdelaziz AM, Allam GG, et al. A 1-year Clinical and Radiographic Assessment of Regenerative Endodontic Therapy for Necrotic Primary Molars: A Randomized controlled Trial. Int J Clin Pediatr Dent 2023;16(2):295-301.
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Background: Many attempts have been made to enhance the anti-cariogenic properties of the conventional glass ionomer through incorporation of variable materials. However, most importantly, the incorporation of such materials should not jeopardise the physical or mechanical properties of the final restoration. Aims: To investigate the effect of adding silver nanoparticles (Ag-NPs) and titanium dioxide nanoparticles (TiO2-NPs) to conventional glass ionomer cement (GIC) on its anti-bacterial effect against Streptococcus mutans (S. mutans), fluoride ion release, and compressive strength (CS). Settings and Design: This study was an in vitro investigation where 30-disc specimens were prepared in each of the three studied groups. Materials and Methods: The specimens were categorized into the control group (Group C), in which conventional GIC was used, and Group Ag and Group Ti, in which 5 wt% of Ag-NP and TiO2-NP were added, respectively, to GIC powder. In each group, the anti-bacterial effect against S. mutans, fluoride ion release at 24 hours and 14 and 28 days, and CS were assessed. Data were analysed using one-way analysis of variance, followed by Tukey honest significant difference post-hoc test. Results: Both Ag and Ti groups showed a significantly higher anti-bacterial effect than the control group. Ag-NP increased fluoride ion release, whereas TiO2-NP decreased fluoride release; however, cumulative ion release of both experimental groups did not differ significantly compared to the control group. Adding Ag-NP and TiO2-NP increased CS, yet only the Ti group showed the highest CS mean value that was statistically significant compared to other groups. Conclusions: Adding 5 wt% TiO2-NP or Ag-NP to conventional GIC significantly increased its anti-bacterial effect and its CS without affecting fluoride release.
Assuntos
Nanopartículas Metálicas , Prata , Resinas Acrílicas , Força Compressiva , Fluoretos/farmacologia , Cimentos de Ionômeros de Vidro/farmacologia , Teste de Materiais , Dióxido de Silício , Prata/farmacologia , Streptococcus mutans , Titânio/farmacologiaRESUMO
OBJECTIVES: Our aim was to assess the prevalence of dental caries in Egyptian children with cleft lip or cleft lip and palate (CLP), according to dietary habits, and to assess the level of dental care given to these patients. DESIGN: Children aged 4 to 12 years (N = 120) with CLP were recruited: 54 with primary dentition and 66 with mixed dentition. Personal data were gathered and parents completed a 5-day diet diary for the children. The prevalence of dental caries was determined with the dmft and DMFT indices, and debris and calculus were assessed with the simplified oral hygiene index. RESULTS: Of this, 16.7% of children were caries-free. Caries experience was directly correlated with the intake of carbohydrate-containing items between meals, but not with intake at meal times. Oral-hygiene (debris) status did not differ significantly between the CLP groups. Calculus was found in 6.6% of the children. Only 8.3% of the study population had received oral-hygiene instructions from a health care professional. CONCLUSION: A direct correlation was found between caries experience and the intake of sugar-containing items in-between meals, indicating the importance of dietary advice into the comprehensive dental management of patients with CLP. Our sample had not received effective dental services.