Elimination of E. faecalis with NaOCl versus chlorhexidine gluconate from primary molar root canal systems: an ex vivo model study.

OBJECTIVES: This ex vivo human study aimed to evaluate the efficacy of NaOCl and chlorhexidine gluconate (CHG) irrigations in eliminating Enterococcus faecalis from the RCS of primary molars. MATERIALS AND METHODS: Disinfected extracted primary molars were inoculated with E. faecalis for 24 h. Then, the RCS samples were then irrigated with either 2.5% NaOCl, 0.2% and 2% CHG, or sham saline. The samples were collected immediately after irrigation; and 24 h later, the bacterial viability and counts were measured using blood agar and qRT-PCR, respectively. Histological sections were used to measure E. faecalis penetration and viability in dentin tubules using fluorescence microscopy. RESULTS: The recovery of viable E. faecalis after the irrigation of the primary molars showed more significant bactericidal effects of NaOCl and 0.2% and 2% CHG than of saline. Immediately after the irrigation, the NaOCl group showed the greatest reduction in E. faecalis; and 24 h later, all the groups had lower viable E. faecalis than the saline control. The bacterial penetration was also lowest in the NaOCl group, although there was no difference in bacterial viability in the tubules between the groups. CONCLUSION: In primary teeth, NaOCl and CHG showed similar degrees of bacterial elimination efficacy in terms of E.faecalis. CLINICAL RELEVANCE: Within the limitations of this study, NaOCl and CHG have the similar ability to perform endodontic irrigation of primary ex vivo teeth regarding the elimination of E.faecalis, but NaOCl penetrates dentin tubules better.

The efficacy of articaine in pain management during endodontic procedures in pediatric patients.

OBJECTIVE: This trial aimed to study the efficacy of articaine in pain management during endodontic procedures in pediatric patients. METHODS: Ninety-eight children who received endodontic painless treatment were collected and randomly divided into the control group and observation group, with 49 cases in each group. The control group received infiltration anesthesia with lidocaine, and the observation group received infiltration anesthesia with articaine. Anesthesia effect, anesthesia onset time, sensory recovery time, duration of anesthesia, pain intensity, blood pressure, heart rate, and adverse reactions were compared. RESULTS: The effective rate of anesthesia in the observation group was higher than that in the control group. The anesthesia onset time and sensory recovery time were shorter, the duration of anesthesia was longer, and the VAS score and facial expression score were lower in the observation group than in the control group. The heart rate of the observation group was lower, and diastolic blood pressure was higher than those of the control group. The total incidence of adverse reactions in the observation group was lower than that in the control group. CONCLUSION: In the treatment of dental pulp diseases in children, the use of articaine can achieve better anesthesia effect and rapid onset of anesthesia and has less impact on the patient's blood pressure and heart rate, but it also can relieve pain and has good safety after the use of medication. It is worthy of clinical application.

Success rate of silver nano-particles in comparison to silver diamine fluoride in management of deep carious lesions: a randomized controlled clinical trial / Taxa de sucesso de nanopartículas de prata em comparação ao fluoreto de diamina de prata no manejo de lesões cariosas profundas: um estudo clínico controlado randomizado

Objective: Evaluate the effectiveness of nanosilver fluoride in comparison to silver diamine fluoride in management of deep carious lesions. Material and Methods: This double-blinded randomized controlled clinical trial included thirty-six patients with deep carious mandibular molars. Patients were recruited form the outpatient clinic of Suez canal university, Egypt and randomly allocated into three groups, Nanosilver fluoride group, Silver diamine fluoride group and control group. For all groups, teeth were isolated by rubber dam. Access was done followed by partial caries removal. Silver diamine fluoride or Nanosilver fluoride were applied, and all teeth were restored with composite resin restorative. Patients were recalled after 3 and 6 months to follow-up the pulp vitality. R-statistical analysis software for Windows, version 4.1.1, was used to conduct the statistical analysis Results: At 3 month, for all groups, all teeth were successful. After 6 months, for silver diamine fluoride group, a single case failed. Regarding the nanosilver fluoride, all cases were successful. For the control group, two cases failed. No statistically significant difference was found between the tested groups. Conclusion: Application of 5% Nanosilver to fluoride varnish has similar clinical efficacy as silver diamine fluoride in arresting the dentin caries progression (AU)

Objetivo: Avaliar a eficácia de fluoreto de nanoprata em comparação ao fluoreto de diamina de prata no manejo de lesões profundas de cárie. Material e Métodos: Este estudo clínico controlado randomizado duplo-cego incluiu trinta e seis pacientes com lesões de cárie profunda em molares inferiores. Os pacientes foram recrutados no ambulatório da Universidade do Canal de Suez, no Egito, e alocados aleatoriamente em três grupos de tratamento: fluoreto de nanoprata, fluoreto de diamina de prata e grupo controle. Para todos os grupos, os dentes foram submetidos ao isolamento absoluto. O acesso à lesão foi feito seguido pela remoção parcial de tecido cariado. Tanto o fluoreto de diamina quanto fluoreto de nanoprata foram aplicados, e todos os dentes foram restaurados com resina composta. Os pacientes foram avaliados após 3 e 6 meses para o acompanhamento da vitalidade pulpar. O software estatístico R-statistical para Windows, versão 4.1.1, foi usado para as análises. Resultados: Em 3 meses, para todos os grupos, todos os dentes apresentaram sucesso no tratamento. Após 6 meses, para o grupo que utilizou o fluoreto de diamina de prata um único caso falhou. Em relação ao fluoreto de nanoprata, todos os casos apresentaram sucesso. Para o grupo controle, dois casos falharam. Não houve diferença estatística entre os grupos testados. Conclusão: A aplicação de verniz de fluoreto de nanoprata a 5% tem eficácia clínica semelhante ao fluoreto de diamina de prata na interrupção da progressão de cárie no tecido dentinário (AU)

Antibiotic indication in endodontics by Colombian dentists with different levels of training: a survey / Indicação dos antibióticos em Endodontia por dentistas colombianos com diferentes níveis de formação: uma pesquisa por questionário

ABSTRACT Aim: This study investigated how Colombian dentists with different academic levels indicate antibiotics with therapeutic purposes in endodontics. Materials and method: A cross-sectional survey was conducted among 559 dentists in the form of an online questionnaire. Results: Three hundred and twenty questionnaires were answered (57.2%). There were significant differences among respondents. For irreversible pulpitis, 140 dentists (43.7%) said they prescribe antibiotics (57.5% of general practitioners, 20.1% of specialists and 38.9% of those with Master's and/or PhD degrees), while for symptomatic apical periodontitis, 183 (57.2%) did so (74.1% of general practitioners, 28.4% of specialists and 50.0% of those with Master's and/or PhD degrees) (p < 0.05). Amoxicillin was the most frequently prescribed antibiotic, and its association with clavulanic acid was the most often cited for acute periradicular abscess with systemic involvement. Conclusions: The greatest misunderstandings in prescribing antibiotics occurred among general practitioners. Considering all clinical conditions that do not require antibiotics, 60% of general practitioners and 34% of specialists, on average, indicated antibiotics.

RESUMO Objetivo: Este estudo investigou como dentistas colombianos com diferentes níveis acadêmicos indicaram antibióticos com fins terapêuticos em Endodontia. Materiais e método: Realizou-se um levantamento transversal com 559 dentistas. Foi enviado um questionário online. Resultados: Foram respondidos 320 questionários (57,2%). Houve diferenças significativas entre os profissionais com diferentes níveis de formação. Para pulpite irreversível, 140 (43,7%) dentistas afirmaram indicar antibióticos (57,5% clínicos gerais, 20,1% especialistas e 38,9% com mestrado e/ou doutorado), enquanto para periodontite apical sintomática, 183 (57,2%) prescrevem estes medicamentos (74,1% clínicos, 28,4% especialistas e 50,0% com mestrado e doutorado) (p < 0,05). A amoxicilina foi a mais indicada entre os profissionais, e sua associação com ácido clavulânico foi a mais referida para abscesso perirradicular agudo com acometimento sistêmico. Conclusões: Os maiores equívocos na prescrição de antibióticos ocorreram com os clínicos gerais. Considerando todas as condições clínicas que não requerem antibióticos, 60% dos clínicos gerais e 34% dos especialistas, em média, indicaram estes medicamentos.

Dental Pulp Fibroblast: A Star Cell.

INTRODUCTION: Dental pulp fibroblasts (DPFs) are the most abundant cell type in the dental pulp. They play pivotal roles; however, they are often mistaken to be involved only in the repair and maintenance of this connective tissue. METHODS: We used the search terms "pulp fibroblast," "complement system proteins," "pulp inflammation," "angiogenesis," and "dentin pulp regeneration" to identify articles from the PubMed and Scopus databases. RESULTS: These sentinel cells produce all complement system proteins participating in defense processes, control of inflammation, and dentin-pulp regeneration; produce several proinflammatory cytokines and chemokines and express pattern-recognition receptors, demonstrating their involvement in immunoregulatory mechanisms; express neuropeptides and their receptors, playing an important role in neurogenic inflammation and dental pulp wound healing; secrete angiogenic growth factors as well as neurotrophic proteins, essential for dentin-pulp regeneration; regulate neuronal plasticity processes; and can sense the external environment. CONCLUSIONS: This review highlights that DPFs are more than mere passive cells in pulp biology and presents an integrative analysis of their roles and functions.

Comparative evaluation of dental pulp tests in pulpal status diagnostics / Evaluación comparativa de pruebas de pulpa dental en el diagnóstico del estado pulpar

Introduction: The purpose of this study was to evaluate the effectiveness and compare the accuracy of pulp tests in the diagnosis of teeth pulpal health. Material and Methods: Traumatized (n=71) and non-traumatized (n=71) teeth from 42 patients were evaluated. Each tooth underwent cold, heat, electric and oximetry tests, followed by radiographic examination and calculation of the sensitivity, specificity, PPV, NPV and accuracy. Results: Clinical and radiographic examination showed no alteration for the 71 teeth from the intact contralateral group. From the traumatized group, 29 teeth presented complete endodontic treatment, 17 presented periapical alterations that required endodontic treatment and 25 teeth did not present conclusive radiographic alteration. The cold test showed a significantly higher proportion of correct results, while the electric test showed a significantly lower proportion. The data showed higher accuracy for the cold, followed by oximeter and heat tests, while the electric test presented the lowest accuracy. Cold and oximeter tests proved superior over the electric and heat tests, while the electric test showed better parameters when diagnosing diseased pulp. Conclusion: Combining two pulp tests seems reasonable for improving the pulp diagnoses using both oximeter and cold or oximeter and heat tests to detect healthy pulp; or cold and electric tests to define diseased pulp.

Introducción: El propósito de este estudio fue evaluar la efectividad y comparar la precisión de las pruebas pulpares en el diagnóstico de la salud pulpar de los dientes. Material y Métodos: Se evaluaron dientes traumatizados (n=71) y no traumatizados (n=71) de 42 pacientes. Cada diente se sometió a pruebas de frío, calor, eléctricas y de oximetría, seguidas de examen radiográfico y cálculo de la sensibilidad, especificidad, VPP, VPN y precisión. Resultados: El examen clínico y radiográfico no mostró alteración en los 71 dientes del grupo contralateral intacto. Del grupo traumatizado, 29 dientes presentaron tratamiento endodóntico completo, 17 presentaron alteraciones peri-apicales que requirieron tratamiento endodóntico y 25 dientes no presentaron alteración radiográfica concluyente. La prueba en frío mostró una proporción significativamente mayor de resultados correctos, mientras que la prueba eléctrica mostró una proporción significativamente menor. Los datos mostraron mayor precisión para la prueba de frío, seguida de las pruebas de oxímetro y calor, mientras que la prueba eléctrica presentó la menor precisión. Las pruebas de frío y oxímetro demostraron ser superiores a las pruebas eléctricas y de calor, mientras que la prueba eléctrica mostró mejores parámetros al momento de diagnosticar pulpa enferma. Conclusión: La combinación de dos pruebas pulpares parece razonable para mejorar los diagnósticos pulpares utilizando tanto el oxímetro como las pruebas de frío u oxímetro y calor para detectar una pulpa sana; o pruebas de frío y eléctricas para definir pulpa enferma.

Adipokines in dental pulp: Physiological, pathological, and potential therapeutic roles.

BACKGROUND: Hundreds of adipokines have been identified, and their extensive range of endocrine functions-regulating distant organs such as oral tissues-and local autocrine/paracrine roles have been studied. In dentistry, however, adipokines are poorly known proteins in the dental pulp; few of them have been studied despite their large number. This study reviews recent advances in the investigation of dental-pulp adipokines, with an emphasis on their roles in inflammatory processes and their potential therapeutic applications. HIGHLIGHTS: The most recently identified adipokines in dental pulp include leptin, adiponectin, resistin, ghrelin, oncostatin, chemerin, and visfatin. They have numerous physiological and pathological functions in the pulp tissue: they are closely related to pulp inflammatory mechanisms and actively participate in cell differentiation, mineralization, angiogenesis, and immune-system modulation. CONCLUSION: Adipokines have potential clinical applications in regenerative endodontics and as biomarkers or targets for the pharmacological management of inflammatory and degenerative processes in dental pulp. A promising direction for the development of new therapies may be the use of agonists/antagonists to modulate the expression of the most studied adipokines.

Antibiotic indication in endodontics by Colombian dentists with different levels of training: a survey.

AIM: This study investigated how Colombian dentists with different academic levels indicate antibiotics with therapeutic purposes in endodontics. MATERIALS AND METHOD: A cross-sectional survey was conducted among 559 dentists in the form of an online questionnaire. RESULTS: Three hundred and twenty questionnaires were answered (57.2%). There were significant differences among respondents. For irreversible pulpitis, 140 dentists (43.7%) said they prescribe antibiotics (57.5% of general practitioners, 20.1% of specialists and 38.9% of those with Master's and/or PhD degrees), while for symptomatic apical periodontitis, 183 (57.2%) did so (74.1% of general practitioners, 28.4% of specialists and 50.0% of those with Master's and/or PhD degrees) (p<0.05). Amoxicillin was the most frequently prescribed antibiotic, and its association with clavulanic acid was the most often cited for acute periradicular abscess with systemic involvement. CONCLUSIONS: The greatest misunderstandings in prescribing antibiotics occurred among general practitioners. Considering all clinical conditions that do not require antibiotics, 60% of general practitioners and 34% of specialists, on average, indicated antibiotics.

OBJETIVO: Este estudo investigou como dentistas colombianos com diferentes níveis acadêmicos indicaram antibióticos com fins terapêuticos em Endodontia. Materiais e método: Realizou-se um levantamento transversal com 559 dentistas. Foi enviado um questionário online. RESULTADOS: Foram respondidos 320 questionários (57,2%). Houve diferenças significativas entre os profissionais com diferentes níveis de formação. Para pulpite irreversível, 140 (43,7%) dentistas afirmaram indicar antibióticos (57,5% clínicos gerais, 20,1% especialistas e 38,9% com mestrado e/ou doutorado), enquanto para periodontite apical sintomática, 183 (57,2%) prescrevem estes medicamentos (74,1% clínicos, 28,4% especialistas e 50,0% com mestrado e doutorado) (p < 0,05). A amoxicilina foi a mais indicada entre os profissionais, e sua associação com ácido clavulânico foi a mais referida para abscesso perirradicular agudo com acometimento sistêmico. Conclusões: Os maiores equívocos na prescrição de antibióticos ocorreram com os clínicos gerais. Considerando todas as condições clínicas que não requerem antibióticos, 60% dos clínicos gerais e 34% dos especialistas, em média, indicaram estes medicamentos.

Research progress on metformin in the prevention and treatment for oral diseases / 口腔疾病防治

@#Metformin is currently the first-line drug for the treatment of diabetes. In addition to its hypoglycemic effect, it has also been found to have other potential effects, such as anti-inflammatory, odontogenic differentiation-promoting, osteogenic differentiation-promoting, and antitumor effects. Previous studies have shown that metformin can promote the healing of periapical lesions, and its mechanism may be related to the promotion of osteogenic differentiation and the induction of dental pulp cell differentiation by activation of adenylate-activated protein kinase by dimethyldiphosphate. Clinical indexes, such as the probing depth, attachment loss level and probing bleeding index, were significantly improved in patients with periodontitis treated with metformin, which may play a role in the prevention and treatment of periodontal disease by promoting the proliferation, migration and osteogenic differentiation of periodontal ligament stem cells. Metformin has been proven to inhibit the growth and proliferation of tumor cells and plays an important role in the prevention and treatment of oral tumors such as oral squamous cell carcinoma. At present, research remains in the in vitro and animal experimental stage, and the related mechanism needs to be further explored. Clinical trials remain in the evaluation of clinical indicators, so large-scale, long-term, multicenter, randomized controlled clinical trials need to be further developed

Research progress on nano-calcium phosphate modified dental materials for the prevention and treatment of dental pulp diseases / 口腔疾病防治

@#Nanomaterials usually refer to tiny particles with a diameter of 1-100 nm, which often have unique physicochemical properties and are one of the main areas of research interest for development of dental biomaterials. Nano-calcium phosphate modified dental materials have been widely used in pit and fissure sealing, dental resin restoration, tooth adhesion, and root canal sealing. The current research shows that the dental material modified by nano-calcium phosphate has stronger mechanical properties and shows long-term calcium and phosphorus ion release and excellent ion recharging ability, which can promote the remineralization of tooth hard tissue and has good prospects for application. However, it is difficult to accurately simulate the complex environment of the oral cavity. Therefore, the biocompatibility, cytotoxicity and effect of clinical application of nano-calcium phosphate modified dental materials still needs further study. This review summarizes and discusses the recent research progress regarding nano-calcium phosphate modified dental materials in the prevention and treatment of dental pulp diseases.

Impacto de la hipertensión arterial sobre la microcirculación pulpar / Impact of arterial hypertension on pulp microcirculation

Resumen Introducción: La hipertensión arterial, es una enfermedad crónica, la cual es considerada un problema de salud pública en todo el mundo. Se conoce que es causada por distintos mecanismos fisiopatológicos. De la misma forma las alteraciones pulpares son muy comunes, siendo un grupo de cuadros clínicos de origen infeccioso e inflamatorio. Objetivo: El propósito de este artículo es dar a conocer si existe algún impacto de la hipertensión arterial sobre la microcirculación pulpar. Métodos: Revisión de literatura Conclusiones: La pulpa dental no es propensa a alteraciones importantes ante fenómenos antihipertensivos.

Abstract Introduction: Hypertension, is a chronic disease, which is considered a public health problem throughout the world. It is known that it is caused by different physiopathological mechanisms. In the same way, the alterations are very common, as a group of clinical characteristics of infectious and inflammatory origin. Objective: The purpose of this article is to show if there is any impact of high blood pressure on the pulpal microcirculation. Methods: Literature Review Conclusions: The dental pulp does not develop considerable alterations when subjected to antihypertensive phenomena.

Role of CD146 Enrichment in Purification of Stem Cells Derived from Dental Pulp Polyp.

INTRODUCTION: Hyperplastic pulpitis (pulp polyp) tissues contains cells with stem cell properties similar to that of the dental pulp stem cells (DPSCs). It has also been shown that CD146 enrichment can homogenize the cultures of DPSCs and enhance the colony forming potentials of their cultures. This study determines whether CD146 enrichment can help purifying the stem cells from heterogeneous cultures of the pulp polyp derived stem cells (PPSCs). METHODS AND MATERIALS: Healthy dental pulps and pulp polyp tissues were enzymatically digested and the harvested single cells were sorted according to the presence of CD146 marker. The sorted cells were seeded directly for colony forming unit (CFU) assays of the negative and positive portions. Flowcytometric antigen panel and differentiation assays were used to see if these cells conform with mesenchymal stems cells (MSCs) definition. Differences between the between groups was assessed using independent t-test. The level of significance was set at 0.05. RESULTS: Normal pulp tissue derived cells formed higher colonies (42.5±16.8 per 104 cells) than the pulp polyp (17.75±8.9 per 104 cells) (P=0.015). The CD146 positive portion of the polyp derived cells formed an average of 91.5±29.7 per 104 cells per CFU. On the other hand, CD146 negative portion did not show any colonies (P<0.001). Both resources showed cells with flowcytometric antigen panel and differentiation potentials conforming to MSC definition. CONCLUSION: The entire CFU of PPSCs were formed within CD146 enriched portion. It seems that CD146 enrichment may reduce the number of possible fibroblasts of the pulp polyps and may further homogenize the culture of the PPSCs.

Anesthetic effect of compound articaine on children's dental pulp without pain / 中国生化药物杂志

Objective To analyze the anesthetic effect of Compound Articaine on Children's dental pulp without pain, and provide reference for clinical treatment.Methods124 patients with children with dental pulp disease in hospital from February 2015 to May 2016 were selected, patients were randomly divided into observation group and control group, every group with 62 cases.Control group patients were given Lidocaine anesthesia, observation group patients were taken trentment of compound articaine anesthesia, anesthetic effect of patients were compared.Changes in heart rate, blood pressure, adverse effects, and patient pain were recorded before and after anesthesia.ResultsThe total effective rate (96.8%) in the observation group was significantly higher than that in the control group (80.9%) (P<0.05).Observation group (79%) was significantly higher than the control group (1.6%,P<0.05), the observation group of severe pain rate (58.1%) was significantly lower than the control group (11.3%) (P<0.05),The heart rate and blood pressure in the observation group were no significant change, In the control group, the diastolic blood pressure (71.7±10.8) mmHg was significantly lower in the observation group (74.5±12.8) mmHg and the heart rate (80.2±8.8)/min was significantly higher than that in the observation group (76.2±8.3).Two groups of patients in the treatment of adverse reactions, including tachycardia, dizziness, headache, observation group of adverse reaction rate and the control group was not significantly different.ConclusionCompound articaine anesthesia was the implementation of children's dental painless treatment, can reduce the pain of patients, maintain the blood pressure and heart rate stable, has the use value.

Clinical analysis of calcium hydroxide in the treatment of dental pulp diseases / 中国生化药物杂志

Objective To investigate the clinical effect of calcium hydroxide in the treatment of dental pulp diseases. Methods The control group in the treatment of the conventional mummification agent, the study group used calcium hydroxide in the treatment process, compared the two groups of clinical curative effect, dental pulp disease patients the incidence of adverse reactions. Results The study group of dental pulp disease in patients with clinical total efficiency up to 92.00％, the control group of dental pulp disease in patients with clinical total effective rate was only 72.00％, the difference between the two groups was statistically significant(P<0.05).After the treatment of different measures, the incidence of adverse reactions in the study group (8.00％) was significantly lower than that in the control group(28.00％), the difference between the two groups was statistically significant (P<0.05). Conclusion The use of calcium hydroxide in the treatment of patients with dental pulp disease can significantly improve the clinical efficacy, and help to protect the quality of life of patients, physical and mental health.

Impacto de la hipertensión arterial sobre la microcirculación pulpar

Introducción: La hipertensión arterial, es una enfermedad crónica, la cual es considerada un problema de salud pública en todo el mundo. Se conoce que es causada por distintos mecanismos fisiopatológicos. De la misma forma las alteraciones pulpares son muy comunes, siendo un grupo de cuadros clínicos de origen infeccioso e inflamatorio. Objetivo: El propósito de este artículo es dar a conocer si existe algún impacto de la hipertensión arterial sobre la microcirculación pulpar. Métodos: Revisión de literatura Conclusiones: La pulpa dental no es propensa a alteraciones importantes ante fenómenos antihipertensivos.

Introduction: Hypertension, is a chronic disease, which is considered a public health problem throughout the world. It is known that it is caused by different physiopathological mechanisms. In the same way, the alterations are very common, as a group of clinical characteristics of infectious and inflammatory origin. Objective: The purpose of this article is to show if there is any impact of high blood pressure on the pulpal microcirculation. Methods: Literature Review Conclusions: The dental pulp does not develop considerable alterations when subjected to antihypertensive phenomena.

Minocycline hydrochloride slow-release antibacterial ointment in the treatment of combined periodontal-endodontic lesions / 中国组织工程研究

BACKGROUND:The role of minocycline hydrochloride in adjuvant therapy of chronic periodontitis and periodontal abscess has been widely reported, but detailed study of minocycline hydrochloride for combined periodontal-endodontic lesions is rare at present. OBJECTIVE:To investigate the effect of minocycline hydrochloride in the treatment of combined periodontal-endodontic lesions. METHODS:A total of 68 teeth with combined periodontal-endodontic lesions were treated with periodontal mechanical treatment and root canal therapy. According to the patient’s wiling, 68 patients were divided into experimental group (n=24; local injection of minocycline hydrochloride after periodontal mechanical treatment), positive control group (n=24; local injection of iodine glycerol after periodontal mechanical treatment), and negative control group (n=20; no injection after periodontal mechanical treatment). These three groups were reviewed 1 month after periodontal mechanical treatment, and the differences before and after treatment were compared, including periodontal probing depth, attachment loss and gingival bleeding index. RESULTS AND CONCLUSION: Probing depth, attachment loss and gingival bleeding index in three groups were significantly improved after 1 month of periodontal mechanical treatment (P sulcus bleeding index in experimental group and positive control group were better than that of the negative control group (P of positive control group (P periodontal-endodontic lesions, in addition to periodontal mechanical treatment and root canal therapy, local application of minocycline hydrochloride can effectively reduce the depth of periodontal pocket, improve gingival inflammatory conditions and consolidate curative effect.

Treatment of pulps in teeth affected by deep caries - A systematic review of the literature.

BACKGROUND: This systematic review assesses the effect of methods commonly used to manage the pulp in cases of deep caries lesions, and the extent the pulp chamber remains uninfected and does not cause pulpal or periapical inflammatory lesions and associated tooth-ache over time. STUDY DESIGN: An electronic literature search included the databases PubMed, EMBASE, The Cochrane Central Register of Controlled Trials and Cochrane Reviews from January 1950 to March 2013. In addition, hand searches were carried out. Two reviewers independently evaluated abstracts and full-text articles. An article was read in full if at least one of the two reviewers considered the abstract potentially relevant. Altogether, 161 articles were read in full text. Of these, 24 studies fulfilled established inclusion criteria. Based on studies of at least moderate quality, the quality of evidence of each procedure was rated in four levels according to GRADE. RESULTS: No study reached the high quality level. Twelve were of moderate quality. The overall evidence was insufficient to assess which of indirect pulp capping, stepwise excavation, direct excavation and pulp capping/partial pulpotomy, pulpotomy or pulpectomy is the most effective treatment approach for teeth with deep caries. CONCLUSIONS: Because of the lack of good studies it is not possible to determine whether an injured pulp by deep caries can be maintained or whether it should be removed and replaced with a root canal filling. Both randomized studies and prospective observational studies are needed to investigate whether a pulp exposed to deep caries is best treated by measures intended to preserve it or by pulpectomy and root filling.

Study on 2 years follow-up clinical effects in periodontal endodontic lesion in treatment with Vitapex / 重庆医学

Objective To analysis 2 years follow-up clinical effects in endodontic lesion combined periodontal in treatment with Vitapex .Methods 112 patients with periodontal endodontic lesion combined periodontal were randomly divided into control group (56 cases ,75 teeth) and study group(56 cases ,77 teeth) .Treatment of Zinc oxide glycerin paste combined with gutta percha filling root canal was used in control group ,while Vitapex combined with gutta percha filling root canal was used in study group .After 2 years ,the clinical data of the two groups were analysed .Results The total effective rate of anterior and posterior in study group were significant higher than in control group(P<0 .05) .The total effective rate of of I type ,II type and III type lesions in study group were higher than in control group(P<0 .05) .Conclusion Treatment of Vitapex combined with gutta percha filling root canal in endodontic lesion combined periodontal has better clinical effectiveness to promote periapical and periodontal tissue healing than control group .