Microtomographic and histological evaluation of two bioceramics as pulp capping agents in vivo / Evaluación microtomográfica e histológica de dos agentes biocerámicos como recubrimiento pulpar in vivo

ABSTRACT Maintaining pulp vitality and function is a priority of the medicaments employed in pulp therapy to preserve tooth integrity. Aim This study evaluated inflammatory response and reparative dentin bridge formation after direct pulp capping with two different bioceramics. Materials and Method This was an in vivo controlled experimental study on 12 male Wistar rats. Pulpotomies were performed and the exposed pulps were capped with Biodentine or Neo MTA. After 15, 45 and 90 days, maxillary segments were obtained and prepared for histologic analysis and Micro-CT. Hounsfield Units (HU) were quantified. Results Micro-CT analysis showed greater mineralization at 90 days with Neo MTA than with Biodentine. HU did not differ significantly (p >0.05) between molars treated with Biodentine and Neo MTA at 15 and 45 days, but at 90 days, there was statistically significant difference (p <0.05) between them. Reparative dentin was observed near the pulp exposure and canal orifice with both bioceramics. At 45 and 90 days, molars treated with Neo MTA showed mineralized tissue filling the canal orifice. Molars treated with Biodentine showed mineralized tissue and dentin bridge at the site of exposure at 45 days, and total pulp exposure coverage and mineralized dentin matrix at 90 days. Conclusions Biodentine and Neo MTA induce the formation of reparative dentin bridge after 45 days with inflammatory cell infiltrate.

RESUMEN Mantener la vitalidad pulpar y su función es una de las prioridades de los medicamentos utilizados en la terapia pulpar con la finalidad de preservar la integridad del diente. Objetivo El objetivo de este estudio fue evaluar la respuesta inflamatoria y la reparación del puente dentinario con dos biocerámicas. Materiales y Métodos: Se realizó un estudio experimental in vivo en 12 ratas Wistar formando dos grupos de estudio (n = 6), en las que se realizaron pulpotomías. Posterior a 15, 45 y 90 días, se obtuvieron segmentos de los maxilares y se prepararon los especímenes para análisis histológicos y cortes microtomográficos. Las Unidades Hounsfield (UH) se cuantificaron. Resultados El análisis microtomográfico mostró un incremento en la mineralización después de 90 días con Neo MTA comparado con Biodentine. No existió diferencia significativa (p >0.05) entre las UH posterior a 15 y 45 días, sin embargo, a los 90 días hubo diferencia significativa (p <0.05) entre Biodentine y Neo MTA. A los 45 y 90 días los molares tratados con Neo MTA mostraron la formación de tejido mineralizado en el orificio comunicados. Los molares tratados con Biodentine mostraron la formacion de tejido mineralizado, a los 45 dias se observó un puente de dentina en el sitio expuestos y una cobertura total de la exposición pulpar y una matriz de dentina mineralizada a los 90 días. Conclusiones Biodentine y Neo MTA inducen la formación del puente dentinario reparador posterior a 45 días con infiltrado de células inflamatorias.

Sensibilidade dentinária associada ao clareamento dental em dentes vitais - uma revisão de literatura / Tooth sensitivity related to vital teeth dental bleaching ­ a literature review

O clareamento dental pode ser realizado através da técnica caseira ou de consultório, utilizando agentes como o peróxido de carbamida (PC) e peróxido de hidrogênio (PH). Apesar de seguro, existem alguns efeitos adversos relacionados ao clareamento dental, como a sensibilidade dentinária (SD), que pode estar presente em diferentes graus dependendo da técnica utilizada. A aplicação de agentes dessensibilizantes antes, durante ou depois do clareamento dental vem sido estudada para evitar ou reduzir a sensibilidade associada ao clareamento. O estudo visa revisar a literatura em relação a aspectos e conceitos importantes do clareamento dental, discutindo seus possíveis efeitos adversos com foco na sensibilidade dentinária. Foi realizada uma pesquisa digital da base de dados Medline, via PubMed, utilizando palavras-chave relacionadas ao tema, priorizando artigos publicados há menos de 20 anos e escritos em inglês ou português. Artigos também foram buscados manualmente e foram utilizados livros de odontologias relacionados ao tema. De um total de 48 artigos, 28 foram escolhidos para a composição do trabalho, além de 2 livros de dentística que abordam o clareamento dental. Constata-se que a sensibilidade dentinária é um efeito adverso comum relacionado ao clareamento dental, que possui causa exata desconhecida, porém sabe-se que está relacionada à difusão do peróxido de hidrogênio pelos tecidos dentários. A sensibilidade dentinária é mais frequente na técnica de clareamento de consultório do que na técnica caseira, e pode ser agravada por fatores relacionados ao indivíduo e/ou ao dente. Alguns agentes como o nitrato de potássio, fosfopeptídeos de caseína-fosfato de cálcio amorfo (CPP-ACP), vidros bioativos e partículas de hidroxiapatita, se mostraram efetivos no controle da sensibilidade dentinária.

Dental bleaching can be performed in at-home or in-office techniques, using agents such as carbamide peroxide or hydrogen peroxide. Although it's safe, there are some side effects related to dental bleaching, such as tooth sensitivity, which may be present in different degrees, depending on the chosen technique. The application of desensitizing agents before, during or after dental bleaching is being studied to avoid or reduce the bleaching related sensitivity. The study aims to review the literature over important aspects and concepts of dental bleaching, discussing its possible side effects, focusing on tooth sensitivity. Methods: an online search was done on Medline's database, through PubMed, using keywords related to the theme, prioritizing articles published less than 20 years ago, written in English or Portuguese. Articles were also researched manually, and dentistry books related to the theme were used as well. Out of 48 articles, 28 were chosen to this study's composition, in addition to 2 books that approach dental bleaching. Tooth sensitivity is a common side effect related to dental bleaching, with an unknown cause, however, it is known that it's related to hydrogen peroxide's diffusion through dental tissues. Tooth sensitivity is more frequent within in-office technique than within at-home technique, and may be worsen by individual and/or dental related factors. Agents such as potassium nitrate, CPP-ACP, bioactive glasses and hydroxyapatite particles, showed up to be effective in dental sensitivity control.

Effects of a benzalkonium chloride surfactant-sodium hypochlorite combination on microhardness and mineral content of dentin / Efectos de una combinación de tensioactivo de cloruro de benzalconio e hipoclorito de sodio en la microdureza y el contenido mineral de la dentina

Abstract This study aimed to investigate the impact of the combination of Benzalkonium chloride (BAC) and sodium hypochloride (NaOCl) and its application after ethylenediaminetetraacetic acid (EDTA) in root canal irrigation procedures on the microhardness and mineral content of dentin. Distal roots of mandibular third molars were embedded in auto-polymerizing acrylic resin, sectioned coronally to apically resulting in fifty-four root sections. Thirty sections underwent microhardness evaluation, and twenty-four sections were randomly chosen for mineral analysis. The microhardness assessment comprised three groups: Group 1 (2.5% NaOCl), Group 2 (2.5% NaOCl with 0.084% BAC), and Group 3 (2.5% NaOCl with 0.084 BAC post-17% EDTA). Initial and post-irrigation microhardness values were measured for each group. For mineral analysis, samples were categorized into four groups: distilled water, 2.5% NaOCl, 2.5% NaOCl with 0.084% BAC, and 17% EDTA+2.5% NaOCl with 0.084% BAC. X-ray photoelectron spectroscopy immediately measured magnesium, phosphorus, and calcium mineral contents on dentin surfaces post-irrigation. Results indicated a significant reduction in root dentin microhardness for all solutions (p<0.05). However, no statistically significant difference in the percentage of reduction was observed among the groups (p>0.05). XPS analysis revealed no significant disparity in dentin surface mineral content among the groups (p>0.05). In conclusion, the addition of Benzalkonium chloride to sodium hypochloride, either alone or after EDTA, did not induce a significant alteration in dentin microhardness or mineral content. These findings contribute to a nuanced understanding of dental irrigation protocols and their effects on dentin properties during endodontic procedures.

Resumen Este estudio tuvo como objetivo investigar el impacto de la combinación de cloruro de benzalconio (BAC) e hipocloruro de sodio (NaOCl) y su aplicación después del ácido etilendiaminotetraacético (EDTA) en procedimientos de irrigación del conducto radicular sobre la microdureza y el contenido mineral de la dentina. Las raíces distales de los terceros molares mandibulares se incluyeron en resina acrílica autopolimerizable y se seccionaron de coronal a apical, lo que dió como resultado cincuenta y cuatro secciones de raíz. Treinta secciones se sometieron a una evaluación de microdureza y veinticuatro secciones fueron elegidas al azar para el análisis mineral. La evaluación de la microdureza comprendió tres grupos: Grupo 1 (2,5% NaOCl), Grupo 2 (2,5% NaOCl con 0,084% BAC) y Grupo 3 (2,5% NaOCl con 0,084 BAC post-17% EDTA). Para cada grupo se midieron los valores de microdureza inicial y post- irrigación. Para el análisis mineral, las muestras se clasificaron en cuatro grupos: agua destilada, 2,5% NaOCl, 2,5% NaOCl con 0,084% BAC y 17% EDTA+2,5% NaOCl con 0,084% BAC. La espectroscopía fotoelectrónica de rayos X midió inmediatamente el contenido de minerales de magnesio, fósforo y calcio en las superficies de la dentina después de la irrigación. Los resultados indicaron una reducción significativa en la microdureza de la dentina radicular para todas las soluciones (p<0,05). Sin embargo, no se observó diferencia estadísticamente significativa en el porcentaje de reducción entre los grupos (p>0,05). El análisis XPS no reveló ninguna disparidad significativa en el contenido mineral de la superficie de la dentina entre los grupos (p>0,05). En conclusión, la adición de cloruro de benzalconio al hipocloruro de sodio, solo o después de EDTA, no indujo una alteración significativa en la microdureza o el contenido mineral de la dentina. Estos hallazgos contribuyen a una comprensión matizada de los protocolos de irrigación dental y sus efectos sobre las propiedades de la dentina durante los procedimientos de endodoncia.

Selamento dentinário imediato em restauração semidireta: relato de caso / Immediate dentin sealing in semi-direct restoration: case report

O selamento dentinário imediato é um procedimento essencial na Odontologia, que envolve a aplicação de agentes de selamento na interface entre a dentina e o material restaurador imediatamente após a remoção da cárie e do preparo da cavidade dentária. Este processo busca selar os túbulos dentinários expostos, proporcionando proteção à polpa dentária. O presente caso foi realizado em um paciente do sexo masculino, 56 anos que se queixou de desconforto no elemento dentário 17. Após avaliação clínica e radiográfica, foi constatado uma ampla restauração desadaptada na porção mesio - oclusal do referido dente, sendo que o elemento em questão não possui tratamento endodôntico. Após planejamento e assinatura do TCLE, os seguintes passos foram realizados: remoção da lesão cariosa do dente 17, seguido da realização do levantamento marginal mesial e a realização do selamento dentinário imediato. Moldagem com silicone de adição do dente em questão e do antagonista, assim como registro da mordida. Foi confeccionada uma restauração semidireta em resina composta sob o modelo de gesso obtido. A cimentação da restauração foi feita na consulta seguinte, cumprindo os requisitos fundamentais para restaurar forma, função e estética, resultando na melhoria da qualidade de vida do paciente(AU)

Immediate dentin sealing is an essential procedure in dentistry, involving the application of sealing agents at the interface between dentin and the restorative material immediately after caries removal and cavity preparation. This process aims to seal exposed dentinal tubules, providing protection to the dental pulp. The present case involved a 56-year-old male patient who complained of discomfort in tooth number 17. After clinical and radiographic evaluation, a wide, maladapted restoration in the mesio-occlusal portion of the tooth was identified, with no endodontic treatment in the affected element. Following planning and informed consent, the following steps were taken: removal of the carious lesion from tooth number 17, followed by the execution of mesial marginal elevation and immediate dentin sealing. Silicone addition molding of the affected tooth and antagonist, along with bite registration, was performed. A semi-direct restoration in composite resin was fabricated based on the obtained gypsum model. The restoration was cemented in the subsequent appointment, meeting the essential requirements to restore form, function, and aesthetics, resulting in an improvement in the patient's quality of life(AU)

Peróxido de carbamida 37% no clareamento dentário e sua atuação na efetividade clareadora e eliminação de sensibilidade: relato de caso / The usage of 37% carbamide peroxide in tooth bleaching and its effect on bleaching effectiveness and elimination of sensitivity: a case report / Peróxido de carbamida al 37% en el blanqueamiento dental y su efecto sobre la eficacia del blanqueamiento y la eliminación de la sensibilidad: informe de un caso

Introdução:A sensibilidade dentária é o efeito adverso mais comum relacionado ao clareamento dentário. Na técnica de consultório, o peróxido de carbamida a 37%, surgiu como possibilidade de clarear e não causar sensibilidade.Objetivo:trata-se deum relato de caso, que avaliou a eficácia (mudança de cor) e a presença ou não de sensibilidade dentária quando se fezo uso de um produto àbase de peróxido de hidrogênio a35% e outro de peróxido de carbamida a 37%, na técnica de clareamento dentário de consultório.Relato de caso:Paciente de25 anos, sexo masculino, submetido a estudo de boca dividida, onde no hemiarco esquerdo foi aplicado peróxido de hidrogênio a 35% e no hemiarco direito, peróxido de carbamida a 37%. Foram feitas 3 sessões, sendo Peróxido de Carbamidacom aplicação única de 45 minutos, e Peróxido de Hidrogêniocom 3 aplicações de 15 minutos, em seu respectivo lado de aplicação e intervalo de sete dias entre cada sessão. Os valores de sensibilidade foram analisados antes e depois de cada sessão por meio da escala visual analógica de dor, e a alteração de cor foi avaliada através da Escala Vita, analisando incisivos e caninos superiores, antes de cada sessão.Conclusões:O clareamento dental com o Peróxido de Hidrogênio apresentou melhor eficácia clareadora e o Peróxido de Carbamida apresentou ausência de sensibilidade durante o procedimento clareador. Sugerem-se mais estudos do tipo ensaio clínico, com o Peróxido de Carbamida, para que se possa, com uma amostra maior de pacientes, verificar suas vantagens no quesito sensibilidade, bem como sua efetividade clareadora (AU).

Introduction:Tooth sensitivity is the most common adverse effect related to tooth bleaching. In the in-office technique, 37% carbamide peroxide has emerged as a way of tooth bleaching which does not cause sensitivity.Objective:This paper consists of a case report that evaluated the efficacy (color change) and the presence or absence of tooth sensitivity when using a product based on 35% hydrogen peroxide and another product based on 37% carbamide peroxide in the in-office tooth bleaching technique.Case report:A 25-year-old male patient underwent a split-mouth study in which 35% hydrogen peroxide was applied to the left hemi-arch and 37% carbamide peroxide to the right hemi-arch. Three sessions were carried out, carbamide peroxide with a single 45-minute application, and hydrogen peroxide with three 15-minute applications, on their respective application side and with a seven-day interval between each session. Sensitivity values were analyzed before and after each session using the visual analogue pain scale, and color change was assessed using the Vita Scale, analyzing upper incisors andcanines before each session. Conclusions:Teeth bleaching with hydrogen peroxide showed better bleaching efficacy and carbamide peroxide showed no sensitivity during the bleaching procedure. Further clinical trials with carbamide peroxide are suggested inorder to verify, with a larger sample of patients, its advantages in terms of sensitivity, as well asits bleaching effectiveness (AU).

Introducción: La sensibilidad de la dentina es el efecto adverso más común relacionado con el blanqueamiento dental. En la técnica en clínica, el peróxido de carbamida al 37% ha surgido como una posibilidad de blanqueamiento sin causar sensibilidad.Objetivo: Se tratade un informe de caso que evaluó la eficacia (cambio de color) y la presencia o ausencia de sensibilidad de la denina al utilizar un producto a base de peróxido de hidrógeno al 35% y otro a base de peróxido de carbamida al 37% en la técnica de blanqueamiento dental en clínica.Informe de caso:Un paciente del sexo maculino de 25 años fue sometido a un estudio de boca dividida en el que se aplicó peróxido de hidrógeno al 35% en la hemiarcada izquierda y peróxido de carbamida al 37% en la hemiarcada derecha.Se realizaron tres sesiones, la peróxido de carbamida con una única aplicación de 45 minutos, y la peróxido de hidrógeno con tres aplicaciones de 15 minutos, en sus respectivos lados de aplicación y con un intervalo de siete días entre cada sesión. Se analizaron los valores de sensibilidad antes y después de cada sesión mediante la escala analógica visual del dolor, y se evaluó el cambio de color mediante la Escala Vita, analizando los incisivos superiores y los caninos antes de cada sesión. Conclusiones: El blanqueamiento dental con peróxido de hidrógeno demostró una mayor eficacia blanqueadora y el peróxido de carbamida no manifestó sensibilidad durante el procedimiento de blanqueamiento. Se sugiere realizar más ensayos clínicos con peróxido de carbamidaparapoder utilizar una muestra mayor de pacientes y verificar sus ventajas en términos de sensibilidad, así como su eficacia blanqueadora (AU).

Tratamento sintomático (blindagem do esmalte) em paciente com hipersensibilidade dentinária seguido de clareamento dentário: relato de caso / Symptomatic treatment (enamel shielding) in a patient with dentin hypersensitivity followed by tooth bleaching: acase report / Tratamiento sintomático (blindaje del esmalte) en un paciente con hipersensibilidad dentinaria seguido de blanqueamiento dental: informe de un caso

Introdução:A hipersensibilidade é uma doença que acomete grande parte da população que, por muitas vezes, também almejam uma melhor estética dos dentes através do clareamento e não alcançam seu objetivo devido sua condição sintomática.Objetivo:Verificar se uma paciente com hipersensibilidade dentinária e trincas no esmalte, ficaria sem dor após realização da blindagem do esmaltecom agentes dessensibilizantes de ação neural e oclusiva em sessão única e, ainda, se continuaria sem dor após o clareamento de consultório utilizando o peróxido de carbamida a 37%. Relato de caso:Paciente do sexo feminino, 31 anos, apresentava todos os elementos dentários com alta translucidez, muitas trincas e desgaste dental erosivo restrito à ponta de cúspide nos elementos 36 e 46. Após estes achados e associado àhistória clínica relatada de alta sensibilidade na dieta principalmente gelada, fechou-se o diagnóstico de um caso de hipersensibilidade dentinária. Foi realizado um procedimento dessensibilizante, em sessão única, com agentes de ação neural e oclusiva e, sequencialmente, clareamento dentário de consultório. A paciente relatou eliminação da sensibilidade com o tratamento dessensibilizante (blindagem do esmalte), o que levou àconcordância da paciente em realizar o clareamento com produto àbase de peróxido de carbamida a 37% que promete ausência de dor. Conclusões:o protocolo dessensibilizante utilizado cumpriu seu papel no quesito eliminação da dor com retorno da paciente às atividades diárias antes impossibilitadas (como ingerir bebidas geladas) e propiciou a realização de clareamento dentário sem dor, porém sem muito sucesso na mudança de cor alcançada (AU).

Introduction:Hypersensitivity is a disease that affects a large part of the population who, very often, also seek to improve the esthetics of their teeth through tooth bleaching and fail to achieve their goal due to their symptomatic condition.Objective:To ascertain whether a patient with dentin hypersensitivity and cracked enamel would be pain-free after enamel shielding with neuraland occlusive desensitizing agents in a single session, and whether she would continue to be pain-free after in-office tooth bleaching using 37% carbamide peroxide. Case report:A 31-year-old female patient who showcased high translucency in all dental elements, with many cracks and erosive tooth wear restricted to the cusp tips of elements 36 and 46. Following these findings and in association with the reported clinical history of high sensitivity, especially to cold diets, a diagnosis of dentin hypersensitivity was made. A single-session desensitizing procedure was carried out with neural and occlusive agents, and subsequently followed by in-office tooth bleaching. The patient reported the elimination of sensitivity with the desensitizing treatment (enamel shielding), which led to the patient agreeing to undergo teeth bleaching with a 37% carbamide peroxide-based product that guarantees no pain. Conclusions:The desensitizing protocol utilized fulfilled its role in terms of eliminating pain, with the patient returning to daily activities that had previously been impossible (such as drinking cold beverages) and allowing pain-free tooth bleaching to be carried out, but without much success in the color change achieved (AU).

Introducción: La hipersensibilidad es una enfermedad que afecta a gran parte de la población la cual, muchas veces, también pretende mejorar la estética de sus dientes a través del blanqueamiento y no alcanza su objetivo debido a su condición sintomática.Objetivo: Comprobar si una paciente con hipersensibilidad de la dentina y grietas en el esmalte estaría libre de dolor tras el blindaje del esmalte con agentes desensibilizantes neurales y oclusivos en una sola sesión, y, además, si seguiría estando libre de dolor tras el blanqueamiento dental en clínica utilizando peróxido de carbamida al 37%.Informe de caso: Una paciente de 31 años presentaba todos los elementos dentales con alta translucidez, con muchas grietas y desgaste dental erosivo restringido a las puntas de las cúspides de los elementos 36 y 46.Tras estos hallazgos y junto a la historia clínica descrita de alta sensibilidad especialmentefrente a una dieta fría, se realizó un diagnóstico de hipersensibilidad dentinaria. Se llevó a cabo un procedimiento de desensibilización en una sola sesión, con agentes neurales y oclusivos, seguido de un blanqueamiento dental clínico. La paciente declaró la eliminación de la sensibilidad con el tratamiento desensibilizante (blindaje del esmalte), lo que la llevó a aceptar el blanqueamiento con un producto a base de peróxido de carbamida al 37% que promete ser indoloro. Conclusiones: El protocolo de desensibilización utilizado cumplió su función en cuanto a la eliminación del dolor, permitiendo que la paciente volviera a realizar actividades cotidianas que antes le resultaban imposibles (como tomar bebidas frías) y permitiendo realizar el blanqueamiento dental sin dolor, pero sin mucho éxito en el cambio de color conseguido (AU).

Comparison of the Efficacy of Two Desensitizing Toothpastes in Occluding Dentinal Tubules under Artificial Saliva and Acid Conditions: An In-Vitro SEM Study.

Introduction: Dentin hypersensitivity, a prevalent clinical condition is typically treated with desensitizing toothpastes as the primary choice for relieving pain. Ideally, desensitizing toothpaste must minimize dentin permeability and sustain the tubule occlusion despite acid challenges and immersion in saliva. Aim: To evaluate and compare the effectiveness of 5% NovaMin® dentifrice and 5% Potassium nitrate dentifrice in dentinal tubule occlusion after citric acid challenge and immersion in artificial saliva through scanning electron microscope (SEM). Materials and Method: 36 samples of EDTA etched dentin discs prepared from extracted teeth were equally distributed in to three groups. Group 1 was brushed with 5% NovaMin® dentifrice and Group 2 with 5% Potassium nitrate dentifrice. Group 3 was brushed with Distilled water as a control. Each group was equally divided in to two subgroups to be treated with: 6 wt% citric acid or 24 hrs artificial saliva immersion. The samples underwent SEM analysis and images were subjected to Gutmann JL et al scoring method. The agreement between the scores of two examiners was assessed by Spearmans correlation coefficient. The data were analyzed using ANOVA and Tukey HSD test. Results: Group 1 had showed better dentinal tubule occlusion after artificial saliva immersion and citric acid challenge when compared to other groups. Conclusion: Hence 5% NovaMin® dentifrice represented an excellent approach to dentinal tubule occlusion on artificial saliva immersion and acid challenges compared to 5% potassium nitrate dentifrice

The Impact of Testosterone Suppression on Dental Structures: An In vivo Study

Aim: The aim of this study was to evaluate the impact of testosterone (T) suppression during puberty on the development of dental, periodontal and alveolar structures in rats. Materials and Methods: Thirty-six Wistar rats were selected for this study. Orchiectomy (ORX) was performed on the animals of the experimental group (n=18) and sham surgery on the animals of the control group (n=18) on the 23rd day of life. The animals were allocated into 4 groups: an ORX group (n=9) and a sham group (n=9) euthanized at 45 days of age, and the other ORX group (n=9) and the other sham (n=9) euthanized at 73 days of age. After the experimental period, the animals were euthanized and the mandibles and maxillas were removed, dissected and fixed in 10% formalin, decalcified, cut at 7 µm and stained with hematoxylin and eosin and picrosirius red. Qualitative analysis of slides stained with Hematoxylin and Eosin were performed, while collagen synthesis obtained from slides stained with Red Silver was quantitatively evaluated using ImageJ software. Collagen synthesis was compared between groups using the student's t test using the IBM SPSS software. Results: Histologically, the animals submitted to orchiectomy showed variations in the periodontal region, immature alveolar bone and periodontal ligament with the presence of atypical fat cells, in the dental structures, hyperemic pulp with calcification points (nodules) and variation in the arrangement and shape of the odontoblasts, with considerable significance when compared with the animals of the Sham group. Conclusion: In conclusion, the testosterone suppression induces changes in the differentiation of cells that form the tissues of dental and alveolar structures, through the incidence of pulp alterations, presence of atypical cells in the periodontal ligament and delay in the neoformation of alveolar bone in rats during puberty.

Displasia dentinaria tipo I: Manejo clínico y estudio histológico a propósito de dos casos / Dentin dysplasia type I: clinical management and histological study based on two cases

La displasia dentinaria tipo I (DD-I) corresponde a una alteración dentinaria de heterogeneidad genética y penetrancia completa, en donde se presenta un defecto en el desarrollo de las raíces de los dientes tanto temporales como definitivos. Clínicamente se observan dientes con extrema movilidad junto con antecedentes de exfoliación prematura o espontánea. Los defectos estructurales de los tejidos dentarios, tales como DD-I; implican un desafío ya que son pocos los casos documentados en la literatura que hablan de esta condición. Además implican un tratamiento multidisciplinario y altamente invasivo. El objetivo de este artículo es presentar dos casos de DD-I, enfatizando en su tratamiento y características histopatológicas.

Dentin Dysplasia Type I (DD-I) consists of a pathological dentinary alteration with genetic heterogeneity that results in a defectuous development of dental roots both in primary and secondary dentition. Clinically we can appreciate teeth with extreme pathological mobility and premature or spontaneous exfoliation. Alterations within normal dental structure, such as DD-I imply a challenge for the common practitioner, because of the scarce number of case reports with in the scientific literature regarding this condition and also, because of the need for a highly invasive and multidisciplinary approach they require. The aim of this article is to present two DD-I cases, emphasizing on their treatment and histopathological features.

O uso do laser de alta e baixa intensidade para o tratamento de hipersensibilidade dentinária: uma revisão integrativa

Objetivo: Determinar as evidências científicas sobre a influência do uso de lasers de baixa e alta intensidade no tratamento da hipersensibilidade da dentina. Revisão de literatura: Foram realizadas buscas na Biblioteca Virtual em Saúde (BVS), incluindo as bases de dados: Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS); Bibliografia Brasileira de Odontologia (BBO); e National Library of Medicine (MEDLINE). A maioria dos estudos destacam a eficácia dos lasers na redução da HD, com o laser Nd:YAG mostrando-se eficaz na obliteração dos túbulos dentinários e proporcionando alívio a longo prazo. Apesar dos benefícios, alguns estudos alertam para possíveis danos à polpa dentária, especialmente com lasers de alta potência. Considerações finais: Embora os lasers tenham se mostrado eficazes na redução da HD, a escolha do laser deve ser personalizada para cada paciente, destacando a necessidade de aprimorar os protocolos clínicos e adquirir experiência relevante por parte dos profissionais especialistas.

Objective: To determine the scientific evidence on the influence of the use of low and high intensity lasers in the treatment of dentin hypersensitivity. Literature review: Searches were carried out in the Virtual Health Library (VHL), including the databases: Latin American and Caribbean Literature in Health Sciences (LILACS); Brazilian Bibliography of Dentistry (BBO); and National Library of Medicine (MEDLINE). Most studies highlight the effectiveness of lasers in reducing HD, with the Nd:YAG laser proving effective in obliterating dentinal tubules and providing long-term relief. Despite the benefits, some studies warn of possible damage to the dental pulp, especially with high-power lasers. Final considerations: Although lasers have been shown to be effective in reducing HD, the choice of laser must be personalized for each patient, highlighting the need to improve clinical protocols and acquire relevant experience on the part of specialist professionals.

Selective removal of hidden caries in permanent molars: a clinical and radiographic analysis - Case Report / Remoção seletiva de cárie oculta em molares permanentes: uma análise clínica e radiográfica - Relato de Caso

Background: Hidden caries is characterized by lesions that cannot be detected exclusively through clinical examination, requiring the use of radiographic examinations for their identification. Case Report: This case study presents the management of two lower molars with microcavitations and enamel shading. Additionally, the presence of a pigmented occlusodistal fissure in one of the elements is noted. The radiographic examination revealed an extensive carious lesion in the dentin, which was not in proximity to the pulp and did not exhibit any periapical lesions. This finding led to the diagnosis of hidden caries. The technique of selective removal of the carious tissue was chosen due to its depth and the potential risk of pulp exposure. Then, the dentin/pulp complex was protected, and the definitive restoration was performed. Conclusion: The progression of hidden carious lesions can lead to tooth destruction without visible clinical signs. Treatment should adhere to minimally invasive dentistry principles to preserve tooth structure and reduce the risk of pulp exposure.

Introdução: A cárie oculta caracteriza-se por lesões que não são detectáveis exclusivamente por meio do exame clínico, exigindo a utilização de exames radiográficos para sua identificação. Relato de Caso: Apresentamos o manejo de dois molares inferiores com microcavitações e sombreamento do esmalte, além da presença de fissura oclusodistal pigmentada em um dos elementos apresentados. O exame radiográfico revelou uma lesão cariosa extensa na dentina, sem proximidade com a polpa e sem lesão periapical, estabelecendo o diagnóstico de cárie oculta. A técnica de remoção seletiva do tecido cariado foi escolhida devido à sua profundidade e ao risco potencial de exposição pulpar. Em seguida, o complexo dentina/polpa foi protegido, e a restauração definitiva foi realizada. Conclusão: A progressão de lesões cariosas ocultas pode destruir dentes sem sinais clínicos visíveis. O tratamento deve adotar princípios de odontologia minimamente invasiva para preservar a estrutura dental e reduzir o risco de exposição pulpar.

Pathogenesis, diagnosis, and management of dentin hypersensitivity

Dentin sensitivity is a problem characterized by brief sharp pain that occurs in response to things like changes in temperature, sweet or sour substances and mechanical factors. This condition significantly affects the lives of patients leading to restrictions and changes in oral hygiene routines. It is crucial for care to understand the causes, symptoms, diagnosis and management of dentin sensitivity. The development of dentin sensitivity is closely related to the structure of teeth which involves the exposure of tubes in the dentin that contain nerve endings sensitive to stimuli. Different theories, such as the theory and direct innervation theory provide insights into how this pain occurs. Diagnosis involves an evaluation of signs and symptoms along with patient history and specific tests to confirm sensitivity. Management options include adjusting behaviors using desensitizing toothpaste or fluoride applications utilizing bonding agents or even undergoing procedures like gingival grafts. These approaches aim to reduce pain and improve the quality of life for individuals affected by dentin sensitivity. Dental professionals play a role, in diagnosing, treating and educating patients about this condition to ensure results and better oral health.

Pulp Revascularization: A Boon for Future Therapy in Young Permanent Teeth

Introduction: Pulp revascularization can be a favourable treatment option for permanent teeth with damaged pulp since it allows the continuous development of root and thicker walls which is in contrast with other treatment options. It requires minimum instrumentation and since the blood clot acts as a biological scaffold the formation of a good quality of blood clot is important. The three important components which are essential for pulp revascularization are stem cells, scaffolds and growth factors. Stem cells help in pulp revascularization due to their various unique properties/advantages like tissue specificity, antiinflammatory potential. Objectives: This review concentrates not only on the beneficial effects of pulp revascularization but also on the role of various other factors that influence and makes it a success like stem cells, growthfactors, scaffolds. Materials and Methods: This review paper was written using original research articles, reviews, and case studies that were published in online databases like PubMed, Google Scholar and books like Cohen’s Pathways of the Pulp 12th Edition. Results: This review gives an acknowledgement of pulp revascularization in terms of its basic principle, process, role of stem cells and scaffolds and its comparison with other treatment options along with its disadvantages.

Preparation and performance of gelatin modified by methacrylic anhydride/treated dentin matrix bioactive scaffolds / 中国组织工程研究

BACKGROUND:Pulp regeneration has been a hot and difficult research topic in recent years,and the construction of composite bio-scaffolding materials provides new ideas and methods for pulp regeneration. OBJECTIVE:To observe the effect of freeze-dried gelatin modified by methacrylic anhydride/treated dentin matrix bioactive scaffolds on proliferation,migration,and osteogenic differentiation of human dental pulp stem cells. METHODS:The mass ratios of gelatin modified by methacrylic anhydride and treated dentin matrix at 2:1,1:1 and 1:2 were obtained by dispersing different masses of treated dentin matrix into gelatin modified by methacrylic anhydride solution.The gelatin modified by methacrylic anhydride/treated dentin matrix bioactive scaffolds were prepared by vacuum freeze-drying.The microstructure,water absorption,and mechanical properties of the scaffolds were measured.Human dental pulp stem cells were cultured with different mass ratios of scaffold extract and DMEM(control group)to detect cell proliferation and migration.Human dental pulp stem cells were cultured with different mass ratios of scaffold extract + osteogenic induction solution and DMEM + osteogenic induction solution(control group),and their osteogenic ability was analyzed by alkaline phosphatase staining. RESULTS AND CONCLUSION:(1)Under scanning electron microscopy,the scaffolds of the three groups all had porous structures.The porosity of the scaffolds increased with the increase of treated dentin matrix quality,and there was significant difference between the two groups(P＜0.05).The water absorption of scaffolds increased with the increase of treated dentin matrix mass,and there was significant difference between groups(P＜0.05).The compressive strength and shear strength of the scaffold increased with the increase of the mass of treated dentin matrix.(2)CCK-8 assay showed that after 3,5,and 7 days of culture,the cell proliferation absorbance values in the 2:1,1:1,and 1:2 scaffold groups were higher than those in the control group(P＜0.05).The cell proliferation absorbance values increased with the increase of treated dentin matrix mass in the scaffold(P＜0.05).The cell scratch test showed that the cell migration rate in the 2:1,1:1,and 1:2 scaffold groups was higher than that in the control group(P＜0.05),and the cell migration rate increased with the increase of treated dentin matrix mass in the scaffold(P＜0.05).(3)Alkaline phosphatase staining showed that the osteogenic differentiation ability of cells in the 2:1,1:1,and 1:2 scaffold groups was stronger than that in the control group,and the osteogenic ability of cells was enhanced with the increase of treated dentin matrix mass in the scaffold.(4)The results showed that the scaffold with a mass ratio of 1:2 between gelatin modified by methacrylic anhydride and treated dentin matrix was the most suitable for the proliferation and differentiation of dental pulp stem cells.

Research progress on the mechanical compatibility of restorative materials with dental tissue / 口腔疾病防治

@#As the main means of mastication, teeth can withstand countless functional contacts. The mechanical properties of teeth are closely related to their tissue structure. Enamel and dentin have a high hardness and modulus of elasticity, and their graded structure allows them to withstand bite forces without being susceptible to fracture. When tooth tissue is defective, full crown restoration is often needed to restore the normal shape and function of the tooth. Metal materials, ceramic materials, and polyetheretherketone (PEEK) materials are commonly used for crown restoration. Metal materials have certain disadvantages in terms of aesthetics and are relatively rarely used in clinical practice. Ceramic materials with different compositions exhibit differences in performance and aesthetics, but their elastic modulus and hardness are much higher than those of dental tissue, resulting in mismatching mechanical properties. In contrast, the elastic modulus of PEEK is lower than that of tooth tissue and similar to that of bone tissue, but its properties can be improved by fiber reinforcement. Notably, when the mechanical properties of a restoration material and tooth tissue are not fully matched, the interface between them often forms a potential weak link, which ultimately affects the stability and long-term effect of the restoration. This article introduces the mechanical properties and corresponding structural characteristics of enamel and dentin. On this basis, the advantages and limitations of existing restoration materials are analyzed, and the possibility of biomimetic design of full crowns is further explored.

Effect of Morinda citrifolia juice on the bonding strength and nanoleakage of crowns dentin / 口腔疾病防治

Objective@#To explore the effect of Morinda citrifolia juice (MCJ) combined with ethylene diamine tetraacetic acid (EDTA) on premolar bonding strength and nanoleakage and compare the results with those of the most commonly used root canal irrigation solution, sodium hypochlorite (NaClO), to provide a reference for clinical application.@*Methods@#This study was approved by the ethics review committee. Sixty-three human premolars extracted for orthodontic treatment were randomly divided into a control group (distilled water group) and 6 experimental groups according to the different rinsing solutions used after the surface enamel was removed. The experimental groups included Group A (2.5% NaClO), Group B (5.25% NaClO), Group C (6% MCJ), Group D (2.5% NaClO-17% EDTA), Group E (5.25% NaClO-17% EDTA), and Group F (6% MCJ-17% EDTA) (n = 9). After soaking in the corresponding rinsing solution for 20 minutes, they were layered and stacked on their surfaces to form 4 mm × 4 mm × 3 mm Z350 resin blocks. Six samples from each group were cut into 1 mm × 1 mm × 8 mm specimen strips for microtensile bonding strength testing. The fracture type was determined under a stereomicroscope, and the remaining 3 samples from each group were aged and cut into 1 mm thick slices for interface nanoleakage testing and scanning electron microscopy observation of the resin dentin bonding interface.@*Results@#There were significant differences in the microtensile bonding strength among the groups (P<0.05), and the control group had the highest bonding strength. Among experimental groups, Group B had the lowest bonding strength, mainly bonding interface fracture, and Group F had the highest bonding strength, mainly mixed fracture. There were significant differences in nanoleakage among all groups (P<0.05), and the control group had the lowest nanoleakage value. Among experimental groups, Group B had the highest nanoleakage, with resin protrusions being unaltered, and Group F had the lowest nanoleakage value, with resin protrusions being thick and dense.@*Conclusion@#The higher the concentration of NaClO was, the worse the bonding strength and edge sealing of the crown dentin were. The effects of root canal irrigation with MCJ and EDTA on the adhesive strength and edge sealing of crown dentin were less pronounced than those of root canal irrigation with NaClO and EDTA.

Research progress on the dentin adhesion of Enterococcus faecalis and its influencing factors / 口腔疾病防治

@#Enterococcus faecalis is the main pathogen causing refractory apical periodontitis (RAP). This bacterium can tolerate harsh environments and trigger periapical immune inflammatory responses that result in persistent infection inside and outside the root canal. Adhesion to the dentin wall of root canals and the subsequent formation of biofilms significantly enhances the drug resistance and anti⁃erosion ability of Enterococcus faecalis, which is the key factor medi⁃ ating its pathogenesis. The adhesion of Enterococcus faecalis to dentin involves non⁃specific adhesion and specific adhe⁃ sion, and the latter is mediated by adhesion⁃related virulence factors, mainly including the adhesin of collagen from en⁃terococci (Ace), extracellular surface protein (Esp), gelatinase (GelE), serine protease (SprE), endocarditis and biofilm associated pilus (Ebp) and aggregation substance (AS), which is regulated by multiple two⁃component systems. The two⁃ component system Fsr can promote the expression of gelE and sprE when the cell population density increases. GelE can further reduce Ace, while the two⁃component system GrvRS directly downregulates ace expression in response to the serum environment. The two⁃component systems CroRS and WalRK may also promote and inhibit the expression of vari⁃ ous virulence factors, including ace and gelE, thus affecting the adhesion of Enterococcus faecalis. In addition, the mech⁃ anochemical preparation and the internal environment of the root canal can also influence the adhesion of Enterococcus faecalis to dentin. Avoiding the introduction of Enterococcus faecalis and using adhesion⁃interfering medications during root canal treatment can effectively prevent the adhesion of Enterococcus faecalis, and a variety of activated irrigation protocols can also be effective at increasing the clearance of Enterococcus faecalis from the root canal. The design of ra⁃ tional drugs targeting key factors involved in and regulators of the adhesion of Enterococcus faecalis to dentin is expected to provide new ideas and strategies for root canal infection control. The present paper reviews the adhesion of Enterococ⁃ cus faecalis to dentin and its influencing factors.

Research progress on the physical and chemical properties and application of graphene and its derivatives / 实用口腔医学杂志

Recent studies show that graphene and its derivatives have good physical and chemical properties and biocompatibility,and can promote cell proliferation and stem cell differentiation.The process of pulp regeneration involves the proliferation and differen-tiation of seed cells,suggesting that graphene and its derivatives have the potential applications perspective in pulp regeneration.How-ever,it has not been reported whether the physical and chemical properties of graphene and its derivatives are suitable for pulp cavity or root canal environment and its effect on pulp regeneration seed cells.This article reviews the physical and chemical properties,cyto-logical effects and the application of graphene and its derivatives in tissue engineering,and provides a basis for its application in dental pulp regeneration.

Application of autologous dentin particles combined with PRF in tooth extraction site preservation:A case report / 实用口腔医学杂志

Undicalcified autologous dentin particles(UADP)combined platelet rich fibrin(PRF)were used in a case after extraction of the left mandibular second molar for tooth extraction site preservation.CBCT images at 3,9 and 24 months after operation showed that the bone mass maintenance effect was obvious.Histological sections showed a large number of new bone formation around dentin particles.

Stability of dentin matrix treated with caffeic acid phenethyl ester at different concentrations

Aim: The aim of this study was to investigate the impact of pretreatment with ethanolic solutions of caffeic acid phenethyl ester (CAPE) at varying concentrations on the dentin collagen matrix, specifically focusing on its biomodification potential. This was assessed through evaluations of the modulus of elasticity and changes in mass. Methods: Seventy dentin collagen matrices (demineralized sticks) were prepared to receive treatments with ethanolic solutions of CAPE at concentrations of 0.05%, 0.1%, 0.5%, or 2.5%, or with control treatment solutions (distilled water or ethanol) for one hour. The dentin matrices were evaluated for modulus of elasticity and mass before (baseline), immediately after treatment (immediately), and after storage in Simulated Body Fluid (SBF) for time intervals of 1 and 3 months. Results: Generalized linear models for repeated measures over time indicated no significant differences between groups (p=0.7530) or between different time points (p=0.4780) in terms of the modulus of elasticity. Regarding mass variation, no differences were observed in the time interval between 1 month and the immediate time (p=0.0935). However, at the 3-month mark compared to the immediate time, the 0.1% CAPE group exhibited less mass loss compared to the water group (p=0.0134). Conclusion: This study concludes that various concentrations of CAPE in an ethanolic solution did not affect the modulus of elasticity of dentin, suggesting that CAPE lacks biomodifying potential in this context. However, it was observed that 0.1% CAPE positively influenced the variation in mass over different evaluation time intervals