Phase transformation behavior and mechanical properties of HyFlex EDM nickel-titanium endodontic rotary instrument: Evaluation at body temperature.

Background/purpose: Temperature-dependent phase compositional changes influence the mechanical properties of heat-treated nickel-titanium (NiTi) rotary instruments. This study evaluated the phase composition, bending properties, and cyclic fatigue resistance of HyFlex EDM NiTi rotary instruments against differently heat-treated and non-heat-treated NiTi instruments at body temperature (BT). Materials and methods: HyFlex EDM OneFile (EDM) instruments, heat-treated HyFlex CM (CM) and Twisted File (TF) instruments, and non-heat-treated K3 instruments (size #25/.08) were subjected to differential scanning calorimetry, and the martensitic, R-phase, and reverse transformation starting and finishing temperatures were determined. A cantilever bending test and a cyclic fatigue test were conducted at BT (37 °C ± 1.0 °C), and the bending load and number of cycles to failure (NCF) were recorded. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U tests (α = 0.05). Results: TF and K3 had reverse transformation finishing temperatures lower than BT, while those for EDM and CM were higher than BT. The bending loads at a 0.5 mm deflection were in the order of EDM < TF < CM < K3 (P < 0.05), and those at a 2.0 mm deflection were EDM < CM and TF < K3 (P < 0.05). EDM had the highest NCF among the four instruments (P < 0.05). Conclusion: The EDM instrument had a reverse transformation finishing temperature higher than BT indicating its martensite/R-phase composition at BT. The EDM instrument had superior flexibility and greater resistance to cyclic fatigue than the CM, TF, and K3 instruments at BT.

Effect of preset torque setting on torque/force generation, shaping ability and surface changes of nickel titanium rotary instrument in different root canal curvature locations: An ex vivo study.

The aim of this study was to evaluate how preset torque settings influence the torque, vertical force, and root canal-centering ability of ProGlider and ProTaper NEXT nickel-titanium rotary instruments in canals with different curvature locations. Based on micro-computed tomography, mesial roots of human mandibular molars (25°-40° curvature) were allocated to the apical curvature (apical 1-5 mm) or the middle curvature (apical 5-9 mm) groups, and mandibular incisors (curvature <5°) to the straight canal group. Each group was subjected to automated instrumentation and torque/force measurement with the preset torque of 1, 2.5, or 5 N•cm. Canal-centering ratios were determined with micro-computed tomography. Instrument fracture occurred only in the 2.5 and 5 N•cm groups in curved canals. The preset torque setting and curvature location did not influence canal shaping ability.

Correction: Han et al. MicroRNA-146b-5p Suppresses Pro-Inflammatory Mediator Synthesis via Targeting TRAF6, IRAK1, and RELA in Lipopolysaccharide-Stimulated Human Dental Pulp Cells. Int. J. Mol. Sci. 2023, 24, 7433.

In the original publication, there was a mistake in Figure 4J,K as published [...].

Improvement of the setting properties of mineral trioxide aggregate cements using cellulose nanofibrils.

Cellulose nanofibrils (CNFs) exhibit excellent mechanical properties and are used to reinforce various composites. The effects of incorporating CNFs into commercial mineral trioxide aggregate (MTA) cements (NEX MTA (NEX) and ProRoot® MTA (PR)) on the underwater setting properties, compressive strength, and flowability were estimated in this study. NEX mixed without CNFs disintegrated after water immersion. NEX mixed with CNF-suspended solutions showed good setting properties under water immersion and a similar compressive strength, which was kept in air (100% relative humidity). PR did not degrade after water immersion, regardless of the presence of CNFs, and no significant difference in the compressive strength caused by CNFs incorporation was detected. The relative flowability of the NEX mixture decreased with increasing CNFs content up to 1.0 w/v%. The application of CNF-incorporated MTA in various dental cases is promising because CNFs prevent the water-immersion-dependent collapse of some MTA cements immediately after mixing.

Phase transformation and mechanical properties of heat-treated nickel-titanium rotary endodontic instruments at room and body temperatures.

BACKGROUND: The aim of this study was to evaluate the phase composition, phase transformation temperatures, bending property, and cyclic fatigue resistance of different heat-treated nickel-titanium (NiTi) rotary instruments with the same tip diameter and taper at room (RT; 25 ± 1 °C) and body (BT; 37 ± 1 °C) temperatures. METHODS: Five heat-treated NiTi rotary instruments, HyFlex EDM (EDM), HyFlex CM (CM), Vortex Blue (VB), RE file CT (RE) and JIZAI, and a non-heat-treated NiTi rotary instrument (Mtwo) with a size 40, 0.04 taper were investigated. Temperature-dependent phase transformation was examined with differential scanning calorimetry (DSC). The bending loads of the instruments at RT and BT were evaluated using a cantilever-bending test. Cyclic fatigue resistance at RT and BT was measured using a dynamic test, during which the instruments were rotated in combination with a 2-mm back-and-forth motion in an artificial curved canal, and the number of cycles to failure (NCF) was determined. The results were analyzed using two-way repeated measures analysis of variance, a simple main effect test, and the Bonferroni test (α = 0.05). RESULTS: DSC results indicated that EDM and Mtwo were primarily composed of martensite/R-phase and austenite, respectively, while the other heat-treated instruments were composed of a mix of martensite/R-phase and austenite at the tested temperatures. Regardless of the temperature setting, the bending loads of heat-treated instruments were significantly lower than those of Mtwo (p < 0.05). EDM showed the lowest bending loads and highest NCF at both temperatures (p < 0.05). CM, VB, and JIZAI showed significantly higher bending loads at BT than at RT (p < 0.05). The NCF of all the heat-treated instruments, except VB, was lower at BT than at RT (p < 0.05). At BT, the NCF of CM, VB, RE, and JIZAI were not significantly higher than that of Mtwo (p > 0.05). CONCLUSIONS: Heat-treated NiTi instruments exhibited lower bending loads and higher NCF values than Mtwo. However, this tendency was less pronounced at BT than at RT, especially in the NCF values of instruments with a mixture of martensite/R-phase and austenite phases at the tested temperatures.

Hydraulic calcium silicate-based root canal sealers mitigate proinflammatory cytokine synthesis and promote osteogenesis in vitro.

Background/purpose: The mineralized tissue-inductive ability and anti-inflammatory properties of hydraulic calcium silicate-based (HCSB) sealers have not been fully elucidated. This study aimed to evaluate the effects of the HCSB sealers Bio-C sealer (BioC), Well-Root ST (WST), and EndoSequence BC sealer (BC), on osteoblastic differentiation/mineralization and proinflammatory cytokine synthesis by macrophages. Materials and methods: Diluted extracts of set sealers or calcium chloride solutions of approximately equivalent Ca2+ concentrations were applied to a mouse osteoblastic cell line (Kusa-A1 cells) and lipopolysaccharide-stimulated mouse macrophage cell line (RAW264.7 cells). Expressions of osteoblastic markers in Kusa-A1 cells and proinflammatory cytokines in RAW264.7 cells were evaluated by reverse transcription-quantitative polymerase chain reaction and enzyme-linked immunosorbent assays. Mineralized nodules were detected by Alizarin red S staining. Cell proliferation was assessed by WST-8 assay and cell attachment on set sealers was examined by scanning electron microscopy. Results: The three sealer extracts significantly upregulated osteocalcin and osteopontin mRNA, and promoted significant mineralized nodule formation in Kusa-A1 cells. The three sealer extracts significantly downregulated the mRNA expressions of interleukin (IL)-1α, IL-1ß, IL-6, and tumor necrosis factor (TNF)-α and protein levels of IL-6 and TNF-α in RAW264.7 cells. Calcium chloride solutions induced osteoblastic differentiation/mineralization. AH Plus Jet (a control sealer) extract did not. The three HCSB sealers did not interfere with the growth and attachment of Kusa-A1 cells. Conclusion: BioC, WST, and BC were biocompatible, upregulated osteoblastic differentiation/mineralization, and downregulated proinflammatory cytokine expression. Ca2+ released from HCSB sealers might be involved, at least in part, in the induction of osteoblastic differentiation/mineralization.

Dynamic torque and screw-in force of four different glide path instruments assessed in simulated single- and double-curved canals: An in vitro study.

Background/purpose: The glide path instruments are the introductory instruments into the canals; thus, they should be durable enough to withstand torsional stress/screw-in force. This study aimed to investigate the torque and screw-in force of TruNatomy Glider (TN), ProGLIDER (PG), Hyflex EDM (EDM) and Dent Craft RE (RE) glide path instruments in single- and double-curved canals. Materials and methods: Each instrument brand was divided into two groups (n = 7 each) according to the canal configuration. Torque and screw-in force were recorded during automated instrumentation of simulated resin canals with XSmart IQ cordless motor after the canal patency was checked with a #10 K-file. The values were statistically analyzed using the Kolmogorov-Smirnov test followed by the Kruskal Wallis test and the Mann-Whitney U test with Bonferroni correction (α = 0.05). Results: TN produced significantly higher torque than RE in single-curved canals and PG in double-curved canals (P < 0.05). EDM yielded significantly higher screw-in force than TN and RE in single-curved canals (P < 0.05), but there was no significant difference in double-curved canals (P > 0.05). A significant effect of different canal configurations was only detected for screw-in force in EDM (P < 0.05). Conclusion: TN in single-curved canals and RE in double-curved canals yielded higher torque values, while EDM exhibited greater screw-in force in both canal configurations. No effect of different canal configurations was detected for torque, but a significant impact was detected for screw-in force in EDM.

Autologous concentrated growth factor mediated accelerated bone healing in root-end microsurgery: A multicenter randomized clinical trial.

Introduction: Concentrated growth factor (CGF) is a new-generation autologous platelet concentrate that promotes tissue regeneration and has anti-inflammatory properties. This randomized multicenter trial aimed to evaluate the effects of CGF on bone healing in combination with root-end microsurgery. Methods: Healthy adult patients indicated for root-end microsurgery were randomly assigned to either the CGF or control (no CGF implantation) groups. CGF was implanted into the bone cavity after root-end filling with mineral trioxide aggregate. Clinical and periapical radiographic evaluations were conducted at 1, 3, 6, and 12 months postoperatively, with follow-up cone-beam computed tomography (CBCT) at 6 months. The lesion volume reduction rate was calculated based on data from the preoperative and follow-up CBCT images. Results: A total of 24 patients were enrolled. The treatment success rate was 91.7% and 83.3% on 12-month periapical radiography and 6-month CBCT, respectively, without a significant difference between the two groups. The lesion volume reduction rate in the CGF group (75.6%) was significantly higher than that in the control (61.0%) group. Conclusions: Autologous CGF in conjunction with root-end microsurgery accelerated lesion reduction as observed on CBCT. Administering autologous blood products to stimulate healing in addition to removing the source of infection appears to be a promising treatment option for root-end microsurgery.

Comparison of vapor bubble kinetics and cleaning efficacy of different root canal irrigation techniques in the apical area beyond the fractured instrument.

Background/purpose: Intracanal fractured instruments hamper adequate root canal disinfection. The aim of this study was to evaluate vapor bubble kinetics and cleaning efficacy of different irrigation techniques in the apical area beyond the fractured instrument. Materials and methods: Sixty curved root canal models, in which a 3-mm fragment of a #20 K-file or a WaveOne Gold Primary (WOG) instrument was intentionally separated at 3 mm from the apical foramen, were irrigated with laser-activated irrigation with photon-induced photoacoustic streaming (LAI-PIPS; 20 mJ/15 Hz), laser-activated irrigation using an Er:YAG laser unit (LAI; 30 mJ/20 Hz), or ultrasonic-activated irrigation (UAI) for 5 s. Vapor bubble velocity and counts were analyzed using high-speed video imaging. To evaluate canal wall cleanliness, 40 canals of extracted human teeth with an intentionally separated 3-mm WOG fragment in the canal at 3 mm from the apical foramen were irrigated with LAI-PIPS, LAI, UAI or conventional syringe irrigation, using 17% EDTA (30 s, two cycles), saline (30 s), and 3% NaOCl (30 s, three cycles) as irrigants. Debris and smear layer on the apical canal wall beyond the fractured instrument were scored using scanning electron microscopy. Results: LAI-PIPS and LAI demonstrated higher vapor bubble counts than UAI. The WOG fragment permitted higher bubble velocity and count than the K-file fragment. LAI-PIPS and LAI showed better debris and smear removal than the other techniques. Conclusion: LAI and LAI-PIPS demonstrated higher vaporized bubble kinetics and better cleaning efficacy in the apical area, even in the presence of a fractured instrument.

Influence of different kinematics on stationary and dynamic torsional behavior of JIZAI nickel-titanium rotary instruments: An in vitro study.

Background/purpose: Using conventional approach to examine stationary torque of nickel-titanium rotary instruments contradicts the clinical condition, and its validity for motions involving clockwise and counterclockwise rotations is questionable. This study aimed to examine the effect of different kinematics on the torsional behavior using a JIZAI instrument (#25/.04) under stationary/dynamic test conditions using clinical torque limit settings. Materials and methods: In the stationary test, the 5-mm tip of JIZAI was fixed in a cylinder-shaped vise and rotated in continuous rotation (CR) with auto-torque-reverse, optimum-torque-reverse (OTR), or reciprocation (REC) until fracture (n = 10, each). In the dynamic test, straight and severe curved canals were instrumented with JIZAI using the single-length technique with CR, OTR, or REC (n = 10, each). The stationary torque at fracture, time to fracture (Tf), dynamic torque, and screw-in force were recorded using automated-shaping-device with torque/force measuring unit. One-way ANOVA or Kruskal-Wallis test and Mann-Whitney U test with Bonferroni correction were used for statistical analysis (⍺ = 0.05). Results: The kinematics did not influence the stationary or dynamic torques (P > 0.05); however, did influence the screw-in force in straight canals (P < 0.05). REC had significantly longer Tf, and severe curved canals yielded significantly greater torque and screw-in force in CR (P < 0.05). Conclusion: Under the present experimental conditions, parameters other than torque showed significant effects on different kinematics. The dynamic torque and screw-in force of OTR were similar to the other rotational modes and not influenced by the canal curvature.

MicroRNA-146b-5p Suppresses Pro-Inflammatory Mediator Synthesis via Targeting TRAF6, IRAK1, and RELA in Lipopolysaccharide-Stimulated Human Dental Pulp Cells.

MicroRNA-146b-5p (miR-146b-5p) is up-regulated during and to suppress the inflammation process, although mechanisms involved in the action of miR-146b-5p have not been fully elucidated. This study examined the anti-inflammation effects of miR-146b-5p in lipopolysaccharide (LPS)-stimulated human dental pulp cells (hDPCs). An increase in human miR-146b-5p (hsa-miR-146b-5p) expression following the mRNA expression of pro-inflammatory cytokines was observed in LPS-stimulated hDPCs. The expression of hsa-miR-146b-5p and pro-inflammatory cytokines was down-regulated by a nuclear factor-kappa B (NF-κB) inhibitor, and the expression of hsa-miR-146b-5p was also decreased by a JAK1/2 inhibitor. Enforced expression of hsa-miR-146b-5p abolished phosphorylation of NF-κB p65 and down-regulated the expression of pro-inflammatory cytokines and NF-κB signaling components, such as interleukin-1 receptor-associated kinase 1 (IRAK1), tumor necrosis factor receptor-associated factor 6 (TRAF6), and REL-associated protein involved in NF-κB (RELA). Expression of rat miR-146b-5p (rno-miR-146b-5p) and pro-inflammatory cytokine mRNA was also up-regulated in experimentally-induced rat pulpal inflammation in vivo, and rno-miR-146b-5p blocked the mRNA expression of pro-inflammatory mediators and NF-κB signaling components in LPS-stimulated ex vivo cultured rat incisor pulp tissues. These findings suggest that the synthesis of miR-146b-5p is controlled via an NF-κB/IL6/STAT3 signaling cascade, and in turn, miR-146b-5p down-regulates the expression of pro-inflammatory mediators by targeting TRAF6, IRAK1, and RELA in LPS-stimulated hDPCs.

Prostaglandin E2-Transporting Pathway and Its Roles via EP2/EP4 in Cultured Human Dental Pulp.

INTRODUCTION: Prostaglandin E2 (PGE2) exerts biological actions through its transport pathway involving intracellular synthesis, extracellular transport, and receptor binding. This study aimed to determine the localization of the components of the PGE2-transporting pathway in human dental pulp and explore the relevance of PGE2 receptors (EP2/EP4) to angiogenesis and dentinogenesis. METHODS: Protein localization of microsomal PGE2 (mPGES)synthase, PGE2 transporters (multidrug resistance-associated protein-4 [MRP4] and prostaglandin transporter [PGT]), and EP2/EP4 was analyzed using double immunofluorescence staining. Tooth slices from human third molars were cultured with or without butaprost (EP2 agonist) or rivenprost (EP4 agonist) for 1 week. Morphometric analysis of endothelial cell filopodia was performed to evaluate angiogenesis, and real-time polymerase chain reaction was performed to evaluate angiogenesis and odontoblast differentiation markers. RESULTS: MRP4 and PGT were colocalized with mPGES and EP2/EP4 in odontoblasts and endothelial cells. Furthermore, MRP4 was colocalized with mPGES and EP4 in human leukocyte antigen-DR-expressing dendritic cells. In the tooth slice culture, EP2/EP4 agonists induced significant increases in the number and length of filopodia and mRNA expression of angiogenesis markers (vascular endothelial growth factor and fibroblast growth factor-2) and odontoblast differentiation markers (dentin sialophosphoprotein and collagen type 1). CONCLUSIONS: PGE2-producing enzyme (mPGES), transporters (MRP4 and PGT), and PGE2-specific receptors (EP2/EP4) were immunolocalized in various cellular components of the human dental pulp. EP2/EP4 agonists promoted endothelial cell filopodia generation and upregulated angiogenesis- and odontoblast differentiation-related genes, suggesting that PGE2 binding to EP2/EP4 is associated with angiogenic and dentinogenic responses.

Effect of different axial speed patterns on cyclic fatigue resistance of rotary nickel-titanium instruments.

BACKGROUND: To evaluate the effect of pecking motions with faster upward speed on the dynamic cyclic fatigue resistance of nickel-titanium rotary instruments with different metallurgy. METHODS: Forty each of ProTaper Universal F3 (PTU) and ProTaper Gold F3 (PTG) instruments (size #30/.09) were equally divided into four groups. The test was performed using an 18-mm-long stainless steel artificial canal with a 5-mm radius of curvature, a 45° canal curvature and a 2-mm canal diameter. A downward speed of 100 mm/min was employed, while the upward speed was set at 100, 150, 200 or 300 mm/min. Time to failure (Tf), number of cycles to failure (Nf) and number of pecking motions to failure (Np) were recorded. Statistical analysis was performed using Kruskal Wallis and Mann-Whitney U tests for Tf, Nf, and Np (α = 0.05). RESULTS: The 100/300 mm/min group showed significantly higher Np values than the 100/100 mm/min group (p < 0.05), whereas there were no significant differences in Tf and Nf among the tested speed groups (p < 0.05) in either PTU or PTG. PTG exhibited significantly higher Tf, Nf, and Np than PTU (p < 0.05). CONCLUSIONS: Under the tested conditions, the fastest upward speed group showed significantly higher cyclic fatigue resistance, as demonstrated by larger Np, than the same speed group. PTG had significantly higher cyclic fatigue resistance than PTU in all groups.

Mechanical Properties and Root Canal Shaping Ability of a Nickel-Titanium Rotary System for Minimally Invasive Endodontic Treatment: A Comparative In Vitro Study.

Selection of an appropriate nickel−titanium (NiTi) rotary system is important for minimally invasive endodontic treatment, which aims to preserve as much root canal dentin as possible. This study aimed to evaluate selected mechanical properties and the root canal shaping ability of TruNatomy (TRN), a NiTi rotary system designed for minimally invasive endodontic shaping, in comparison with existing instruments: HyFlex EDM (HEDM), ProTaper Next (PTN), and WaveOne Gold (WOG). Load values measured with a cantilever bending test were ranked as TRN < HEDM < WOG < PTN (p < 0.05). A dynamic cyclic fatigue test revealed that the number of cycles to fracture was ranked as HEDM > WOG > TRN > PTN (p < 0.05). Torque and vertical force generated during instrumentation of J-shaped artificial resin canals were measured using an automated instrumentation device connected to a torque and vertical force measuring system; TRN exhibited smaller torque and vertical force values in most comparisons with the other instruments. The canal centering ratio for TRN was smaller than or comparable to that for the other instruments except for WOG at the apex level. Under the present experimental conditions, TRN showed higher flexibility and lower torque and vertical force values than the other instruments.

Effect of Rotational Modes on Torque/Force Generation and Canal Centering Ability during Rotary Root Canal Instrumentation with Differently Heat-Treated Nickel-Titanium Instruments.

This study aimed to evaluate how various rotational modes influence the torque/force production and shaping ability of ProTaper Universal (PTU; non-heat-treated) and ProTaper Gold (PTG; heat-treated) nickel−titanium instruments. J-shaped resin canals were instrumented with PTU or PTG using an automated instrumentation device operated with reciprocating rotation [150° clockwise and 30° counterclockwise (R150/30) or 240° clockwise and 120° counterclockwise (R240/120)], optimum torque reverse motion (OTR), or continuous rotation (CR) (n = 10 each). Maximum force and torque were recorded, and canal centering ratios were calculated. Statistical analysis was performed with two-way ANOVA and a Bonferroni test (α = 0.05). The results were considered with reference to previous studies on the microstructure of the instruments. The upward force generated by R240/120 and OTR was smaller than that generated by R150/30 and CR in PTG (p < 0.05). The clockwise torque produced by OTR was lower than that produced by R150/30 in PTU and R240/120 and CR in PTG (p < 0.05). R240/120 and OTR induced less canal deviation compared to CR in PTU at 0 mm from the apex (p < 0.05). In conclusion, R240/120 and OTR reduced the screw-in force in PTG and improved the canal centering ability in PTU, which may be associated with the heat treatment-induced microstructural difference of the two instruments.

Biocompatibility and pro-mineralization effect of tristrontium aluminate cement for endodontic use.

Background/purpose: Tristrontium aluminate (S3A) is a hydraulic cement with setting behavior similar to that of mineral trioxide aggregate (MTA). This study examined the biological effects of S3A on mouse dental papilla cells (MDPs) in vitro and on rat exposed pulps in vivo. Materials and methods: Extracts of S3A and MTA were prepared by immersing each cement in ultrapure water. MDPs were cultured with S3A or MTA extracts, and cell proliferation was evaluated with a tetrazolium-salt assay. Attachment of MDPs on the set cements was examined with scanning electron microscopy (SEM). mRNA expression of bone morphogenic protein (Bmp2), osteocalcin (Oc) and osteopontin (Opn) in MDPs exposed to S3A or MTA extracts was determined with reverse transcription-quantitative polymerase chain reaction. Mineralized nodule formation was evaluated with Alizarin Red S staining. Simulated body fluid (SBF)-dipped S3A was examined with SEM and energy dispersive X-ray analysis (EDX). Exposed molar pulps of male Wistar rats capped with S3A or MTA were histologically examined. Results: S3A extract did not inhibit proliferation of MDPs. Set S3A and MTA exhibited attachment of MDPs on their surface. S3A extract showed significantly higher mineralized nodule formation and mRNA expression of Bmp2, Oc, and Opn than did MTA extract. SBF-dipped S3A exhibited formation of surface precipitates, which were composed of Ca, P, Sr, and Al. Direct pulp capping with S3A and with MTA induced mineralized tissue repair of the exposed pulp. Conclusion: S3A possesses biocompatibility and pro-mineralization effects comparable to those of MTA.

Angiogenesis during coronal pulp regeneration using rat dental pulp cells: Neovascularization in rat molars in vivo and proangiogenic dental pulp cell-endothelial cell interactions in vitro.

Background/purpose: Angiogenesis is considered a crucial event for dental pulp regeneration. The purpose of this study was to demonstrate neovascularization during coronal pulp regeneration in rat molars using rat dental pulp cells (rDPCs) and to examine whether rDPC-endothelial cell interactions promote proangiogenic capacity in vitro. Materials and methods: Maxillary first molars of Wistar rats (n = 42) were pulpotomized and rDPCs isolated from incisors were implanted with a porous poly (l-lactic acid) (PLLA) scaffold and hydrogel (Matrigel). After 3, 7, and 14 days, coronal pulp tissues were examined histologically and by nestin and CD146 immunohistochemistry. rDPCs and rat dermal microvascular endothelial cells (rDMECs) were cocultured for 4 days and vascular endothelial growth factor (VEGF) synthesis and angiogenic factor gene expression were determined by enzyme-linked immunosorbent assays and real-time polymerase chain reaction, respectively. Effects of cocultured medium on tube formation by rDMECs were also evaluated. Results: Implantation of rDPC/PLLA/Matrigel induced coronal pulp regeneration with dentin bridge formation and arrangement of nestin-positive odontoblast-like cells at 14 days. PLLA/Matrigel without rDPCs did not induce pulp regeneration. CD146-positive blood vessels increased in density in the remaining pulp tissues at 3 and 7 days, and in the regenerated pulp tissue at 14 days. rDPC/DMEC coculture significantly promoted VEGF secretion and mRNA expression of nuclear factor-kappa B, angiogenic chemokine CXCL1, and chemokine receptor CXCR1. Cocultured medium significantly promoted tube formation. Conclusion: Coronal pulp regeneration with rDPC/PLLA/Matrigel was accompanied by neovascularization. rDPC-rDMEC interactions may promote angiogenic activity represented by proangiogenic factor upregulation and tube formation in vitro.

Effect of Different Downward Loads on Canal Centering Ability, Vertical Force, and Torque Generation during Nickel-Titanium Rotary Instrumentation.

This study aimed to examine how downward loads influence the torque/force and shaping outcome of ProTaper NEXT (PTN) rotary instrumentation. PTN X1, X2, and X3 were used to prepare J-shaped resin canals employing a load-controlled automated instrumentation and torque/force measuring device. Depending on the torque values, the handpiece was programmed to move as follows: up and down; downward at a preset downward load of 1 N, 2 N or 3 N (Group 1N, 2N, and 3N, respectively; each n = 10); or upward. The torque/force values and instrumentation time were recorded, and the canal centering ratio was calculated. The results were analyzed using a two-way or one-way analysis of variance and the Tukey test (α = 0.05). At the apex level, Group 3N exhibited the least canal deviation among the three groups (p < 0.05). The downward force was Group 3N > Group 2N > Group 1N (p < 0.05). The upward force, representing the screw-in force, was Group 3N > Group 1N (p < 0.05). The total instrumentation time was Group 1N > Group 3N (p < 0.05). In conclusion, increasing the downward load during PTN rotary instrumentation improved the canal centering ability, reduced the instrumentation time, and increased the upward force.

Kinetics of LYVE-1-positive M2-like macrophages in developing and repairing dental pulp in vivo and their pro-angiogenic activity in vitro.

Tissue-resident macrophages expressing lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1) are found in multiple tissues and organs. We aimed to evaluate the dynamics and biological functions of LYVE-1+ macrophages in dental pulp during post-injury tissue remodeling. Immunofluorescence staining of mouse embryos revealed that LYVE-1+ macrophages colonized dental pulp before birth. In mature rat molar dental pulp, LYVE-1+ macrophages were the main subset of macrophages expressing CD163, an M2 marker, and were distributed throughout the tissue. In response to dental pulp injury induced by cavity preparation, LYVE-1+ macrophages quickly disappeared from the affected area of the pulp and gradually repopulated during the wound healing process. RAW264.7 mouse macrophages cultured with a mixture of macrophage colony-stimulating factor, interleukin-4, and dexamethasone increased LYVE-1 expression, whereas lipopolysaccharide-stimulation decreased LYVE-1 expression. Enforced expression of Lyve1 in RAW264.7 cells resulted in increased mRNA expression of matrix metalloproteinase 2 (Mmp2), Mmp9, and vascular endothelial growth factor A (Vegfa). Lyve1-expressing macrophages promoted the migration and tube formation of human umbilical vein endothelial cells. In conclusion, LYVE-1+ tissue-resident M2-like macrophages in dental pulp showed dynamism in response to pulp injury, and possibly play an important role in angiogenesis during wound healing and tissue remodeling.

Effect of kinematics on the torque/force generation, surface characteristics, and shaping ability of a nickel-titanium rotary glide path instrument: An ex vivo study.

AIM: To evaluate the effect of various rotational motions on the torque/force generation, surface wear, and shaping ability of the ProGlider glide path instrument (Dentsply Sirona). METHODOLOGY: Mesiobuccal and mesiolingual canals of mandibular molars were selected based on the canal volume, length, angle of curvature (25°-40°), and radius of curvature (4-8 mm) after micro-computed tomographic scanning. The samples were randomly assigned to four groups (n = 13, each) according to movement kinematics [continuous rotation (CR; 300 rpm), optimum torque reverse motion (OTR; 180° forward and 90° reverse when torque >0.4 N cm), time-dependent reciprocal motion (TmR; 180° forward and 90° reverse), and optimal glide path motion (OGP; a combination of 90° forward, 90° reverse, 90° forward, and 120° reverse)]. Instrumentation was performed with an automated root canal instrument and torque/force analysing device. Maximum torque/force values, canal volume changes, and canal-centring ratios at 1, 3, 5, and 7 mm were evaluated. Surface defects (pits, grooves, microcracks, blunt cutting edges, and disruption of cutting edges) and spiral distortion on the ProGlider instrument were scored at the tip and 5 mm short of the tip before and after five consecutive uses with scanning electron microscopy. The Kruskal-Wallis test followed by Dunn's post-test with Bonferroni correction and Wilcoxon signed-rank test were used to analyse the data (α = 0.05). RESULTS: Optimal glide path motion generated significantly less clockwise torque and greater upward force than other groups (p < .05). OGP resulted in significantly fewer surface defects than CR (p < .05). In OGP and CR, the tip exhibited more surface defects than 5 mm short of the tip (p < .05). CR resulted in greater volume changes than OGP and TmR (p < .05) and greater centring ratios (i.e., more deviation) than OGP at 1 mm and OTR at 3 mm (p < .05). CONCLUSIONS: Under laboratory conditions using the ProGlider instrument, OGP generated significantly less clockwise torque and greater upward force than the other rotatory motions. OGP generated fewer superficial defects than CR, and the three modes of reciprocal rotation better maintained the apical curvature of root canals than CR with the ProGlider instrument.