Infected Teeth Research Articles

Replantation of a Permanent Tooth With a Curved Root From Infected Tooth Germ: A Case Report With a Four-Year Follow-Up

Replantation of a Permanent Tooth With a Curved Root From Infected Tooth Germ: A Case Report With a Four-Year Follow-Up

Endodontic treatment in patients undergoing hematopoietic stem cell transplantation: a retrospective cohort study

This study investigated the implications of root canal treatment (RCT) of infected teeth with apical periodontitis (AP) in patients undergoing hematopoietic stem cell transplantation (HSCT). One hundred patients were selected. Clinical data, oncological and endodontic diagnosis and treatment, and type of HSCT were recorded. Data on the exacerbation of AP was investigated. Leukocyte/neutrophil and C-reactive protein (CRP) levels were evaluated before and after RCT. One hundred patients underwent HSCT (55% autologous). The need for RCT was identified in 41% of the participants. AP was diagnosed in 75.6% of these patients and large lesions (> 5 mm) occurred in 45.2%. A higher prevalence of AP was observed in males (p=0.012). RCT was performed in 54.8% of the individuals and no AP exacerbation, pain, swelling, bacteremia, and need for additional medications was observed. Blood cultures were negative for bacteria and fungi. CRP levels were >1mg/dL in 54.9% of the individuals 1 month before RCT and <1mg/dL in 64.6% 6 months after treatment (p>0.05). RCT was effective in controlling infection with no complications in patients undergoing HSCT. Given the potential for exacerbation of endodontic infections, RCT and patient monitoring are essential and highly recommended.

Bovine pulp extracellular matrix hydrogel for regenerative endodontic applications: in vitro characterization and in vivo analysis in a necrotic tooth model

BackgroundRegenerative endodontic procedures (REPs) offer the promise of restoring vitality and function to a previously necrotic and infected tooth. However, the nature of regenerated tissues following REPs remains unpredictable and uncontrollable. Decellularized extracellular matrix scaffolds have gained recent attention as scaffolds for regenerative endodontics.ObjectivesPreparation and characterization of a bovine dental pulp-derived extracellular matrix (P-ECM) hydrogel for regenerative endodontic applications. Biocompatibility and regenerative capacity of the prepared scaffold were evaluated in vivo in a canine animal model.MethodsFifteen freshly extracted bovine molar teeth were used to prepare P-ECM hydrogels following approval of the institutional review board of the faculty of dentistry, Alexandria University. Decellularization and lyophilization of the extracted pulp tissues, DNA quantification and histological examination of decellularized P-ECM were done. P-ECM hydrogel was prepared by digestion of decellularized pulps. Prepared scaffolds were evaluated for protein content and release as well as release of VEGF, bFGF, TGF-β1 and BMP2 using ELISA. Rabbit dental pulp stem cells’ (rDPSCs) viability in response to P-ECM hydrogels was performed. Finally, proof-of-concept of the regenerative capacity of P-ECM scaffolds was assessed in an infected mature canine tooth model following REPs versus blood clot (BC), injectable platelet-rich fibrin (i-PRF) or hyaluronic acid (HA). Statistical analysis was done using independent t test, the Friedman test and chi-square tests (p value ≤ 0.05).ResultsDNA was found to be below the cut-off point (50 ng/mg tissue). Histological evaluation revealed absence of nuclei, retention of glycosaminoglycans (GAGs) and collagen content, respectively. P-ECM hydrogel had a total protein content of (493.12 µg/µl) and protein release was detected up to 14 days. P-ECM hydrogel also retained VEGF, bFGF, TGF-β1 and BMP2. P-ECM hydrogel maintained the viability of rDPSCs as compared to cells cultured under control conditions. P-ECM hydrogel triggered more organized tissues compared to BC, i-PRF and HA when used in REPs for necrotic mature teeth in dogs. Periapical inflammation was significantly less in HA and P-ECM groups compared to blood-derived scaffolds.ConclusionBovine dental pulp-derived extracellular matrix (P-ECM) hydrogel scaffold retained its bioactive properties and demonstrated a promising potential in regenerative endodontic procedures compared to conventional blood-derived scaffolds.

2,4-Di-Tert-Butylphenol of Streptomyces luridiscabiei MMS-10 Inhibits Biofilm Forming Cariogenic Streptococcus mutans ULSP-2.

Dental caries is a common chronic infectious disease of the oral cavity that affects the overall oral health of the individual. Cariogenic bacteria have long been recognized for their role in developing chronic dental infections. Drug-resistant bacteria represent a global challenge to effective pathogen control in caries. The present study aimed to isolate and identify soil actinomycetes for their antibacterial and anti-biofilm activities against antibiotic-resistant and biofilm-forming cariogenic bacteria. Thirteen caries bacteria isolated from infected tooth samples were evaluated for antibiotic resistance and biofilm formation. The isolate ULSP-2 showed the highest antibiotic resistance score (0.714) and was found to be a strong biofilm producer when tested by congo red agar and microtiter plate assays. The bacterium was identified as Streptococcus mutans based on morphological, biochemical, and molecular characterization. The effect of ethyl acetate extracts from 20 soil actinomycetes on the growth and biofilm formation ability of S. mutans was evaluated. The MMS-10 extract strongly inhibited growth (18.5 ± 0.5mm) and biofilm formation (56.46 ± 0.32%) of S. mutans at 100µg/mL. The isolate MMS-10 was identified at the molecular level as Streptomyces luridiscabiei. Based on FTIR, NMR, and GC-MS analysis, the purified MMS-10 extract was characterized and identified as 2,4-Di-tert-butylphenol. The metabolite's physiological, physicochemical, and pharmacokinetic properties were analyzed using the Swiss ADME web server and found to satisfy the criteria of drug-likenessof a molecule. The study revealed the significance of soil actinomycetes in controlling growth and biofilm formation in cariogenic S. mutans.

Postoperative pain in oncological patients subjected to nonsurgical root canal treatment: a prospective case-control study.

The purpose of this prospective study was to evaluate the incidence and intensity of postoperative pain in oncological patients with infected teeth subjected to nonsurgical root canal treatment or retreatment. Teeth with apical periodontitis from healthy control patients and oncological patients (n = 70 per group) were root canal treated/retreated and evaluated for the development of postoperative pain. Patients from the two groups were matched for tooth type, gender, clinical manifestation of apical periodontitis, and intervention type. A visual analogue scale (VSA) was used to evaluate the incidence of postoperative pain at 24h, 72h, 7d, and 15d after chemomechanical procedures. Data were statistically analyzed for the incidence and intensity of postoperative pain in the two groups. Preoperative pain occurred in 10% of the individuals and in all these cases pain showed a reduction in intensity or was absent after endodontic intervention at 24-h evaluation. The overall incidence of postoperative pain at 24h was 14% in oncology patients and 30% in controls (p = 0.03). At 72h, the respective corresponding figures were 4% and 8.5% (p > 0.05). At 7 and 15 days, all patients were asymptomatic, irrespective of the group. No significant differences in postoperative pain were found between control and oncological patients. The low incidence of postoperative pain observed in both groups supports the routine use of nonsurgical root canal treatment/retreatment as valid options in oncological patients. Oncological patients had no increased risk of postoperative pain in comparison with control patients.

Regenerative potential of mesoporous silica nanoparticles scaffold on dental pulp and root maturation in immature dog’s teeth: a histologic and radiographic study

ObjectiveTo evaluate histologically and radiographically the potential of dog’s immature roots with apical periodontitis to regenerate after regenerative endodontic treatment using mesoporous silica nanoparticles (MSNs) with/without bone morphogenic protein (BMP-2) as scaffolds.MethodsIn 4 mongrel dogs, 56 immature teeth with 96 roots were infected, resulting in necrotic pulps and periapical pathosis. According to the evaluation time (Group I = 30 days and Group II = 90 days), 90 roots were divided into two equal groups (45 roots each) and 6 roots used to replace any lost root during the procedure. The two main groups were further divided according to treatment protocol into 5 subgroups (9 roots each): blood clot (BC subgroup), mesoporous silica nanoparticles scaffold only (MSNs subgroup), mesoporous silica nanoparticles impregnated with BMP2 (MSNs + BMP2 subgroup), infected teeth without treatment (+ ve control subgroup) and normal untouched teeth (-ve control subgroup). All teeth surfaces were coated with Tincture iodine and calcium hydroxide was applied prior to treatment protocols. Then, teeth were restored with glass ionomer filling to seal the remaining part of the access cavity. Radiography evaluation of the increase in root length, root thickness and occurrence of apical closure were performed. Following the sacrifice of the two dogs at each time of evaluation, histopathological analysis was performed and included the inflammatory cells count, bone resorption, tissue ingrowth, deposition of hard tissue, and closure of the apical part. All data were statistically analyzed.ResultsCompared to BC subgroup, MSNs and MSNs + BMP-2 subgroups exhibited significant higher increase in root length and thickness as well as higher vital tissue in-growth and new hard tissue formation in group II (P < 0.05). MSNs + BMP-2 subgroup had significant higher increase in root length and thickness as well as significant lower inflammatory cell count than MSNs subgroup in both groups (P < 0.05). There were no significant differences between MSNs and MSNs + BMP-2 subgroups regarding new hard tissue formation in both groups and apical closure in group I (P > 0.05).ConclusionMSNs with/without BMP-2 scaffolds enabled the continuing growth of roots in immature teeth with necrotic pulps and periapical pathosis. Addition of BMP-2 to MSNs scaffold improved its outcome in regenerative endodontics.Clinical relevanceMSNs with/without BMP-2 scaffolds may alternate blood clot for regenerative endodontic treatment of immature teeth with necrotic pulps.

Comparative evaluation of selected concentrations of sodium hypochlorite on the outcome of endodontic therapy among Ghanaians.

Endodontic treatment is one of the main dental treatments to manage inflamed or infected root canal systems of teeth. The success of endodontic treatment principally depends on eradicating microorganisms in the root canal by chemo-mechanical debridement with irrigation solutions like sodium hypochlorite (NaOCl). NaOCl has been used in concentrations ranging from 0.5% to 5.25%. This study determined the antimicrobial effectiveness of selected concentrations (0.5%, 1.0%, 2.6%, and 5.2%) of NaOCl in endodontic treatment. The study sites were the University of Ghana Dental School (UGDS) and Noguchi Memorial Institute for Medical Research (NMIMR). Sixty infected single-rooted single-canal teeth were used. Before (S1) and after (S2), root canal samples during the endodontic treatment with the selected concentrations of NaOCl were examined via anaerobic and aerobic cultures. The isolates were identified using Matrix Assisted Laser Desorption Ionization-Time Of Flight Mass Spectrometry (MALDI-TOF MS). All S1 samples were positive for cultivable bacteria. Fifty-three (53) different microbial species belonging to 20 different microbial genera were isolated. Streptococcus viridans was the most frequently isolated microbe. There were zero isolates in the root canals irrigated with 2.6% and 5.2% NaOCl. Two teeth had isolates in the groups irrigated with the lower concentrations (0.5% and 1.0%) of NaOCl. The persistent bacteria were one species each of Streptococcus mitis and Streptococcus oralis, respectively. Root canal treatments using chemo-mechanical preparation with the selected concentrations (0.5%, 1.0%, 2.6%, and 5.2%) of NaOCl were effective in significantly reducing the microbial load, and for the 5.2% and 2.6% concentrations, in eliminating all the microorganisms.

Effect of Intracanal Cryotherapy and Curcuma Longa as a Final Irrigant in Reducing Post Operative Pain: An In-Vivo Study

ABSTRACT Aim: The point of search of present study was to assess intracanal viability of cold saline, curcumin as an irrigant, and ordinary saline as last irrigant in lessening post endodontic torment. Material and Method: In total, 60 individuals were chosen and divided into 3 groups: Group I: intracanal cryotherapy using 2.5°C cold saline, Group II: curcumin irrigant, and Group III: ordinary saline. After the biomechanical preparation, the above mentioned irrigant was used. On the visual analogue scale, participants were asked to rank the intensity of their discomfort following the procedure before, after 6 h and 24 h after the procedure. The outcomes were dissected utilizing ANOVA test. Result: Both the regimens were successful in reducing post endodontic soreness associated with infected teeth. Conclusion: Curcumin and cryotherapy both the regimens were successful in lessening post endodontic torment.

Evaluation of ozonated olive oil in the success of immediate dental implants placed into infected sockets

Abstract Purpose This prospective study was conducted to assess the clinical and radiographic influences of topical application of ozonated olive oil on immediate implants inserted into infected fresh extraction sockets. Patients and methods This study was implemented on 14 cases with infected nonrestorable teeth or remaining roots. All cases underwent two-stage implant surgery, stage I: extraction of the tooth, application of ozonated olive oil gel into the infected postextraction socket, and immediate insertion of dental implant fixture, and stage II: 4 months after stage I surgery, the abutment was installed onto the implant fixture. After soft tissue healing around the abutment, the implant was loaded with the final functional prosthesis. All the patients had regular follow-up intervals throughout the study period to evaluate soft tissue and bone healing and implant stability. Results Fourteen patients enrolled in this study, of which there were six (42.9%) males and eight (57.1%) females. The age of the patients ranged between 21 and 45 years with a mean of 33.21 ± 9.16 years. The clinical outcomes including visual analog scale, soft tissue dehiscence, infection, implant stability quotient, gingival index, and peri-implant probing depth all indicated uneventful postoperative healing and 100% survival rate of the implants throughout the follow-up intervals. Radiographic outcome included interpreting cone beam computed tomography measurement of alveolar bone height which showed marked significant positive difference between stage I and stage II surgeries indicating a potential enhancing effect of ozonated olive oil on osseointegration and tissue healing. Conclusion Based on the outcomes of this study, we concluded that topical administration of ozonated olive oil might potentially enhance healing and osseointegration of implants immediately inserted into infected fresh extraction sockets and could exhibit a significant influence on increasing the success rate and minimizing complications. However, further investigation employing a control group, larger sample size, and longer follow-up duration is required to confirm this influence.

Enriched advanced platelet-rich fibrin plus gold nanoparticles against Enterococcus faecalis for its potential use in revascularization for necrotic immature permanent teeth.

Regenerative endodontic procedures allow reinforcement of root canal wall and continuation of root development, opening new therapeutic possibilities. The root canal system of infected teeth is colonized by a variety of microorganisms, which hinder the regenerative process, leading to treatment failure if not adequately addressed, thereby requiring careful attention to microbial control. The aim of the study was to assess the antimicrobial activity of advanced platelet-rich fibrin (A-PRF) and gold nanoparticles (AuNps) against Enterococcus faecalis. Intravenous blood (5-6 ml) was drawn from four healthy individuals, and A-PRF was prepared through centrifugation at 1500 revolutions per minute (rpm) for 14 min. A-PRF was doped with 3 µl of AuNps and centrifuged at 1000 rpm for 1 min. Antimicrobial activity was assessed using disk diffusion; inhibition zones were measured. For minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC), A-PRF + AuNps were added to the microbial broth at varying concentrations to determine growth inhibition and microbial death. Disk diffusion assays revealed significant antibacterial effects against E. faecalis. Norfloxacin displayed the highest mean zone of inhibition (20.33 ± 1.53 mm), followed by the Test group (A-PRF + AuNPs) (19.33 ± 0.58 mm). Multiple comparisons indicated significant differences (P < 0.001). MIC of A-PRF + AuNPs against E. faecalis was 0.031 mg/ml, with MBC at 0.015 mg/ml. The addition of AuNPs to A-PRF offers the potential for sustained growth factor release while maintaining the sterility of the canal, leading to successful revitalization and regeneration. The combined use of A-PRF + AuNps shows promise for enhancing revascularization in necrotic immature permanent teeth.

Preclinical comparison study of experimental peri-implantitis between alveolar ridge preservation and spontaneous healing sites in infected and noninfected tooth: a randomized blinded in vivo study.

This study compared the progression of experimental peri-implantitis between alveolar ridge preservation (ARP) and spontaneous healing (SH) sites in infected (IT) and noninfected tooth (NIT). Bilateral mandibular third or fourth premolars of six beagle dogs were randomly assigned to IT and NIT groups. Before extraction, chronic dehiscence defects were created at the mesial root of mid-buccal area in IT group. Four weeks later, the mesial roots of the third and fourth premolars were extracted in all groups.ARP procedure was randomly conducted on one side of the extraction sockets using collagenated bovine bone substitutes and resorbable collagen membrane, and contralateral side was allowded spontaneous healing. After 12weeks of healing, bone-level implants (ϕ 3.6 × 8.0mm) were placed at the extraction sockets. Three months of ligature induced peri-implantitis and three months of spontaneous progression were allowed, with radiographs taken at each phase. Biopsies were retrieved at the implant site for histomorphometric, immunohistochemical, and polarized light-microscopic analyses. Radiography demonstrated that the changes in the marginal bone level during the spontaneous progression period showed no significant differences between ARP and SH sites. Only small and/or nonsignificant differences in the progression of peri-implantitis were observed between ARP and SH sites in histomorphometric, immunohistochemical, and polarized light microscopic analyses. Additionally, the IT and NIT groups exhibited similar outcomes for most parameters. ARP with xenogenic bone substitutes might provide similarly robust results as SH sites regarding the progression of experimental peri-implantitis, irrespective of the infected or noninfected nature of the site before tooth extraction.

Phytochemical Analysis and Antibacterial Property of Green Okra Fruit Extract Against Enterococcus Faecalis Bacteria Tooth Root Canals

Background: Root canal treatment aims to eliminate bacteria that cause pulp abnormalities. Enterococcus faecalis is a bacteria in the infected tooth pulp, even those that have been treated. Irrigation was carried out together with biomechanical preparation using a combination of NaOCl and EDTA. The material is antibacterial, dissolves the organic and inorganic tissue of the root canal dentin, lacks odor and irritates the soft tissue. An alternative irrigation material from Jember cultivation is green okra. The fruit contains flavonoids, tannins, steroids, terpenoids. This study aims to analyze the phytochemical and antimicrobial properties of green okra fruit extract on the growth of E. Faecalis bacteria. Method: Phytochemical analysis to see the content of alkaloids, flavonoids, tannins, saponins, steroids and terpenoids. Antimicrobial analysis included the inhibition test using disc diffusion, MIC and MBC tests using the dilution method. Samples were green okra fruit extract 100%, 50%, 25%, 12.5%, 6.25%, 3.125%, 1.563%, 2.5% NaOCl, 17% EDTA. The MIC and MBC tests were examined for Optical Density values ​​with a spectrophotometer and then subcultured to see whether there was growth of bacterial colonies. Analysis of the research data used ANOVA and LSD parametric statistical tests Result: Phytochemical content sequentially is Polyphenols, Alkaloids, Flavonoids, Saponins, Tannins, Steroids, Terpenoids. Antimicrobial properties Green okra fruit extract concentration of 6.25% had the smallest inhibition zone, the largest OD value and the highest colony count. The concentration of 100% has the largest inhibition zone, the lowest OD, there are no bacterial colonies. Antimicrobial power The concentration of 100% is close to that of 17% EDTA and 2.5% NaOCl. In the Kruskal Wallis test, there were differences in the Mann-Whitney test study group, there were significant differences between all groups Conclusion: The phytochemical content of green okra fruit extract has antimicrobial activity against E. faecalis approaching 2.5% NaOCl and 17% EDTA at 100% concentration, 6.25% MIC concentration and 12.5% ​​MBC concentration. Keywords: Phytochemical, Antibacterial, Green okra fruit extract, Enterococcus faecalis

Treatment outcome of coronal pulpotomy and indirect pulp capping in mature permanent molars with symptoms of moderate pulpitis: A randomized clinical trial.

This clinical trial aimed to compare the clinical success of coronal pulpotomy and indirect pulp capping (IPC) in managing symptomatic deep proximal caries in molars with moderate pulpitis over a 12-month period. A total of 108 vital mature permanent molars with moderate pulpitis were randomly allocated to the IPC (n = 54) or coronal pulpotomy group (n = 54). Dycal and Biodentine were used as pulp-capping materials, followed by composite restoration. The absence of periapical infection and asymptomatic teeth that positively responded to the cold pulp sensitivity test (only in IPC) was considered posttreatment success at 12 months. Data from the study were analyzed using the Chi-square test and Kaplan-Meier survival analysis. There was a statistically significant difference between preoperative symptoms and the cold pulp sensibility test response (P = 0.000), indicating an association between symptoms and pulp sensibility. The average remaining dentine thickness (RDT) value was 0.48 ± 0.5 mm, with no statistically significant difference found between the location of caries and RDT (P = 0.084, P > 0.05). Compared to the IPC group, the pulpotomy group had a greater number of patients at 12 months after treatment that required no intervention. The Kaplan-Meier survival analysis revealed that the mean survival duration for pulpotomy was 48 weeks, and for IPC, it was 42.3 ± 2.35 weeks. Coronal pulpotomy with Biodentine proved more effective in reducing symptoms, achieving radiographic success, and ensuring tooth survival compared to IPC with calcium hydroxide.

Revascularization Revisited with Modified Triple Antibiotic Paste and NeoPutty MTA®

ABSTRACT Introduction and Aim: Performing endodontic treatment in an immature permanent tooth that has experienced trauma or carious exposure can pose challenges. The root canals in these teeth are typically open and fragile, making instrumentation and obturation difficult. Traditional apexification, which involves placing calcium hydroxide paste in the root canal for a specified period to induce the formation of a calcified barrier, has been a long-standing approach. While it is a widely used method, leaving the paste in the root for extended periods can weaken it due to the paste’s hygroscopic properties and the proteolytic activities of calcium hydroxide. As a result, researchers have been exploring alternative treatments that allow for the full development of immature teeth. Revascularization has emerged as one such alternative, with a variety of treatment protocols documented in scientific literature. Description of the Case: This case report, for the first time, describes the use of NeoPutty MTA® and triple antibiotics paste for revascularization in a young female child on a carious, exposed lateral incisor with opex apex with success. Conclusion: The revascularization process attempted on the infected tooth met with success and closure of apex was noticed in a short period of time.

Time-Dependent Antibacterial Effects of Citrullus Colocynthis Seed Extract Compared to Calcium Hydroxide in Teeth Infected with Enterococcus Faecalis.

Endodontic efforts are focused on eliminating intracanal pathogens. Applying intracanal medicament for infected teeth is beneficial for achieving better antibacterial effects in endodontic treatments. Different intracanal medicaments should be assessed and compared for this purpose. The aim of this study was to assess the antibacterial efficacy of Citrullus colocynthis seed extract comparing to Ca(OH)2 on teeth contaminated with Enterococcus faecalis. In this in vitro study, a novel strain of Enterococcus faecalis (Enterococcus spp. ATCC 19433) yielded from the root canal treated tooth with persistent apical periodontitis. The canals of 78 human single-rooted extracted teeth were contaminated with mentioned strain and treated with Citrullus colocynthis essential oil and Ca(OH)2 for 1, 7, and 14 days. To determine the chemical composition of the oils, gas chromatography-mass spectrometry (GC-MS) was applied. The percentage reduction from baseline c.f.u./mL values was estimated. Oleic acid, benzoic acid, and gallic acid were the major contents of Citrullus colocynthis essential oil. The c.f.u./mL count decreased considerably as contact duration rose for both medicaments. After 7 days, a statistically significant difference was identified between the medicaments. Citrullus colocynthis showed higher antimicrobial efficacy. However, after 14 days, no substantial difference was found. Citrullus colocynthis essential oil, displayed great antimicrobial efficacy against Enterococcus faecalis higher than Ca(OH)2 over the first week contact period.

СРАВНИТЕЛЬНЫЙ АНАЛИЗ ЦИТОТОКСИЧНОСТИ СИЛЕРОВ ДЛЯ ПРОВЕДЕНИЯ ПЛОМБИРОВАНИЯ КОРНЕВЫХ КАНАЛОВ (IN VITRO)

Endodontics, being a part of the discipline "Dentistry", includes sections on the study of morphology, physiology and pathology of dental pulp and human periapical tissues, as well as the prevention and treatment of diseases and injuries associated with these tissues. Its scope of application includes the diagnosis and treatment of pain of pulpar and/or periapical origin, vital pulp therapy, regenerative endodontic procedures, non-surgical root canal treatment, surgical or non-surgical re-treatment of teeth with persisting infection and intracanal teeth whitening with discoloration. Ultimately, the main goal is to preserve the natural dentition.&#x0D; Like other dental specialties, endodontics combines two inseparable parts in its practical part: art and science. The art lies in performing technical procedures during root canal treatment. The scientific part includes fundamental and clinical disciplines, studying.&#x0D; Objectives. To study the cytotoxicity of epoxy resin-based silers in laboratory conditions on human cell lines and conduct their comparative analysis.&#x0D; Methodology. The article presents an analysis of the results of in vitro cytotoxicity of silers by assessing cell viability with direct injection of the studied materials into human cell culture.&#x0D; Conclusion. It has been experimentally proven that samples 1 (AH plus, Dentsply Sirona, Germany) and 3 (Epoxidin DUO, TecnoDent, Russia) do not have cytotoxic properties, unlike 2 samples (Sealart, Dentac, Turkey).

Intentional Replantation as the Treatment of Left Mandibular Second Premolar Refractory Periapical Periodontitis: A Case Report

Introduction This report aims to assess the feasibility of intentional replantation combined with concentrated growth factor(CGF) membrane treatment for refractory apical periodontitis of the left mandibular second premolar (35), with a 13-month follow-up period. Case Report A 24-year-old female patient underwent root canal treatment for pulpitis of the left mandibular second premolar 3 years ago, and her gum repeatedly swelled and drained pus after the treatment. CBCT revealed that the apical area of 35 was adjacent to mental foramina, and the cyst range was large. There could be issues of poor visual field, trauma, difficulty in apical preparation and backfilling after the apical resection. The left mandibular second premolar (35) was extracted, and the inflammatory tissues in the apical and alveolar fossa were removed, followed by the removal of apical irritants. The extracted premolar was then implanted into the alveolar fossa and fixed. Results and Prognosis After a duration of 13 months, the left mandibular second premolar 35 exhibited no clinical symptoms and was able to perform normal masticatory function. There was an absence of gum swelling, pain or mobility; cone beam computed tomography imaging revealed bone regeneration below the root apex with the absence of new lesions, root resorption, or adhesion to the alveolar bone. The periodontal ligament demonstrated healing between the root and alveolar bone, effectively controlling infection, preserving infected teeth and facilitating the formation of new attachments around them. Discussion Intentional tooth replantation has some advantages, like short operation time, less cost, less bone injury, and less limitations in terms of anatomy and location. However, clinicians should consider whether intentional replantation could be performed before dental implantation for the affected teeth with intractable periapical lesions. Nonetheless, its efficacy needs further evaluations through long-term clinical follow-ups.

Effectiveness of Calcium Hydroxide and Gingerols Mixture as a Novel Obturation Material for Infected Root in Primary Teeth: A Randomized Clinical Trial.

The tendency to use dental materials of plant origin is one of the prevailing trends in dentistry to reduce exposure to materials that could have some toxic impact in the long term. To evaluate the efficacy of calcium hydroxide combined with gingerols (Ginge-Cal) as a novel obturation material for treating infected primary teeth and decreasing the recurrence of infection. The study was conducted on 30 lower primary molars with infected pulp for children aged 4-8 years. The sample was randomly divided into two groups depending on the tested obturation material: Ginge-Cal group and the Metapex group. The evaluation was done by different parameters clinically and radiographically at various intervals up to 12 months. Based on chi-squared and McNamara's test with a 5% significance level, the clinical results indicated that Ginge-Cal group was more effective than the Metapex group in reducing or eliminating pain (P=0.467) after 1 week, sensitivity to percussion (P=0.090) at 3 months of follow-up, purulent swelling (P=0.444) at 6 and 9 months of follow-up, fistula, and tooth mobility. The radiographic results, based on the periapical and furcation area radiolucency at 12 months of follow-up, favored Ginge-Cal group over the Metapex group (P=0.683), (P=0.456), respectively. There were no statistically significant differences in pathological root resorption and periodontal space. The differences within the Ginge-Cal group were directly influenced by the time intervals in a statistically significant manner, ranging from (P=0.004) to (P < 0.001). The success percentage was 87.5% for Ginge-Cal group and 64.3% for Metapex group. Ginge-Cal can be considered a promising material for treating the infected root canal when used as an obturation material for the infected root canal. This trial is registered with NCT05181813.

Evaluation of the efficacy of buffered local anesthetic in extraction of infected teeth-randomized double-blind study.

In the presence of infection, acidic pH of a lignocaine local anesthetic causes undesirable effects such as burning on injection, relatively slow onset, and lack of numbness. Buffered lignocaine will increase the pH of the solution and may resolve above problems. Thus, the objective of this study is to compare the efficacy of buffered lignocaine with that of commercial lignocaine. Seventy patients with infected teeth were randomly divided into two equal groups. The study group received buffered lignocaine (8.4% sodium bicarbonate added to 2% lignocaine mixture) while the control received commercial lignocaine preparation (2% lignocaine with 1:80,000 adrenaline). Burning while injection, pain using VAS scale and onset of action with EPT (electric pulp tester) were recorded. In the study group, the VAS score after injection was 1.20 ± 0.68 and the control group was 2.57 ± 0.92 (p = 0.001). There was a statistically significant reduction in pain reduction in the study group. The time of onset was 3.97 ± 0.71 and 5.67 ± 1.15min, respectively, and the difference was statically significant. Only one-third of the study group experienced burning on injection as compared to two-thirds in the control group. Buffered lignocaine is more effective as compared to commercial lignocaine in the extraction of infected teeth. CTRI/2022/01/039476.

Unraveling the Life History of Past Populations through Hypercementosis: Insights into Cementum Apposition Patterns and Possible Etiologies Using Micro-CT and Confocal Microscopy.

The "teeth-as-tools" hypothesis posits that Neanderthals used their anterior teeth as a tool or a third hand for non-dietary purposes. These non- or para-masticatory activities (e.g., tool-making or food preparation prior to ingestion) have also been described in other past and extant human populations, and other Primates. Cementum is the mineralized tissue that covers the tooth root surface and anchors it to the alveolar bone. Under certain conditions (e.g., mechanical stress, infection), its production becomes excessive (i.e., beyond the physiological state) and is called 'hypercementosis'. Several studies in dental anthropology have established a correlation between the teeth-as-tools and hypercementosis. The present work aims to characterize the different patterns of cementum apposition on archeological teeth and discuss their supposed etiology. Using microtomography and confocal microscopy, the patterns of cementum apposition (i.e., thickness, location, and surface characteristics) were analyzed in 35 hypercementotic teeth (Sains-en-Gohelle, France; 7th-17th c. A.D.). Four groups were identified with distinct hypercementosis patterns: (1) impacted, (2) infected, (3) hypofunctional, and (4) hyperfunctional teeth. Characterizing hypercementosis can contribute to documenting the oral health status (paleopathology) and/or masticatory activity of individuals, even from isolated teeth. This has implications for the study of fossil hominins, particularly Neanderthals, known for their use of anterior teeth as tools and frequent and substantial occurrence of hypercementosis.