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1.
Cureus ; 15(10): e47463, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38021766

RESUMEN

PURPOSE: The purposes of this study were to assess decision-making, material selection, and management of deep carious lesions in permanent teeth requiring vital pulp therapy (VPT); investigate the intradepartmental and interdepartmental consensus in the management of those cases; and correlate this study's results to the current scientific literature, clinical experience, and postgraduate training among staff and postgraduate students at the Faculty of Dentistry, King Abdulaziz University. MATERIALS AND METHODS: The survey included faculty from pedodontics, endodontics, and restorative/operative dentistry; postgraduate students; and interns, excluding specific categories such as retired faculty, external trainers, non-faculty hospital specialists, general practitioners, students, interns outside the institution, and other departments. An anonymous electronic questionnaire was developed and validated. Ethical approval was obtained, and the questionnaire was distributed to all 148 English-proficient members of the targeted population via email and WhatsApp, accompanied by a cover letter. The questionnaire encompassed demographic, education, experience, assessment, decision-making, and management sections. Data were collected and analyzed using Microsoft Excel, with results presented using categorical variables, Pareto charts, and statistical tests. RESULTS: There were 86 responses, representing 58% of the target population, with the key findings including the prominence of "Pre-operative vitality test result" as the most important factor in assessing deep carious lesions, with no significant differences among specialties. The (one-step and one-visit) management approach was preferred by 50% of participants, with no significant specialty differences. For deep carious lesions without pulpal exposure, glass ionomer (GI)/resin-modified glass ionomer (RMGI) base was the top choice, with no variation among all specialties. In cases with pulpal exposure, the one-visit approach (direct pulp capping (DPC), base, and restoration) was the most favored, with no specialty differences. Material availability significantly influenced decision-making, with no specialty variations. CONCLUSION: The study highlights the crucial role of pre-operative vitality tests in assessing deep carious lesions for VPT or root canal treatment (RCT). Participants generally favored VPT for cases with normal pulp vitality, with some departmental variation. Controlling bleeding post-pulpal exposure was a central concern. Mineral trioxide aggregate (MTA) was the most commonly used VPT material, followed by Ca(OH)2 and Biodentine. Factors such as treatment access, patient compliance, remaining dentin thickness, and oral hygiene had minimal impact on treatment choice. Limited availability of VPT materials was the primary reason for non-use. The survey's acceptable response rate raises concerns about potential non-response bias, though limitations include a lack of data on non-responders. Nevertheless, the survey's strength lies in its comprehensive coverage of key clinical aspects, engaging professionals from diverse specialties and educational levels who are collectively interested in addressing deep caries cases.

2.
BMC Oral Health ; 21(1): 595, 2021 11 19.
Artículo en Inglés | MEDLINE | ID: mdl-34798874

RESUMEN

BACKGROUND: Various systems of nickel-titanium (NiTi) instrument have long been commercially available. However, the preparation of narrow and curved root canals has always been challenging. The purpose of this study was to compare the shaping ability of two NiTi systems (2Shape and NeoNiTi) in severely curved root canals with different morphological patterns using micro-computed tomography (Micro-CT). METHODS: A total of 22 human extracted permanent teeth of mandibular first molars, with the exact mesial angle of curvature of 25 and 35 degrees, according to Schneider's technique, were distributed randomly into two groups (group I: 2Shape, group II: NeoNiTi) based on the rotary system used (n = 22). The groups were subdivided into two subgroups corresponding to the angle of canal curvature (25° and 35°) (n = 11). Canals were scanned using Micro-CT pre- and post-preparation to assess the volume of dentin removed; canal transportation; and canal centering ratio at 3, 6, and 9 mm from the apex. The Mann-Whitney U test was utilized to determine any significant differences between the two systems. The level of statistical significance was set at p < 0.05. RESULTS: There was no significant difference between the two groups in volume of dentin removed; canal transportation; and centering ability for 25° and 35° canal curvatures at 3, 6, and 9 mm from the apex (coronal, middle, and apical) thirds (p > 0.05). At the middle third, the NeoNiTi group demonstrated a statistically significant increase in volume of dentin removed for 35° canal curvatures compared to the 2Shape group. CONCLUSION: Within the limitation of our in vitro study, 2Shape and NeoNiTi systems with severely curved canals were confirmed to be relatively safe in preparation and to respect original canal anatomy. Nevertheless, NeoNiTi instruments produced more centered preparation and minimal canal deviation compared to the 2Shape system.


Asunto(s)
Aleaciones Dentales , Preparación del Conducto Radicular , Cavidad Pulpar/diagnóstico por imagen , Dentina , Diseño de Equipo , Humanos , Titanio , Microtomografía por Rayos X
3.
J Cell Commun Signal ; 10(1): 17-31, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26627907

RESUMEN

Lysyl oxidase pro-enzyme is secreted by tumor cells and normal cells as a 50 kDa pro-enzyme into the extracellular environment where it is cleaved into the ~30 kDa mature enzyme (LOX) and 18 kDa pro-peptide (LOX-PP). Extracellular LOX enzyme activity is required for normal collagen and elastin extracellular cross-linking and maturation of the extracellular matrix. Extracellular LOX-PP acts as a tumor suppressor and can re-enter cells from the extracellular environment to induce its effects. The underlying hypothesis is that LOX-PP has the potential to promote bone cell differentiation, while inhibiting cancer cell effects in bone. Here we investigate the effect of LOX-PP on bone marrow cell proliferation and differentiation towards osteoblasts or osteoclasts, and LOX-PP modulation of prostate cancer cell conditioned media-induced alterations of proliferation and differentiation of bone marrow cells in vitro. Effects of overexpression of rLOX-PP in DU145 and PC3 prostate cancer cell lines on bone structure in vivo after intramedullary injections were determined. Data show that prostate cancer cell conditioned media inhibited osteoblast differentiation in bone marrow-derived cells, which was reversed by rLOX-PP treatment. Prostate cancer conditioned media stimulated osteoclast differentiation which was further enhanced by rLOX-PP treatment. rLOX-PP stimulated osteoclast differentiation by inhibiting OPG expression, up-regulating CCN2 expression, and increasing osteoclast fusion. In vivo studies indicate that rLOX-PP expression by PC3 cells implanted into the tibia of mice further enhanced PC3 cell ability to resorb bone, while rLOX-PP expression in DU145 cells resulted in non-significant increases in net bone formation. rLOX-PP enhances both osteoclast and osteoblast differentiation. rLOX-PP may serve to enhance coupling interactions between osteoclasts and osteoblasts helping to maintain a normal bone turnover in health, while contributing to bone abnormalities in disease.

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