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1.
J Contemp Dent Pract ; 25(4): 392-401, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38956856

RESUMO

AIM: To elucidate the factors that determine the success of direct pulp capping (DPC) in permanent teeth with pulp exposure due to dental caries. MATERIALS AND METHODS: A comprehensive electronic search from 1980 to 2023 across PubMed, Scopus, and ISI Web databases was conducted using specific keywords and MeSH terms in Q1 or Q2 journals. Only prospective/retrospective clinical studies in English on 15 or more human permanent teeth with carious pulpal exposure treated with DPC agents-mineral trioxide aggregate (MTA), Biodentine, or calcium hydroxide with a rubber dam and minimum 1-year follow-up, were considered. The factors retrieved and analyzed were based on study design, patient age, sample size, type of cavity, exposure size and location, pulp diagnosis, solutions to achieve hemostasis, hemostasis time, capping material, restoration type, follow-up period, methods of evaluation, and overall success. REVIEW RESULTS: Out of 680 articles, only 16 articles were selected for the present systematic review on application of the selection criteria. A wide age range of patients from 6 to 88 years were considered among these studies with sample sizes ranging from 15 to 245 teeth with reversible pulpitis being the predominant diagnosis of the cases. Mineral trioxide aggregate as a capping material was evaluated in 4 studies as a lone agent, while compared with other capping agents such as biodentine or calcium hydroxide in 7 studies. The follow-up period ranged from 9 days to nearly 80 months. While both clinical and radiographic evaluation was carried out in all studies, cold testing dominated the clinical tests while IOPR was the common radiograph considered. Mineral trioxide aggregate success rate was higher and similar to biodentine than calcium hydroxide. CONCLUSION: Direct pulp capping has a high and predictable success rate in permanent teeth with carious exposure to reversible and irreversible pulpitis. Currently, mineral trioxide aggregate and biodentine have better long-term results in DPC than calcium hydroxide, hence, they should be used as an alternative to calcium hydroxide. Definitive restoration within a short period improves long-term prognosis. CLINICAL SIGNIFICANCE: The significance of this review lies in its provision of evidence-based information on the effectiveness of DPC and the factors that influence its success. By considering these factors, clinicians can optimize treatment outcomes and improve the long-term prognosis of the treated teeth. This systematic review serves as a valuable resource for clinicians and researchers in the field of endodontics. How to cite this article: Gomez-Sosa JF, Granone-Ricella M, Rosciano-Alvarez M, et al. Determining Factors in the Success of Direct Pulp Capping: A Systematic Review. J Contemp Dent Pract 2024;25(4):392-401.


Assuntos
Compostos de Cálcio , Cárie Dentária , Capeamento da Polpa Dentária , Humanos , Capeamento da Polpa Dentária/métodos , Cárie Dentária/terapia , Compostos de Cálcio/uso terapêutico , Silicatos/uso terapêutico , Hidróxido de Cálcio/uso terapêutico , Agentes de Capeamento da Polpa Dentária e Pulpectomia/uso terapêutico , Óxidos/uso terapêutico , Compostos de Alumínio/uso terapêutico , Combinação de Medicamentos , Resultado do Tratamento , Exposição da Polpa Dentária/terapia
2.
Int J Nanomedicine ; 19: 6659-6676, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38975320

RESUMO

Background: Vital pulp therapy (VPT) is considered a conservative treatment for preserving pulp viability in caries and trauma-induced pulpitis. However, Mineral trioxide aggregate (MTA) as the most frequently used repair material, exhibits limited efficacy under inflammatory conditions. This study introduces an innovative nanocomposite hydrogel, tailored to simultaneously target anti-inflammation and dentin mineralization, aiming to efficiently preserve vital pulp tissue. Methods: The L-(CaP-ZnP)/SA nanocomposite hydrogel was designed by combining L-Arginine modified calcium phosphate/zinc phosphate nanoparticles (L-(CaP-ZnP) NPs) with sodium alginate (SA), and was characterized with TEM, SEM, FTIR, EDX, ICP-AES, and Zeta potential. In vitro, we evaluated the cytotoxicity and anti-inflammatory properties. Human dental pulp stem cells (hDPSCs) were cultured with lipopolysaccharide (LPS) to induce an inflammatory response, and the cell odontogenic differentiation was measured and possible signaling pathways were explored by alkaline phosphatase (ALP)/alizarin red S (ARS) staining, qRT-PCR, immunofluorescence staining, and Western blotting, respectively. In vivo, a pulpitis model was utilized to explore the potential of the L-(CaP-ZnP)/SA nanocomposite hydrogel in controlling pulp inflammation and enhancing dentin mineralization by Hematoxylin and eosin (HE) staining and immunohistochemistry staining. Results: In vitro experiments revealed that the nanocomposite hydrogel was synthesized successfully and presented desirable biocompatibility. Under inflammatory conditions, compared to MTA, the L-(CaP-ZnP)/SA nanocomposite hydrogel demonstrated superior anti-inflammatory and pro-odontogenesis effects. Furthermore, the nanocomposite hydrogel significantly augmented p38 phosphorylation, implicating the involvement of the p38 signaling pathway in pulp repair. Significantly, in a rat pulpitis model, the L-(CaP-ZnP)/SA nanocomposite hydrogel downregulated inflammatory markers while upregulating mineralization-related markers, thereby stimulating the formation of robust reparative dentin. Conclusion: The L-(CaP-ZnP)/SA nanocomposite hydrogel with good biocompatibility efficiently promoted inflammation resolution and enhanced dentin mineralization by activating p38 signal pathway, as a pulp-capping material, offering a promising and advanced solution for treatment of pulpitis.


Assuntos
Alginatos , Anti-Inflamatórios , Polpa Dentária , Hidrogéis , Nanocompostos , Polpa Dentária/citologia , Polpa Dentária/efeitos dos fármacos , Humanos , Hidrogéis/química , Hidrogéis/farmacologia , Nanocompostos/química , Animais , Anti-Inflamatórios/química , Anti-Inflamatórios/farmacologia , Alginatos/química , Alginatos/farmacologia , Pulpite/terapia , Células-Tronco/efeitos dos fármacos , Células-Tronco/citologia , Fosfatos de Cálcio/química , Fosfatos de Cálcio/farmacologia , Silicatos/química , Silicatos/farmacologia , Ratos , Diferenciação Celular/efeitos dos fármacos , Compostos de Cálcio/química , Compostos de Cálcio/farmacologia , Células Cultivadas , Compostos de Alumínio/química , Compostos de Alumínio/farmacologia , Arginina/química , Arginina/farmacologia , Ratos Sprague-Dawley , Combinação de Medicamentos , Masculino , Óxidos/química , Óxidos/farmacologia
3.
PLoS One ; 19(7): e0305218, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38968236

RESUMO

This meta-analysis aims to assess the success rate of pulpotomy in the treatment of permanent teeth with carious pulp exposure and to compare the efficacy of different capping materials. Randomized controlled trials were searched in PubMed, EMBASE, Web of Science, Clinicaltrial.gov, and Cochrane Library until August 31, 2023. The pooled success rate was estimated in the overall population and in subgroups. Additional analyses comparing different capping materials using odds ratio (OR) and 95% confidence interval (95%CI) were performed. The certainty of evidence was graded using the GRADE approach. A total of 25 randomized trials with an average follow-up duration ≥ 12 months were finally included. The overall success rate of pulpotomy was 86.7% (95%CI: 82.0-90.7%). The success rate was not significantly affected by root development, pulpotomy type, and follow-up duration. Teeth with irreversible pulpitis had a relatively lower success rate than teeth with normal pulp or reversible pulpitis (82.4% [95%CI: 74.6-89.0%] vs 92.0% [95%CI: 87.9-95.4%], P = 0.013). Directly compared to conventional calcium hydroxide, mineral trioxide aggregate (88.2% vs 79.1%, OR = 2.41, 95%CI: 1.28-4.51, P = 0.006) and Biodentine (97.5% vs 82.9%, OR = 6.03, 95%CI: 0.97-37.6, P = 0.054) had higher successful rates. No significant difference between MTA and other biomaterials was found. The results were graded as very low to low certainty of evidence. In conclusion, pulpotomy is an effective treatment of permanent teeth with carious pulp exposure. Mineral trioxide aggregate and Biodentine can be recommended with more favorable outcomes as capping materials.


Assuntos
Cárie Dentária , Pulpotomia , Ensaios Clínicos Controlados Aleatórios como Assunto , Humanos , Pulpotomia/métodos , Cárie Dentária/terapia , Resultado do Tratamento , Compostos de Cálcio/uso terapêutico , Dentição Permanente , Silicatos/uso terapêutico , Compostos de Alumínio/uso terapêutico , Combinação de Medicamentos , Óxidos/uso terapêutico , Capeamento da Polpa Dentária/métodos , Pulpite/terapia , Hidróxido de Cálcio/uso terapêutico , Exposição da Polpa Dentária/terapia
4.
J Contemp Dent Pract ; 25(4): 365-371, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38956853

RESUMO

AIM: This investigation aimed to observe the effects of Dycal, mineral trioxide aggregate (MTA), and TheraCal LC, as indirect pulp-capping materials in primary molars. MATERIALS AND METHODS: About 75 children with lower primary molars aged between 4 and 7 years suggested for IPC were selected and randomly allocated into: Group I - Dycal, group II - MTA, and group III - TheraCal LC. An immediate postoperative radiograph was taken after the procedure. Recall examination was done after 3 and 6 months for clinical and radiographic assessment. The radiographs were digitized, and the amount of thickness of dentin was assessed using Corel Draw software. The values were tabulated and subjected to paired t-tests and independent t-tests for intra and intergroup analysis, respectively. The p-value < 0.05 was considered statistically significant. RESULTS: There was a statistically significant increase in dentin thickness in the first 3 months compared to the 6-month follow-up. At the end of the research phase, TheraCal LC had more tertiary dentin deposited than MTA, followed by Dycal. CONCLUSION: TheraCal LC can be a reliable indirect pulp-capping agent in primary teeth. CLINICAL SIGNIFICANCE: Indirect pulp capping (IPC) is a very extensively employed treatment regimen to manage extensive caries. For many decades, calcium hydroxide has been regarded as the benchmark of pulp capping materials. With several advancements in materials for restoration, TheraCal LC a resin-modified, light-cured calcium silicate-filled liner serves as a pulp-capping agent and dentin protector, promoting pulp healing and preserving vitality as an obstacle cum protector of the dental pulp complex. How to cite this article: Thomas NA, Jobe J, Thimmaiah C, et al. Comparative Evaluation of Effectiveness of Calcium Hydroxide, MTA, and TheraCal LC in Indirect Pulp Capping in Primary Molars: In Vivo Study. J Contemp Dent Pract 2024;25(4):365-371.


Assuntos
Compostos de Alumínio , Compostos de Cálcio , Hidróxido de Cálcio , Capeamento da Polpa Dentária , Combinação de Medicamentos , Dente Molar , Óxidos , Agentes de Capeamento da Polpa Dentária e Pulpectomia , Silicatos , Dente Decíduo , Humanos , Compostos de Cálcio/uso terapêutico , Compostos de Alumínio/uso terapêutico , Silicatos/uso terapêutico , Capeamento da Polpa Dentária/métodos , Óxidos/uso terapêutico , Criança , Hidróxido de Cálcio/uso terapêutico , Pré-Escolar , Agentes de Capeamento da Polpa Dentária e Pulpectomia/uso terapêutico , Masculino , Feminino , Minerais
5.
Shanghai Kou Qiang Yi Xue ; 33(2): 160-163, 2024 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-39005092

RESUMO

PURPOSE: To explore the efficacy of iRoot BP plus in the treatment of adult carious pulp exposure and its impact on pulp blood flow. METHODS: A total of 126 cases of 156 permanent teeth from adult patients with carious pulp exposure who were treated from January 2020 to January 2022 were selected, the patients were divided into experimental group(63 cases with 79 permanent teeth) and control group(63 cases with 77 permanent teeth) by the envelope method. The experimental group was treated with iRoot BP plus, while the control group was treated with mineral trioxide polymer. The differences in treatment effectiveness, operation time, and tooth discoloration between the two groups were observed. Statistical analysis was performed with SPSS 22.0 software package. RESULTS: There was no significant difference in treatment success rates between the experimental group and the control group at 3, 6, and 12 months after surgery(P>0.05). The operating time for each capsule in the experimental group was (2.53±0.41) min, which was significantly shorter than that in the control group(P<0.05). The incidence of tooth discoloration in the experimental group at 12 months after surgery was 3.80%, which was significantly lower than that in the control group (P<0.05). The bite force quotient and masticatory efficiency of the experimental group 12 months after operation were (16.65±1.14) Ibs and (94.45±5.65)%, which were significantly higher than those of the control group(P<0.05). CONCLUSIONS: IRoot BP plus has good efficacy in the treatment of adult carious pulp exposure, with advantages such as convenient operation, less tooth discoloration, less inflammatory reactions and stable pulp blood flow after decline.


Assuntos
Polpa Dentária , Humanos , Polpa Dentária/efeitos dos fármacos , Polpa Dentária/irrigação sanguínea , Cárie Dentária/terapia , Silicatos/uso terapêutico , Silicatos/administração & dosagem , Adulto , Óxidos/administração & dosagem , Óxidos/uso terapêutico , Compostos de Cálcio/uso terapêutico , Compostos de Cálcio/administração & dosagem , Combinação de Medicamentos , Compostos de Alumínio/uso terapêutico , Compostos de Alumínio/administração & dosagem , Descoloração de Dente , Exposição da Polpa Dentária/terapia , Resultado do Tratamento
6.
Medicina (Kaunas) ; 60(6)2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38929495

RESUMO

Background and Objectives: In teeth with open apices, performing single session apexification is a challenging treatment due to the difficulty in handling mineral trioxide aggregate (MTA). Minimally invasive approaches in dentistry have also influenced the cavity designs in endodontics. Until now, different techniques have not been investigated in addition to manual condensation during the process of placing MTA in traditional (TradACs) or conservative (ConsACs) endodontic access cavities. The aim of this in vitro study was to compare and evaluate the obturation quality of MTA apical plugs placed with different techniques in TradACs or ConsACs. Materials and Methods: Sixty upper central teeth were divided into two main groups based on cavity design, and then each main group was further divided into three subgroups according to MTA placement techniques (n = 10): TradAC-manual, TradAC-manual + indirect ultrasonic activation, TradAC-manual + XP-endo Shaper (XPS), ConsAC-manual, ConsAC-manual + indirect ultrasonic activation, and ConsAC-manual + XPS. Subsequently, the porosity percentages in the MTA apical plug were analyzed using micro-computed tomography. The statistical analysis was performed using the Kruskal-Wallis H test and Mann-Whitney U test. Statistical significance was set at p < 0.05. Results: There were differences in volume of porosity percentages (%) according to cavity designs and MTA application techniques (p < 0.05). Except for the XPS group, more porosity was observed in ConsACs compared to TradACs. In TradACs, the significantly lowest open and total porosity was observed in the manual, ultrasonic, and XPS techniques, respectively. In ConsACs, the significantly lowest porosity was observed in the manual, XPS, and ultrasonic techniques, respectively (p < 0.05). Conclusions: In MTA obturation, cavity designs and application techniques had an impact on the MTA porosity. Creating an apical plug in ConsACs may result in more porosity compared to TradACs, especially when manual or indirect ultrasonic activation is preferred. Opting for the manual technique alone may be considered sufficient for controlling porosity for both TradACs and ConsACs.


Assuntos
Compostos de Alumínio , Compostos de Cálcio , Combinação de Medicamentos , Óxidos , Materiais Restauradores do Canal Radicular , Obturação do Canal Radicular , Silicatos , Microtomografia por Raio-X , Compostos de Cálcio/administração & dosagem , Silicatos/uso terapêutico , Humanos , Microtomografia por Raio-X/métodos , Obturação do Canal Radicular/métodos , Obturação do Canal Radicular/normas , Materiais Restauradores do Canal Radicular/uso terapêutico , Materiais Restauradores do Canal Radicular/normas , Técnicas In Vitro
7.
Hemodial Int ; 28(3): 351-357, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38937150

RESUMO

BACKGROUND: Phosphide metal poisoning results in tens of thousands of fatalities per year worldwide. The mortality in critically ill patients often exceeds 50%. The available treatment is supportive and there is no antidote. Dialysis is recommended to treat advanced complications but has not been prescribed early in the process. In this study we report our experience in using dialysis in the early hours of presentation of the patients and suggest it can favorably improve the prognosis. We also draw attention to the risk of suicide under conditions of chronic conflict such as those in northwestern Syria, and to the lack of necessary mental health support for patients after suicide attempts. METHODS: Retrospective review of records of patients poisoned with aluminum phosphide and admitted to critical care facilities in northwestern Syria between July 2022 and June 2023. RESULTS: During the observation period 16 cases were encountered. Suicide was the reason of the poisoning in 15 patients, the median patient age was 18 years and over two thirds of the patients were female. Early dialysis was used in 11 patients who were critically ill and their mortality rate was 18%. CONCLUSIONS: Phosphide metal poisoning is common in the disasters stricken area of northwestern Syria. Most cases are suicidal and impact young females. Early dialytic interventions may favorably impact the outcomes.


Assuntos
Fosfinas , Diálise Renal , Humanos , Feminino , Masculino , Fosfinas/intoxicação , Diálise Renal/métodos , Adulto , Estudos Retrospectivos , Adolescente , Adulto Jovem , Compostos de Alumínio/intoxicação , Síria , Criança , Pessoa de Meia-Idade , Intoxicação/terapia , Desastres , Tentativa de Suicídio
8.
Anal Methods ; 16(26): 4381-4386, 2024 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-38896043

RESUMO

The abundant bio-markers in saliva provide a new option for non-invasive testing. However, due to the presence of impurities in the saliva background, most of the existing saliva testing methods rely on pre-processing, which limits the application of saliva testing as a convenient means of testing in daily life. Herein, a disposable-gate AlGaN/GaN high electron mobility transistor (HEMT) biosensor integrated with a micro-sieve was introduced to solve the problem of signal interference caused by charged impurities in saliva for HEMT based biosensors, where the micro-sieve was utilized as a pre-treatment unit to remove large particles of impurities from saliva through the size effect and thus greatly improving the accuracy of detection. The experimental results showed that the HEMT based biosensor has excellent linearity (R2 = 0.9977) and a high sensitivity of 6.552 µA dec-1 for urea sensing from 1 fM to 100 mM in 0.1× PBS solution. When it comes to artificial saliva detection, compared to the HEMT sensor without the micro-sieve (sensitivity = 3.07432 µA dec-1), the sensitivity of the HEMT sensor integrated with the micro-sieve showed almost no change. Moreover, to verify that urea can be detected in actual saliva, urea is sensed directly in human saliva. The addition of the microsieve module provides a new way for biosensors to detect specific markers in saliva in real time, and the designed HEMT biosensor with the microsieve function has a wide range of application potential in rapid saliva detection.


Assuntos
Técnicas Biossensoriais , Gálio , Saliva , Transistores Eletrônicos , Ureia , Gálio/química , Gálio/análise , Técnicas Biossensoriais/instrumentação , Técnicas Biossensoriais/métodos , Ureia/análise , Ureia/química , Saliva/química , Humanos , Compostos de Alumínio/química , Compostos de Alumínio/análise , Limite de Detecção , Técnicas Eletroquímicas/instrumentação , Técnicas Eletroquímicas/métodos , Desenho de Equipamento
9.
Gen Dent ; 72(4): 16-22, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38905600

RESUMO

Vital pulp therapy (VPT) has been increasingly advocated due to its advantages in preserving tooth vitality. While VPT is often successful, failures can occur, and traditional root canal therapy is often recommended following VPT failure. This case report provides an example of successful preservation of tooth vitality using coronal pulpotomy (CP), a more invasive type of VPT, after failure of partial pulpotomy (PP) that had been performed in a healthy 10-year-old boy. A mandibular right first molar with a diagnosis of reversible pulpitis was initially treated with PP, which included the use of tricalcium silicate cement as a pulp dressing and a resin-modified glass ionomer cement base, followed by placement of a composite resin restoration. The restoration dislodged after 34 months without complaints from the patient or radiographically detectable lesions. A stainless steel crown was placed on the tooth; however, 15 months after crown placement, the patient returned with symptoms in the treated tooth. The tooth was diagnosed with irreversible pulpitis and asymptomatic apical periodontitis but responded positively to cold testing, and the pulp appeared clinically vital upon direct inspection. The tooth was re-treated with CP, including the use of mineral trioxide aggregate as a dressing material, and examination 21 months posttreatment revealed successful resolution of the periapical lesion. When a tooth remains vital, a more invasive type of VPT may be an alternative to root canal therapy for treating failures in more conservatively treated teeth. Moreover, regular periodic recalls are essential for ensuring tooth survival and early detection of problems (ie, restoration failure) that may worsen treatment outcomes.


Assuntos
Pulpotomia , Retratamento , Humanos , Masculino , Criança , Pulpotomia/métodos , Pulpite/terapia , Silicatos/uso terapêutico , Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Dente Molar , Cimentos de Ionômeros de Vidro/uso terapêutico , Restauração Dentária Permanente/métodos , Resinas Compostas/uso terapêutico , Óxidos/uso terapêutico , Coroas , Combinação de Medicamentos
10.
PeerJ ; 12: e17237, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38699192

RESUMO

Background: Root perforation repair presents a significant challenge in dentistry due to inherent limitations of existing materials. This study explored the potential of a novel polydopamine-based composite as a root repair material by evaluating its sealing efficacy, radiopacity, and surface topography. Methods: Confocal microscopy assessed sealing ability, comparing the polydopamine-based composite to the gold standard, mineral trioxide aggregate (MTA). Radiopacity was evaluated using the aluminium step wedge technique conforming to ISO standards. Surface roughness analysis utilized atomic force microscopy (AFM), while field emission scanning electron microscopy (FESEM) visualized morphology. Results: The polydopamine-based composite exhibited significantly superior sealing efficacy compared to MTA (P < 0.001). Radiopacity reached 3 mm aluminium equivalent, exceeding minimum clinical requirements. AFM analysis revealed a smooth surface topography, and FESEM confirmed successful composite synthesis. Conclusion: This study demonstrates promising properties of the polydopamine-based composite for root perforation repair, including superior sealing efficacy, clinically relevant radiopacity, and smooth surface topography. Further investigation is warranted to assess its clinical viability and potential translation to endodontic practice.


Assuntos
Compostos de Alumínio , Compostos de Cálcio , Indóis , Óxidos , Polímeros , Materiais Restauradores do Canal Radicular , Silicatos , Propriedades de Superfície , Polímeros/química , Indóis/química , Silicatos/química , Compostos de Cálcio/química , Óxidos/química , Materiais Restauradores do Canal Radicular/química , Compostos de Alumínio/química , Humanos , Combinação de Medicamentos , Microscopia Eletrônica de Varredura , Microscopia de Força Atômica/métodos , Microscopia Confocal , Teste de Materiais , Raiz Dentária/lesões , Raiz Dentária/diagnóstico por imagem , Raiz Dentária/cirurgia
11.
BMC Oral Health ; 24(1): 554, 2024 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-38735924

RESUMO

This in vitro study compared various obturation techniques with bioceramic sealers for filling C-shaped 3D-printed replicas. A mandibular molar with a C-shaped root canal with a C1 configuration was obtained. After instrumenting with M3 Pro Gold files (United Dental, Shanghai, China) up to size #30/0.04, a CBCT scan of the tooth was taken. Sixty 3D-printed replicas of the tooth were created. The samples were obturated with EndoSeal TCS sealer (E. TCS; Maruchi, Wonju, Korea) or EndoSeal MTA (E. MTA; Maruchi, Wonju, Korea) (n = 30). The samples in each group were obturated with the following techniques (n = 10): (1) single-cone technique (SC), (2) SC with ultrasonic activation (UA), and (3) cold hydraulic compaction (CHC). Following incubation, the replicas' apical, middle, and coronal thirds were inspected under a digital microscope, and the proportion of filling material and void were calculated. Also, the obturation time and sealer extrusion were recorded. Data were analyzed using ANOVA, LSD post-hoc, and the chi-square tests (α = 0.05). The results indicated that in the apical third, E. TCS-SC, E. TCS-UA, and E. MTA-UA had the lowest void percentage among groups (p < 0.05). In the middle thirds, samples obturated with E. TCS-UA showed a significantly lower void percentage among all groups (p < 0.05). However, in the coronal third, E. TCS-CHC showed the least void percentage (p < 0.05), followed by E. TCS-UA and E. MTA-CHC. The E. TCS-SC and E. TCS-UA were the least time-consuming methods (p < 0.05). Sealer extrusion significantly differed among the groups, with E. MTA-UA and E. TCS-UA showing higher incidence (p = 0.019). It was concluded that E. TCS-UA was the most convenient obturation technique. However, care must be taken when obturating the canals with high flow and ultrasonic activation near the vital anatomical landmarks.


Assuntos
Impressão Tridimensional , Materiais Restauradores do Canal Radicular , Obturação do Canal Radicular , Obturação do Canal Radicular/métodos , Humanos , Combinação de Medicamentos , Dente Molar/diagnóstico por imagem , Técnicas In Vitro , Compostos de Cálcio , Óxidos , Cavidade Pulpar/diagnóstico por imagem , Compostos de Alumínio , Tomografia Computadorizada de Feixe Cônico/métodos , Silicatos
12.
J Transl Med ; 22(1): 498, 2024 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-38796431

RESUMO

OBJECTIVE: The aim of the present pilot study was to assess the effectiveness of the platelet-rich fibrin (PRF) apical barrier for the placement of MTA for the treatment of teeth with periapical lesions and open apices. METHODS: A total of thirty teeth on twenty-eight patients with open apices and periapical periodontitis were enrolled and divided into two groups in the present pilot study. In the PRF group (fourteen teeth in thirteen patients), nonsurgical endodontic treatment was performed using PRF as an apical matrix, after which the apical plug of the MTA was created. For the non-PRF group (fourteen teeth in fourteen patients), nonsurgical endodontic therapy was performed using only the MTA for an apical plug with no further periapical intervention. Clinical findings and periapical digital radiographs were used for evaluating the healing progress after periodic follow-ups of 1, 3, 6, and 9 months. The horizontal dimension of the periapical lesion was gauged, and the changes in the dimensions were recorded each time. The Friedman test, Dunn-Bonferroni post hoc correction, and Mann-Whitney U test were used for statistical analysis, with P < 0.05 serving as the threshold for determining statistical significance. RESULTS: All patients in both groups in the present pilot study had no clinical symptoms after 1 month, with a significant reduction in the periapical lesion after periodic appointments. The lesion width of the PRF group was significantly smaller than that of the non-PRF group in the sixth and ninth month after treatment. CONCLUSIONS: PRF is a promising apical barrier matrix when combined with MTA for the treatment of teeth with open apices and periapical periodontitis. Small number of study subjects and the short time of follow-up period limit the generalizability of these results. TRIAL REGISTRATION: TCTR, TCTR20221109006. Registered 09 November 2022 - Retrospectively registered, https://www.thaiclinicaltrials.org/show/TCTR20221109006 .


Assuntos
Compostos de Alumínio , Compostos de Cálcio , Fibrina Rica em Plaquetas , Silicatos , Ápice Dentário , Humanos , Projetos Piloto , Fibrina Rica em Plaquetas/metabolismo , Feminino , Masculino , Compostos de Alumínio/uso terapêutico , Silicatos/uso terapêutico , Compostos de Cálcio/uso terapêutico , Adulto , Ápice Dentário/patologia , Ápice Dentário/diagnóstico por imagem , Combinação de Medicamentos , Pessoa de Meia-Idade , Óxidos/uso terapêutico , Periodontite Periapical/terapia , Periodontite Periapical/diagnóstico por imagem
13.
Inorg Chem ; 63(21): 9831-9841, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38739498

RESUMO

Aluminum fluoride (AlF) complexes have been used over the past decade to incorporate [18F]fluoride into large biomolecules in a highly selective fashion by using relatively facile conditions. However, despite their widespread usage, there are a large number of variations in the reaction conditions, without a definitive discussion provided on the mechanism to understand how these changes would alter the end result. Herein, we report a detailed mechanistic investigation of the reaction, using a mixture of theoretical studies, fluorine-19 and fluorine-18 chemistry, and the consequences it has on the efficient clinical translation of AlF-containing imaging agents.


Assuntos
Compostos de Alumínio , Quelantes , Fluoretos , Fluoretos/química , Compostos de Alumínio/química , Quelantes/química , Quelantes/síntese química , Radioisótopos de Flúor/química , Estrutura Molecular
14.
J Dent Res ; 103(6): 652-661, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38716736

RESUMO

The process of neovascularization during cell-based pulp regeneration is difficult to study. Here we developed a tube model that simulates root canal space and allows direct visualization of the vascularization process in vitro. Endothelial-like cells (ECs) derived from guiding human dental pulp stem cells (DPSCs) into expressing endothelial cell markers CD144, vWF, VEGFR1, and VEGFR2 were used. Human microvascular endothelial cells (hMVECs) were used as a positive control. DPSC-ECs formed tubules on Matrigel similar to hMVECs. Cells were mixed in fibrinogen/thrombin or mouse blood and seeded into wells of 96-well plates or injected into a tapered plastic tube (14 mm in length and 1 or 2 mm diameter of the apex opening) with the larger end sealed with MTA to simulate root canal space. Cells/gels in wells or tubes were incubated for various times in vitro and observed under the microscope for morphological changes. Samples were then fixed and processed for histological analysis to determine vessel formation. Vessel-like networks were observed in culture from 1 to 3 d after cell seeding. Cells/gels in 96-well plates were maintained up to 25 d. Histologically, both hMVECs and DPSC-ECs in 96-well plates or tubes showed intracellular vacuole formation. Some cells showed merged large vacuoles indicating the lumenization. Tubular structures were also observed resembling blood vessels. Cells appeared healthy throughout the tube except some samples (1 mm apical diameter) in the coronal third. Histological analysis also showed pulp-like soft tissue throughout the tube samples with vascular-like structures. hMVECs formed larger vascular lumen size than DPSC-ECs while the latter tended to have more lumen and tubular structure counts. We conclude that DPSC-ECs can form vascular structures and sustained in the 3-dimensional fibrin gel system in vitro. The tube model appears to be a proper and simple system simulating the root canal space for vascular formation and pulp regeneration studies.


Assuntos
Polpa Dentária , Combinação de Medicamentos , Células Endoteliais , Neovascularização Fisiológica , Proteoglicanas , Regeneração , Células-Tronco , Polpa Dentária/citologia , Polpa Dentária/irrigação sanguínea , Polpa Dentária/fisiologia , Neovascularização Fisiológica/fisiologia , Animais , Camundongos , Humanos , Regeneração/fisiologia , Células Endoteliais/fisiologia , Células-Tronco/fisiologia , Colágeno , Técnicas de Cultura de Células , Laminina , Fator de von Willebrand/análise , Receptor 2 de Fatores de Crescimento do Endotélio Vascular , Fibrinogênio , Cavidade Pulpar , Compostos de Cálcio , Compostos de Alumínio , Materiais Restauradores do Canal Radicular , Microvasos/citologia , Células Cultivadas , Óxidos , Silicatos , Antígeno CD146
15.
BMC Oral Health ; 24(1): 584, 2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38773504

RESUMO

BACKGROUND: Apical surgery with standard retrograde maneuvers may be challenging in certain cases. Simplifying apical surgery to reduce operating time and streamline retrograde manipulation is an emerging need in clinical endodontics. AIM OF THE STUDY: The aim of the study was to compare the bacterial sealing ability of a calcium silicate-based sealer with the single cone technique combined with root end resection only, and calcium silicate-based sealer as a retrograde filling versus MTA retrofilling, and to analyze bacterial viability using confocal laser scanning microscope (CLSM). MATERIALS AND METHODS: In this in vitro experimental study, 50 extracted human maxillary incisor teeth were instrumented and randomly divided into five groups: three experimental groups, a positive control group, and a negative control group (n = 10/group). In the experimental groups, the roots were obturated using the single cone technique (SCT) and a calcium silicate-based sealer. In group 1, the roots were resected 3 mm from the apex with no further retrograde preparation or filling. In groups 2 and 3, the roots were resected, retroprepared, and retrofilled with either a calcium silicate-based sealer or MTA, respectively. Group 4 (positive control) was filled with a single gutta-percha cone without any sealer. In group 5 (negative control), the canals were left empty, and the roots were sealed with wax and nail varnish. A bacterial leakage model using Enterococcus faecalis was employed to assess the sealing ability over a 30-day period, checking for turbidity and analyzing colony forming units (CFUs) per milliliter. Five specimens from each group were examined using CLSM for bacterial viability. Data for the bacterial sealing ability were statistically analyzed using chi-squared and Kruskal-Wallis tests. RESULTS: The three experimental groups did not show significant differences in terms of bacterial leakage, or bacterial counts (CFUs) (P > 0.05). However, significant differences were observed when comparing the experimental groups to the positive control group. Notably, the calcium silicate-based sealer, when used as a retrofilling, yielded the best sealing ability. CLSM imaging revealed viable bacterial penetration in all the positive control group specimens while for the experimental groups, dead bacteria was the prominent feature seen. CONCLUSION: Within the limitations of this study, it could be concluded that the bacterial sealing ability of calcium silicate-based sealer with the single cone technique combined with root end resection only and calcium silicate-based sealer as a retrograde filling were comparable with MTA retrofilling during endodontic surgical procedures.


Assuntos
Compostos de Cálcio , Materiais Restauradores do Canal Radicular , Silicatos , Silicatos/uso terapêutico , Compostos de Cálcio/uso terapêutico , Humanos , Materiais Restauradores do Canal Radicular/farmacologia , Materiais Restauradores do Canal Radicular/uso terapêutico , Óxidos/farmacologia , Óxidos/uso terapêutico , Combinação de Medicamentos , Compostos de Alumínio/uso terapêutico , Técnicas In Vitro , Microscopia Confocal , Infiltração Dentária/microbiologia , Obturação Retrógrada/métodos , Enterococcus faecalis/efeitos dos fármacos , Viabilidade Microbiana , Incisivo , Apicectomia/métodos
16.
J Clin Pediatr Dent ; 48(3): 171-176, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38755996

RESUMO

To explore a new method to implant deciduous tooth pulp into the canal of young permanent teeth with necrotic pulps and apical periodontitis for the regenerative endodontic treatment of tooth no: 41 in a 7-year-old male. Briefly, 1.5% Sodium Hypochlorite (NaOCl) irrigation and calcium hydroxide-iodoform paste were used as root canal disinfectant at the first visit. After 2 weeks, the intracanal medication was removed, and the root canal was slowly rinsed with 17% Ethylene Diamine Tetraacetic Acid (EDTA), followed by flushing with 20 mL saline and then drying with paper points. Tooth no: 72 was extracted, and its pulp was extracted and subsequently implanted into the disinfected root canal along with induced apical bleeding. Calcium hydroxide iodoform paste was gently placed over the bleeding clot, and after forming a mineral trioxide aggregate (MTA) coronal barrier, the accessed cavities were restored using Z350 resin composite. The root developments were evaluated via radiographic imaging at 6 months, 1 year and 5 years after treatment. Imaging and clinical analysis showed closure of the apical foramen, thickening of the root canal wall, and satisfactory root length growth. Autologous transplantation might be useful to regenerate dental pulp in necrotic young permanent teeth.


Assuntos
Compostos de Alumínio , Compostos de Cálcio , Polpa Dentária , Incisivo , Dente Decíduo , Humanos , Masculino , Criança , Polpa Dentária/irrigação sanguínea , Compostos de Cálcio/uso terapêutico , Compostos de Alumínio/uso terapêutico , Óxidos/uso terapêutico , Combinação de Medicamentos , Necrose da Polpa Dentária/terapia , Silicatos/uso terapêutico , Seguimentos , Endodontia Regenerativa/métodos , Mandíbula/cirurgia , Hidróxido de Cálcio/uso terapêutico , Neovascularização Fisiológica , Tratamento do Canal Radicular/métodos , Irrigantes do Canal Radicular/uso terapêutico , Materiais Restauradores do Canal Radicular/uso terapêutico , Periodontite Periapical/terapia , Periodontite Periapical/cirurgia , Hipoclorito de Sódio/uso terapêutico , Cavidade Pulpar , Hidrocarbonetos Iodados
17.
Medicine (Baltimore) ; 103(18): e38015, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38701294

RESUMO

BACKGROUND: Compared with traditional root canal therapy (RCT), vital pulp therapy (VPT) is a personalized and minimally invasive method for the treatment of pulpitis caused by dental caries. However, there are still no clear guidelines for VPT because high-quality randomized clinical trials are scarce. This prospective cohort study evaluated the clinical efficacy of VPT with the light-curable calcium silicate-based material TheraCal LC (TH) and bioceramic material iRoot BP Plus (BP) in reversible and irreversible pulpitis permanent teeth with carious exposures. METHODS: 115 teeth with reversible or irreversible pulpitis caused by deep care were randomly divided into 2 groups. TheraCal LC and iRoot BP Plus were used for the pulp capping. Direct pulp capping (DPC), partial pulpotomy (PP) and full pulpotomy (FP) were performed based on observation of the exposed pulp. Postoperative discomforts were enquired and recorded via follow-up phone calls. Clinical and radiographic evaluations were performed 3, 6, and 12 months postoperatively. RESULTS: The overall clinical success rate in the first year was 90.4% (47/52) in both groups. The TH group required less operating time, showed lower levels of pain, and had shorter pain duration post-operative (P < .001). According to the binary logistic regression model, preoperative pain duration was significantly correlated with the prognosis of VPT (P = .011). CONCLUSION: VPT with TheraCal LC and iRoot BP Plus in pulpitis permanent carious teeth both achieved good clinical outcomes, and TheraCal LC can be easily operated for clinical use. Preoperative pain duration of the affected tooth might have a significant correlation with the prognosis of VPT.


Assuntos
Compostos de Cálcio , Capeamento da Polpa Dentária , Pulpite , Pulpotomia , Silicatos , Humanos , Pulpite/terapia , Compostos de Cálcio/uso terapêutico , Compostos de Cálcio/administração & dosagem , Silicatos/uso terapêutico , Feminino , Masculino , Pulpotomia/métodos , Adulto , Estudos Prospectivos , Capeamento da Polpa Dentária/métodos , Cárie Dentária/terapia , Adulto Jovem , Resultado do Tratamento , Adolescente , Pessoa de Meia-Idade , Combinação de Medicamentos , Hidróxido de Cálcio/uso terapêutico , Compostos de Alumínio/uso terapêutico , Óxidos/uso terapêutico , Óxidos/administração & dosagem
18.
Sci Total Environ ; 931: 172945, 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38703849

RESUMO

The coagulation process has a high potential as a treatment method that can handle pathogenic viruses including emerging enveloped viruses in drinking water treatment process which can lower infection risk through drinking water consumption. In this study, a surrogate enveloped virus, bacteriophage Փ6, and surrogate non-enveloped viruses, including bacteriophage MS-2, T4, ՓX174, were used to evaluate removal efficiencies and mechanisms by the conventional coagulation process with alum, poly­aluminum chloride, and ferric chloride at pH 5, 7, and 9 in turbid water. Also, treatability of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a recent virus of global concern by coagulation was evaluated as SARS-CoV-2 can presence in drinking water sources. It was observed that an increase in the coagulant dose enhanced the removal efficiency of turbidity and viruses, and the condition that provided the highest removal efficiency of enveloped and non-enveloped viruses was 50 mg/L of coagulants at pH 5. In addition, the coagulation process was more effective for enveloped virus removal than for the non-enveloped viruses, and it demonstrated reduction of SARS-CoV-2 Omicron BA.2 over 0.83-log with alum. According to culture- and molecular-based assays (qPCR and CDDP-qPCR), the virus removal mechanisms were floc adsorption and coagulant inactivation. Through inactivation with coagulants, coagulants caused capsid destruction, followed by genome damage in non-enveloped viruses; however, damage to a lipid envelope is suggested to contribute to a great extend for enveloped virus inactivation. We demonstrated that conventional coagulation is a promising method for controlling emerging and re-emerging viruses in drinking water.


Assuntos
SARS-CoV-2 , Purificação da Água , Purificação da Água/métodos , SARS-CoV-2/fisiologia , COVID-19 , Água Potável/virologia , Água Potável/química , Compostos de Alúmen , Microbiologia da Água , Betacoronavirus/fisiologia , Floculação , Compostos de Alumínio , Compostos Férricos/química
19.
Sci Rep ; 14(1): 10998, 2024 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-38745068

RESUMO

Using ferric chloride (FeCl3) to induce experimental superior sagittal sinus (SSS) thrombosis might interfere with magnetic resonance imaging (MRI)-assisted visualization and evaluation of the thrombus, the brain parenchyma, and the quality of the occlusion. The aim of this study was to investigate whether aluminum chloride (AlCl3)-induced thrombosis of the SSS has comparable properties to those of FeCl3 without causing artifacts in MRI. SSS thrombosis was induced in 14 male Wistar rats by exposure of the SSS and subsequent topical application of a filter paper strip soaked in AlCl3 (n = 7) or FeCl3 (n = 7) over a period of 15 min. The animals with AlCl3-induced SSS thrombosis showed a constant and complete occlusion with in histological analysis large thrombi. Blood flow measurements indicated a significant reduction on the first and seventh postoperative day compared to preoperative measurements. MRI enabled visualization and subsequent evaluation of the thrombus and the surrounding parenchyma. In comparison, FeCl3-induced SSS thrombosis could not be evaluated by MRI due to artifacts caused by the paramagnetic properties and increased susceptibility of FeCl3. The occluded sinus and the surrounding area appeared hypointense. The quality of SSS occlusion by AlCl3 was comparable to that of FeCl3. AlCl3 therefore represents a significant alternative substance in experimental SSS thrombosis ideally suited for studies using MRI.


Assuntos
Cloreto de Alumínio , Artefatos , Cloretos , Modelos Animais de Doenças , Compostos Férricos , Imageamento por Ressonância Magnética , Ratos Wistar , Animais , Imageamento por Ressonância Magnética/métodos , Masculino , Ratos , Cloretos/farmacologia , Cloretos/administração & dosagem , Trombose do Seio Sagital/diagnóstico por imagem , Trombose do Seio Sagital/induzido quimicamente , Compostos de Alumínio , Seio Sagital Superior/diagnóstico por imagem , Seio Sagital Superior/efeitos dos fármacos
20.
Int J Immunopathol Pharmacol ; 38: 3946320241250286, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38764158

RESUMO

Background: Aluminum phosphide (AlP) poisoning is prevalent in numerous countries, resulting in high mortality rates. Phosphine gas, the primary agent responsible for AlP poisoning, exerts detrimental effects on various organs, notably the heart, liver and kidneys. Numerous studies have documented the advantageous impact of Coenzyme Q10 (CoQ10) in mitigating hepatic injuries. The objective of this investigation is to explore the potential protective efficacy of CoQ10 against hepatic toxicity arising from AlP poisoning. Method: The study encompassed distinct groups receiving almond oil, normal saline, exclusive CoQ10 (at a dosage of 100 mg/kg), AlP at 12 mg/kg; LD50 (lethal dose for 50%), and four groups subjected to AlP along with CoQ10 administration (post-AlP gavage). CoQ10 was administered at 10, 50, and 100 mg/kg doses via Intraparietal (ip) injections. After 24 h, liver tissue specimens were scrutinized for mitochondrial complex activities, oxidative stress parameters, and apoptosis as well as biomarkers such as aspartate transaminase (AST) and alanine transaminase (ALT). Results: AlP induced a significant decrease in the activity of mitochondrial complexes I and IV, as well as a reduction in catalase activity, Ferric Reducing Antioxidant Power (FRAP), and Thiol levels. Additionally, AlP significantly elevated oxidative stress levels, indicated by elevated reactive oxygen species (ROS) production, and resulted in the increment of hepatic biomarkers such as AST and ALT. Administration of CoQ10 led to a substantial improvement in the aforementioned biochemical markers. Furthermore, phosphine exposure resulted in a significant reduction in viable hepatocytes and an increase in apoptosis. Co-treatment with CoQ10 exhibited a dose-dependent reversal of these observed alterations. Conclusion: CoQ10 preserved mitochondrial function, consequently mitigating oxidative damage. This preventive action impeded the progression of heart cells toward apoptosis.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas , Fígado , Estresse Oxidativo , Fosfinas , Ubiquinona , Fosfinas/intoxicação , Ubiquinona/análogos & derivados , Ubiquinona/farmacologia , Ubiquinona/uso terapêutico , Doença Hepática Induzida por Substâncias e Drogas/prevenção & controle , Doença Hepática Induzida por Substâncias e Drogas/tratamento farmacológico , Doença Hepática Induzida por Substâncias e Drogas/metabolismo , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Animais , Estresse Oxidativo/efeitos dos fármacos , Masculino , Fígado/efeitos dos fármacos , Fígado/metabolismo , Fígado/patologia , Apoptose/efeitos dos fármacos , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Ratos , Aspartato Aminotransferases/sangue , Aspartato Aminotransferases/metabolismo , Compostos de Alumínio/toxicidade , Alanina Transaminase/sangue , Alanina Transaminase/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Ratos Wistar
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