Management of contralateral molar teeth with necrotic pulp and open apexes using platelet-rich plasma and vital pulp therapy.

Regenerative endodontics holds promising potential for the regeneration of living tissues in teeth with necrotic pulp and periapical lesion. Platelet-rich plasma can be easily prepared and used as an ideal scaffold for pulp regeneration.

Extraoral low-level laser therapy can decrease pain but not edema and trismus after surgical extraction of impacted mandibular third molars: a randomized, placebo-controlled clinical trial.

BACKGROUND: This study aimed to assess the effect of extraoral 940 nm low-level diode laser on pain, edema, and trismus following surgical extraction of impacted mandibular third molars. MATERIALS AND METHODS: This split-mouth, randomized, placebo-controlled clinical trial evaluated 25 patients with bilaterally impacted mandibular third molars. One side of the jaw was randomly assigned to the laser and the other side to the control group. The laser quadrant received 940 nm diode laser irradiation (0.5 W, 10 J/cm2, continuous-wave mode, 20 s) at three points in the master muscle in contact mode immediately after surgical extraction of third molar. The third molar in the placebo quadrant was extracted after 2 weeks by the same surgeon using the same standard approach. The pain score was measured at 2 and 7 days postoperatively using a visual analog scale (VAS). To assess trismus, the distance between the incisal edges of the upper and lower central incisors was measured in maximum opening. To assess edema, the distance between the tragus and chin point was measured before and immediately after surgery and after 2 and 7 days. Data were analyzed using t-test, ANOVA, and Bonferroni test. RESULTS: The mean pain score in the first 7 days was significantly lower in the laser group (P < 0.05). Edema and trismus were the same in both groups (P > 0.05). Number of analgesics taken was significantly lower in the laser group (P < 0.05). CONCLUSION: Single-session irradiation of 940 nm diode laser can effectively decrease pain following third molar extraction surgery. TRIAL REGISTRATION NUMBER: IRCT20141209020258N91 on 29/12/2018.

Comparative evaluation of the effect of cold ceramic and MTA-Angelus on cell viability, attachment and differentiation of dental pulp stem cells and periodontal ligament fibroblasts: an in vitro study.

BACKGROUND: Biocompatibility and induction of mineralized tissue formation are the properties expected from a material used in vital pulp therapy and repair of perforations. Cold ceramic (SJM, Iran; CC) is a newly introduced calcium silicate-based cement for above mentioned therapeutic applications. This in-vitro study aimed to compare the effect of CC and White MTA-Angelus (MTA) on cell viability, attachment, odontogenic differentiation, and calcification potential of human dental pulp stem cells (DPSCs) and periodontal ligament fibroblasts (PDLFs). METHODS: Cell viability of DPSCs and PDLFs was assessed using MTT on days 1, 3, 7, and 14 (n = 9) in contact with freshly mixed and set states of CC and MTA. Field emission scanning electron micrographs (FESEM) were taken to evaluate cell-bioceramic interaction (n = 6). Gene expression levels of osteo/odontogenic markers (Dentin sialophosphoprotein, Dentin matrix protein 1, Collagen type I alpha 1, and Alkaline phosphatase (DSPP, DMP1, COL 1A1, and ALP, respectively) (n = 8) were assessed using qrt-PCR. ALP enzymatic activity was evaluated to assess the mineralization potential. A two-way ANOVA test was applied, and p < 0.05 was considered to be statistically significant. RESULTS: The effect of freshly mixed and set MTA and CC on the survival of DPSCs and PDLFs in all study groups was statistically similar and comparable to the positive control group (p > 0.05); the only exception was for the viability of PDLFs in contact with freshly mixed cements on day 1, showing a more significant cytotoxic effect compared to the control and the set state of materials (p < 0.05). PDLFs attached well on CC and MTA. The spread and pseudopodium formation of the cells increased on both samples from day 1 to day 14. Contact of MTA and CC with DPSCs similarly increased expression of all dentinogenesis markers studied on days 7 and 14 compared to the control group (p < 0.001), except for DSPP expression on day 7 (p = 0.46 and p = 0.99 for MTA and CC, respectively). CONCLUSIONS: Within the limitation of this in-vitro study, cold ceramic and MTA-Angelus showed high biocompatibility and induced increased expression of osteo/dentinogenic markers. Therefore, cold ceramic can be a suitable material for vital pulp therapy and the repair of root perforations.

Management of internal root resorption in the maxillary central incisor with fractured root using Biodentine.

Biodentine is desirable to successfully manage internal root resorption, and the MTA apical plug backfilled with thermoplasticized gutta-percha is suggested for the tooth with external apical root resorption.

Management of a complex traumatic dental injury: Crown, crown-root, and root fracture.

Dental trauma can result in different kinds of injuries based on the extent, direction, and location of the impact. Multidisciplinary management of traumatized teeth is critical for successful treatment and improvement of the prognosis.

Revascularization and vital pulp therapy in immature molars with necrotic pulp and irreversible pulpitis: A case report with two-year follow-up.

Management of teeth with inflamed pulp has been always a challenge. Revascularization and vital pulp therapy are suggested as procedures for successful treatment of immature molars diagnosed with pulp necrosis and irreversible pulpitis, respectively.

Enhancement of stem cell differentiation to osteogenic lineage on hydroxyapatite-coated hybrid PLGA/gelatin nanofiber scaffolds.

A combination of polymeric materials and bioceramics has recently received a great deal of attention for bone tissue engineering applications. In the present study, hybrid nanofibrous scaffolds were fabricated from PLGA and gelatin via electrospinning and then were coated with hydroxyapatite (HA). They were then characterized and used in stem cell culture studies for the evaluation of their biological behavior and osteogenic differentiation in vitro. This study showed that all PLGA, hybrid PLGA/gelatin and HA-PLGA/gelatin scaffolds were composed of ultrafine fibers with smooth morphology and interconnected pores. The MTT assay confirmed that the scaffolds can support the attachment and proliferation of stem cells. During osteogenic differentiation, bone-related gene expression, ALP activity and biomineralization on HA-PLGA/gelatin scaffolds were higher than those observed on other scaffolds and TCPS. PLGA/gelatin electrospun scaffolds also showed higher values of these markers than TCPS. Taking together, it was shown that nanofibrous structure enhanced osteogenic differentiation of adipose-tissue derived stem cells. Furthermore, surface-coated HA stimulated the effect of nanofibers on the commitment of stem cells toward osteolineage. In conclusion, HA-PLGA/gelatin electrospun scaffolds were demonstrated to have significant potential for bone tissue engineering applications.

Novel approach to reduce postsurgical adhesions to a minimum: administration of losartan plus atorvastatin intraperitoneally.

BACKGROUND: Intraperitoneal adhesions are the most important cause of intestinal obstruction, pelvic pain, and female infertility. MATERIALS AND METHODS: Losartan (1, 5, and 10 mg/kg), atorvastatin (1, 20, and 30 mg/kg), losartan (10 mg/kg) plus atorvastatin (20 mg/kg), and sodium hyaluronate/carboxymethylcellulose (HA/CMC) were administered intraperitoneally in 90 male NMRI mice. After 7 d, the grade of adhesions was scored by two scaling methods and the concentrations of TGF-ß1, tPA, and PAI-1 were also evaluated. RESULTS: Simultaneous intraperitoneal administration of losartan and atorvastatin led to a much higher reduction of adhesions compared with that in the HA/CMC group (P < 0.05). When losartan plus atorvastatin was administered, significant changes in the serum concentration and mRNA expression, including the increase of tPA and the decrease of TGF-ß1 and PAI-1, were observed compared with those in other groups. CONCLUSIONS: Our findings suggest that the simultaneous application of losartan and atorvastatin leads to an enhanced reduction in adhesion bands more than that of HA/CMC treatment, compared with the control group, possibly through balancing the expression of TGF-ß1, tPA, and PAI-1.