A Randomized Trial Using 3Mixtatin Compared to MTA in Primary Molars with Inflammatory Root Resorption: A Novel Endodontic Biomaterial.

OBJECTIVES: Novel methods for preserving primary teeth can help to maintain their developmental, esthetic, and functional capabilities. The aim of this study was to assess the success of the repair of bony defects, caused by pre-treatment perforations, with a mixture of three antibiotics combined with simvastatin (3Mixtatin) compared to MTA in hopeless primary molars. STUDY DESIGN: In this randomized clinical trial, 80 teeth from 65 healthy children aged 3-6 years with interradicular or periapical root resorption and/or perforation in primary molars were treated either with 3Mixtatin or MTA before conventional pulpectomy and restoration. The subjects were followed up clinically and radiographically for 4, 6, 12 and 24 months after pulp treatment to evaluate and compare the healing process. The data were compared using chi-square test at a significance level of 0.05. RESULTS: By the end of 24 months in 3Mixtatin group, 31 (96.8%) teeth revealed no clinical signs or symptoms with arrested resorption progress in radiographs. In MTA group, clinical signs and symptoms including pain, mobility and sinus tract were observed in 18 (48.6%) teeth with cessation of root/interradicular radiolucency in 7 (18.9%) teeth without bone repair. CONCLUSIONS: Radiographic and clinical healing occurred more successfully following 3Mixtatin treatment compared to treatment with MTA, it may lead to a paradigm shift in the pulpal treatment of primary teeth in the future.

The use of diffuse laser photonic energy and indocyanine green photosensitiser as an adjunct to periodontal therapy.

Light-activated chemical therapy - generally known as photodynamic therapy (PDT) - has been developed within medicine, to allow the use of an applied agent (photosensitiser) that could be activated using laser photonic energy, leading to the destruction of target cellular structures. In clinical dentistry, PDT has been utilised within a wide scope of topical application in endodontic, periodontal and oral epithelial pathology where specifically, anti-bacterial action may prove useful. Underlying the complex and multi-factorial aetiology, periodontal disease remains of essentially-bacterial origin and anti-bacterial PDT (aPDT) has been investigated as an adjunctive to other periodontal treatment therapies. Of several topically-applied photosensitisers, one agent, indocyanine green, may be activated using a diode laser wavelength (810 nm) that is commonly-available in clinical dental practice, to provide generalised bacteriocidal effect. Unlike antibiotics and antibacterial mouthwashes, the mode of action appears to be nonspecific to bacterial species and is linked to cell death through a process of oxidative stress. Additionally, indocyanine green has otherwise low toxicity to non-target host tissue and dental restorative materials. This paper explores the background to this therapy, its position within the broader delivery of periodontal treatment and the specific application of indocyanine green in clinical dental practice.