Effects of EDTA and saline as the final irrigation in regenerative endodontic procedures on the migration, proliferation, and differentiation of human stem cells from the apical papilla.

OBJECTIVES: To evaluate the effect of EDTA and saline as the final irrigation in regenerative endodontic procedures (REPS) on the attachment, proliferation, migration, and differentiation of stem cells from the apical papilla (SCAPs). MATERIALS AND METHODS: Dentin specimens from 140 human third molars were irrigated with various protocols-group 1: normal sterile saline (NSS), group 2: EDTA, group 3: EDTA then 5 mL NSS, or group 4: EDTA then 20 mL NSS. The specimens were used in cell assays. For cell proliferation, SCAPs were seeded on dentin, and the cell viability on days 1, 3, and 7 was determined using an MTT assay. At day 3, the attached cells' morphology was observed using SEM, and cell migration was investigated using a transwell migration assay. The ALP activity and odonto/osteogenic differentiation gene expression were evaluated at days 7, 14, and 21 using an ALP activity assay and RT-qPCR. RESULTS: On days 3 and 7, group 4 demonstrated more viable cells than group 1 (p < 0.01). The amount of migrated cells in groups 2, 3, and 4 was greater compared with group 1 (p < 0.05). Moreover, SCAP differentiation was similar between groups. CONCLUSIONS: Irrigating dentin with EDTA alone or with EDTA then NSS promoted SCAP migration. However, a final irrigation with 20 mL NSS after EDTA promoted SCAP proliferation without affecting their differentiation. CLINICAL RELEVANCE: When using a blood clot as a scaffold, a final flushing with 20 mL NSS after EDTA could be beneficial for clinical REP protocols.

Effect of GuttaClear on Postoperative Pain After Root Canal Retreatment: A Randomized Clinical Trial.

OBJECTIVE: The aim of this study was to evaluate postoperative pain after non-surgical root canal retreatment with or without GuttaClear. METHODS: Sixty participants were randomly distributed in this non-inferiority trial into two parallel singleblinded experimental groups (Group1: non-solvent, Group2: solvent). After root canal retreatment, the participants completed questionnaires using direct (numerical rating scales) and indirect (number of analgesics taken) measurements of postoperative pain at immediate, 6, 12, 24, 48, and 72 h post-retreatment. The predisposing postoperative pain factors were recorded and analysed using Generalized Estimating Equations to identify correlated factors (α=0.05). RESULTS: The pain incidence was not significantly different between the groups at any time point. The highest incidence of postoperative pain occurred immediately after retreatment (35%) and then decreased to 15% at 24 h (P<0.05). The number of participants requiring analgesics was 6.67% in the non-solvent group and 9.99% in the solvent group which were similar between the groups. Patients with a history of previous postoperative pain were 21.6-fold more likely to have postoperative pain than those without (P<0.05). CONCLUSION: There was no difference in postoperative pain or analgesics required after root canal retreatment with or without using GuttaClear. This study is registered in ClinicalTrial.gov (NCT04326998). (EEJ-2022-05-069).

Novel vinegar solution for denture-cleansing agent.

PURPOSE: To study the antimicrobial effects of a novel vinegar-based denture cleansing agent on oral Streptococci and Candida species and the inhibitory effects on pre-formed bacterial and Candida biofilms on denture base. METHODS: The microorganisms used in this study were Streptococcus mutans (S. mutans), Streptococcus sobrinus (S. sobrinus), Streptococcus sanguinis (S. sanguinis), Candida albicans (C. albicans), and Candida glabrata (C. glabrata). The antimicrobial activity of novel vinegar solution was evaluated by time kill assay and biofilm grown on denture base. RESULTS: Time kill assay showed that vinegar exhibited the highest antibacterial effect on S. sobrinus, S. sanguinis, and S. mutans after 15 min of treatment. A 99.9% reduction in C. glabrata and C. albicans required more than 4 and 6 h of treatment, respectively. Vinegar significantly inhibited streptococcal biofilm, with an approximately 6 log-reduction at 30 min of treatment. The results demonstrated that viable Candida cells in biofilm reduced in excess of 6-log CFU/mL after 3 h treatment with vinegar. Moreover, the vinegar-based denture cleanser inhibited bacterial and Candida biofilm formation compared to the control group without treatment with statistical significance. CONCLUSION: A novel vinegar-based denture cleansing agent showed moderate antibacterial properties, but required a slightly longer immersion time to attain anticandidal effects compared to Polident and 0.2% CHX.

Impact of household vinegar on calculus removal and mechanical properties of orthodontic resin.

PURPOSE: This study evaluated calculus removal efficacy of household vinegar and its effect on autopolymerizing orthodontic resin following repeated immersion. METHODS: A total of 72 sectioned specimens of orthodontic retainers with calculus deposits following cleaning with the help of immersion in vinegar of different dilutions between 12.5% and 100%, tap water, effervescent tablets, and mechanical debridement were digitally analyzed. Changes in Ca and Fe ions in vinegar were assessed by atomic emission spectroscopy (AES). For mechanical testing, autopolymerizing polymethyl methacrylate (PMMA) samples were similarly grouped and immersed for 78 cycles and their flexural strength and hardness measured. Fourier-transform infrared spectroscopy (FTIR) was performed to evaluate changes in their chemical composition. One-way analysis of variance (ANOVA) and Tukey's test were used to analyze the differences in the mean flexural strength and hardness between the groups (p ≤ 0.05). RESULTS: A minimum immersion of 2 h in 25% vinegar solution combined with brushing attained efficiency of 74.13 ± 22% calculus removal. Whereas, tap water and effervescent tablets had 15% and 49% efficiency, respectively. AES results showed diffusion of Ca ions from calculus into the vinegar solution as a plausible mechanism for its structural weakening and removal. Results of mechanical testing showed that undiluted vinegar solution affected the flexural strength of PMMA and this effect was significantly different from that of the effervescent tablets and the remaining vinegar concentrations. There was no significant difference in hardness between the groups. The FTIR showed no changes in the chemical composition of PMMA samples following repeated immersions. CONCLUSION: Vinegar can be useful in the removal of calculus from dental appliances but should be used in diluted forms to minimize side effects.

Influence of the cross-linking agent on mechanical properties of PMMA powder with compromised particle morphology.

OBJECTIVE: To investigate the effect of a cross-linking agent on the mechanical properties of self-cured orthodontic acrylic resin using PMMA powder (CPM-PMMA) with a compromised microstructure. MATERIALS AND METHODS: The mechanical properties of three sample groups were investigated in this study: CPM-PMMA, orthocryl and orthoplast. CPM-PMMA powder was prepared by suspension polymerization. It was mixed with a commercially available liquid (orthocryl) to yield a test specimen and to compare its flexural properties and Vicker hardness with the two commercial products. Molecular weight and particle size distribution of all groups were examined. Particle morphology was observed using scanning electron microscopy (SEM) and optical microscopy (OM). RESULTS: The average molecular weight of the CPM-PMMA powder was similar to that of the industrial products. Its particle size distribution was narrow and limited to large sizes (91.1-149µm). SEM and OM presented the compromise particle morphology. However, the flexural properties and Vicker hardness of CPM-PMMA powder mixed with orthocryl liquid showed no significant difference compared with orthocryl sample group. In addition, the CPM-PMMA had higher flexural properties than the orthoplast samples. CONCLUSIONS: Although the CPM-PMMA powder presented a compromised particle morphology and narrow particle size distribution, when mixed with orthocryl liquid, the cured resin produced acceptable mechanical properties due to the large amount of cross-linking agent. This result could indicate that the mechanical properties of self-cured acrylic resins are mainly dependent on the amount of cross-linking agent in the liquid component.