Can instrumentation kinematics affect postoperative pain and substance P levels? A randomized controlled trial.

BACKGROUND: This study aimed to assess the influence of continuous rotation and reciprocation kinematics on postoperative pain (POP) levels and substance P (SP) levels in patients diagnosed with irreversible pulpitis and symptomatic apical periodontitis (SAP). MATERIALS AND SUBJECTS: A total of twenty patients were randomly assigned into two groups: Continuous Rotation Group (CRG) (n = 10), subjected to mechanical preparation with the EdgeEndox7 rotary system (Albuquerque, NM, USA), and Reciprocation Group (RG) (n = 10), treated with the EdgeOne Fire reciprocating system (Albuquerque, NM, USA). Apical fluid (AF) samples were collected, and SP levels were quantified through radioimmunoassay. POP was assessed using the Numerical Rating Scale (NRS) at various time intervals (preoperatively, 6 h, 12 h, 24 h, 48 h, and 72 h). Data were statistically analyzed utilizing the independent t-test, Mann-Whitney U test, Friedman's test, and Nemenyi post hoc test. RESULTS: There was a significant increase in SP levels in the reciprocating group compared to the continuous rotation group (P ≤ 0.05). Additionally, patients in the reciprocating group reported significantly higher POP levels (P ≤ 0.05) at all measured intervals (6 h, 12 h, 24 h, and 48 h), with both groups exhibiting similar pain level reductions at the 72-hour mark. CONCLUSION: Our findings suggest that continuous rotation kinematics in root canal preparation leads to a considerable reduction in SP expression and POP. TRIAL REGISTRATION: The study protocol was retrospectively registered on the www. CLINICALTRIALS: gov database (NCT06081335) at (13/10/2023) after the approval of the Ethics Committee, Faculty of Dentistry, Ain Shams University (FDASU-RecIM012135).

Effects of histone acetyltransferase (HAT) and histone deacetylase (HDAC) inhibitors on proliferative, differentiative, and regenerative functions of Toll-like receptor 2 (TLR-2)-stimulated human dental pulp cells (hDPCs).

OBJECTIVES: This in vitro study aimed to modify TLR-2-mediated effects on the paracrine, proliferative, and differentiation potentials of human dental pulp-derived cells using histone acetyltransferase (HAT) and histone deacetylase (HDAC) inhibitors. MATERIALS AND METHODS: Cell viability was assessed using the XTT assay. Cells were either treated with 10 µg/ml Pam3CSK4 only, or pre-treated with valproic acid (VPA) (3 mM), trichostatin A (TSA) (3 µM), and MG-149 (3 µM) for a total of 4 h and 24 h. Control groups included unstimulated cells and cells incubated with inhibitors solvents only. Transcript levels for NANOG, OCT3-4, FGF-1 and 2, NGF, VEGF, COL-1A1, TLR-2, hßD-2 and 3, BMP-2, DSPP, and ALP were assessed through qPCR. RESULTS: After 24 h, TSA pre-treatment significantly upregulated the defensins and maintained the elevated pro-inflammatory cytokines, but significantly reduced healing and differentiation genes. VPA significantly upregulated the pro-inflammatory cytokine levels, while MG-149 significantly downregulated them. Pluripotency genes were not significantly affected by any regimen. CONCLUSIONS: At the attempted concentrations, TSA upregulated the defensins gene expression levels, and MG-149 exerted a remarkable anti-inflammatory effect; therefore, they could favorably impact the immunological profile of hDPCs. CLINICAL RELEVANCE: Targeting hDPC nuclear function could be a promising option in the scope of the biological management of inflammatory pulp diseases.

Investigation of the regenerative potential of necrotic mature teeth following different revascularisation protocols.

This study aimed to assess the revascularisation potential of necrotic mature teeth in a dog model following different protocols. Periapical infection was induced in 54 mature premolars. Teeth were distributed into seven groups: (1) Double-antibiotic-paste/Blood clot, (2) Ciprofloxacin/collagen, (3) Double-antibiotic-paste/Collagen, (4) Modified Tri-antibiotic-paste /collagen, (5) Ciprofloxacin/Gelfoam, (6) Double-antibiotic-paste/Gelfoam, and (7) Modified Triantibiotic- paste/Gelfoam. Positive and negative controls included infected and healthy teeth, respectively, (n = 12 roots/group). Canals were apically shaped to size 0.6 mm then disinfected for 1 month. Intra-canal bleeding was induced then scaffolds were applied for another month. Teeth and supporting bone were surgically sampled. Tissues were histologically scored and vimentin immuno-intensity was estimated. Ciprofloxacin and Double-antibiotic paste/Collagen resulted in significantly better corono-apical tissue ingrowths, vascularity, cementum formation and significantly lower inflammatory extents (P < 0.05).These groups also showed significantly higher Vimentin intensities, (P < 0.05). The applied protocols revascularised necrotic mature canals and reduced inflammation particularly in the Ciprofloxacin/collagen and Double-antibiotic-paste/collagen groups.

Dentin wettability enhancement for three irrigating solutions and their effect on push out bond strength of gutta percha / AH Plus.

BACKGROUND: The aim of this study was to investigate the effect of wettability enhancement for 17% EDTA, 2.5% sodium hypochlorite and 7% maleic acid solutions on push out bond strength of gutta percha /AH Plus to root dentin. MATERIAL AND METHODS: One hundred and eight extracted single rooted human lower premolars were instrumented up to Protaper Universal F5 then irrigated with 3ml of 2.5% NaOCl after each file. Irrigants were prepared and a pilot study for determination of Tween 80 concentration yielding the lowest surface tension value in every solution was conducted. Samples were randomly divided into a control group and two experimental groups (17% EDTA and 7% Maleate), further split into eight subgroups (n=12), according to Tween 80 implementation sequence. Roots were obturated using gutta percha and AH plus by lateral condensation. Bond strength was measured by push out test. Mode of failure was then evaluated quantitatively by stereomicroscopy. Data were statistically analyzed using one way ANOVA followed by Tukey-Kramer for multiple comparisons. RESULTS: Control group showed the lowest values. Maleic acid subgroups showed significantly higher overall values than EDTA subgroups (P<0.05). Protocols implementing surfactant containing NaOCl showed significantly lower values than plain counterparts. Failure pattern was predominantly cohesive for plain regimens and the ones implementing Tween 80 in maleic acid solutions with plain NaOCl. CONCLUSIONS: Tween 80 addition to demineralizing irrigants increased the bond strength values. Surfactant containing NaOCl solutions yielded lower bond strength than plain ones. Key words:Wettability enhancement for three irrigants vs. corresponding gutta percha/AH Plus bonding.