Efficacy assessment of laser Doppler imager in diagnosing the pulp vitality after dental trauma.

Background/purpose: This is the first paper evaluating the efficacy of laser Doppler imager in diagnosis of pulpal vitality. The purpose of this study was to evaluate and compare the diagnostic benefits of laser Doppler imaging and electric pulp test (EPT) in dental trauma. Materials and methods: Seven patients were selected for pulp vitality evaluation in Kaohsiung Medical University Hospital between 2018 and 2019. EPT and laser Doppler imager evaluation were performed for patients with traumatic injury to teeth. Statistical methods included the Kappa consistency test and the chi-square test. In addition, the receiver operating characteristic (ROC) curve, and the area under the curve (AUC) were used. Results: There was a significant difference in Doppler flow values between the severe trauma group and the mild trauma group, regardless of patient self-reported symptoms (P = 0.043) or physicians' diagnostic classification (P = 0.018). For an EPT instrument, the Kappa coefficient was 0.67 and 1-year pulpal status findings were highly consistent (P < 0.001). Using a Doppler instrument, the Kappa coefficient was 0.85. According to the ROC curve, the AUC for EPT was 0.94, the AUC for Doppler was 1, and the optimal cut-off value was 31.55, indicating that both were superior diagnostic tools. Conclusion: Both laser Doppler imager and EPT can be used as tools for diagnosing traumatic pulp necrosis. Doppler imaging instruments allow for a more timely and accurate assessment of pulp vitality in dental trauma. In the future, ongoing research and related training are necessary for interpretation of Doppler data.

Locating the Mandibular Lingula Using Cone-Beam Computed Tomography: A Literature Review.

This study aimed to review the literature on adult mandibular lingula (ML) locations and related distances determined using cone-beam computed tomography (CBCT). A search was conducted for studies on CBCT using the following databases: PubMed, Web of Science, and Embase. The search results were limited to studies published between 1970 and 2021. The inclusion criteria were the investigation of ML location, CBCT, and participants aged ≥18 years. Eligible studies were examined for the distances from the lingual tip to the anterior ramus border, posterior ramus border, sigmoid notch, inferior ramus border, and occlusal plane. Eight studies on CBCT qualified for inclusion in the study. The mean distances from the ML to the anterior ramus border were 15.57 to 20 mm. In most of these, the ML was located above the occlusal plane. No significant differences were observed in the location and related distances for the ML among patients of different sexes, ethnicities, or skeletal patterns.

Morphological Study of the Mandibular Lingula and Antilingula by Cone-Beam Computed Tomography.

The patterns of the lingula and antilingula are crucial surgical reference points for ramus osteotomy. Cone-beam computed tomography (CBCT) provides three-dimensional images, and patient radiation dose is significantly lower for CBCT than for medical CT. The morphology of the mandibular lingula and antilingula of ninety patients (180 sides) were investigated using CBCT. The lingula were classified as having triangular, truncated, nodular, and assimilated shapes. The antilingula were classified as having hill, ridge, plateau, and plain shapes. The patients' sex, skeletal patterns (Classes I, II, and III), and right and left sides were recorded. The most to least common lingula shapes were nodular (37.8%), followed by truncated (32.8%), triangular (24.4%), and assimilated (5%). The most to least common antilingulae were hill (62.8%), plain (18.9%), plateau (13.9%), and ridge (4.4%) patterns, respectively. The lingula and antilingula had identical patterns on both sides in 47 (52.2%) and 46 patients (51.1%), respectively. Sex and skeletal pattern were not significantly correlated to lingula and antilingula shapes. No significant correlation was observed between lingula and antilingula shapes.

Inducing cathepsin L expression/production, lysosomal activation, and autophagy of human dental pulp cells by dentin bonding agents, camphorquinone and BisGMA and the related mechanisms.

Camphorquinone (CQ) and resin monomers are included in dentin bonding agents (DBAs) and composite resin to restore tooth defects due to abrasion, crown fracture, or dental caries. DBAs, CQ, and bisphenol A-glycidyl methacrylate (BisGMA) applications influence the biological activities of the dental pulp. The current investigation aimed to delineate the effect of DBAs, CQ, and BisGMA on cathepsin L production/expression, lysosomal activity, and autophagy induction in human dental pulp cells (HDPCs). HDPCs were exposed to DBAs, CQ, or BisGMA with/without inhibitors for 24 h. Enzyme-linked immunosorbent assay was employed to determine the cathepsin L level in culture medium. The cell layer was utilized to measure cell viability by 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl -tetrazolium bromide (MTT) assay. Real-time PCR was used to evaluate the mRNA expression. Western blotting or immunofluorescent staining was used to study protein expression. Lysosomal density was evaluated by lysotracker red staining. We found that DBAs, CQ, and BisGMA stimulated cathepsin L mRNA, protein expression, and production in HDPCs. In addition, CQ and BisGMA induced lysosomal activity, Beclin1, ATG12, LC3B, Bax, and p53 expression in HDPCs, indicating the stimulation of autophagy. Glutathione (GSH) prevented CQ- and BisGMA-induced cytotoxicity. Moreover, E64d, cathepsin L inhibitor (two cathepsin inhibitors), and Pifithrin-α (a p53 inhibitor) showed little preventive effect toward CQ- and BisGMA-induced cytotoxicity. Autophagy inhibitors (NH4Cl, Lys05) mildly enhanced the CQ- and BisGMA-induced cytotoxicity. These results indicate that DBAs stimulated cathepsin L, possibly due to their content of CQ and BisGMA that may induce cathepsin L in HDPCs. CQ and BisGMA stimulated lysosomal activity, autophagy, and apoptosis, possibly via induction of Beclin 1, ATG12, LC-3B, Bax, and p53 expression. In addition, CQ and BisGMA cytotoxicity was related to redox change and autophagy. These events are important role in pulpal changes after the restoration of tooth decay using CQ- and BisGMA-containing DBAs and resin composite.

Morphological Investigation of Mandibular Lingula: A Literature Review.

PURPOSE: The purpose of the study was to review the literature on the shape of the mandibular lingula. METHODS: English articles published from 1970 to 2021 in databases (PubMed, Web of Science, and Embase) were selected. Articles meeting the search strategy were evaluated based on the eligibility criteria (participants aged 18 years and over). Dry mandibles and cone beam computed tomography (CBCT) images were used as research materials. The shapes of mandibular lingula were classified as triangular, truncated, nodular, and assimilated. RESULTS: Based on the eligibility criteria, 10 articles (six with dry mandibles and four with CBCT images) were selected for full-text reading and detailed examination. In the dry mandible group, triangular, truncated, nodular, and assimilated lingula were observed on 446, 398, 232, and 69 sides, respectively. In the CBCT group, nodular, truncated, triangular, and assimilated lingula were observed on 892, 517, 267, and 88 sides, respectively. Therefore, the most common lingula types in the dry mandible and CBCT groups were different. The assimilated type was the least common in both groups. CONCLUSION: In the dry mandible group, the most common lingula type was triangular, followed by truncated, nodular, and assimilated types. In the CBCT group, the most common lingula type was nodular, followed by truncated, triangular, and assimilated types. There were no significant differences in lingula types between the left and right sides of the mandible.

Conservative pulp treatment for Oehlers type III dens invaginatus: A case report.

BACKGROUND: Diverse presentations of dens invaginatus (DI) and root canal treatment with an immature open apex often pose challenges to dentists. Adequate treatment planning for DI is the main reason for successful approach, i.e., we should consider the shape and depth of the concave folding, the condition of the original pulp, and the growth stage of the root formation. CASE SUMMARY: A 9-year-old girl complained of severe pain of the right maxillary incisor (tooth 12) when chewing for two weeks. Following clinical and radiographic examinations, Oehlers type III DI of tooth 12, with an immature open apical foramen and a symptomatic periapical pathosis, was diagnosed. Cone-beam computed tomography verified the specific spatial and stereoscopic data regarding the communication between the main root canal and pseudo root canal of the involved tooth. After removing the source of infection, a mineral trioxide aggregate was selected to fill and seal the pseudo root canal; additionally, pulp capping of the main canal was performed through the interconnections between the root canals in the middle segment to preserve pulp vitality and enable continual root formation and eventual root apex closure. CONCLUSION: We propose to conduct main root canal pulp capping for DI with communication between the main and pseudo root canals.