Molar Teeth Research Articles

Prevalence of cervical enamel projections and enamel pearls on furcation area of Iraqi molar teeth

Cervical enamel projections and enamel pearls in relation to molar furcationsmay act as predisposing factors in periodontal attachment loss. The objectives of thisstudy were to investigate the prevalence of cervical enamel projections and enamelpearls on furcation areas of molar teeth of Iraqi population. The material consisted of(465)extracted upper and lower molars. They were (200) upper molars and (200) )lower molars extracted because of` caries and pulp lesions(groupl), while the othermolars extracted because they were periodontally diseased(group2). The cervical )64(enamel projections were classified into three grades(described according to peter et al 2000)For group l the results showed that (5l%) of upper molars and (66%) of lowermolars had cervical enamel projections. Enamel pearls were identified on (1.5%) ofupper molars and (2.5%) of lower molars. Maxillary molars had (59.8%) grade Icervicaljnamel pro`ections and 28.4%) grade ll and (ll.7%) rade III. Whilemandibular molars showed (66.6%) teeth with grade I, (24.2%) teeth with grade IIand (9%) teeth with grade III .For grou 2 cervical enamel rojcctions were identifiedon (70.7%) ofthe collected molarsThe results of the present study give an indication that cervical enamelprojections are frequent enough to be of clinical importance

Root to recovery: Successfully healing a large periapical lesion in the mandibular first molar: A case report

This case report presents the diagnosis, successful management, and healing of a large periapical lesion associated with the mandibular first molar teeth The patient's chief complaint was severe, intermittent pain in the lower right posterior region of the mouth, and radiographic examination revealed a substantial periapical radiolucency around the apices of the mandibular first molar. The treatment involved root canal therapy along with adjunctive procedures to promote healing of the periapical lesion. Follow-up radiographs demonstrated a significant reduction of the periapical lesion with complete resolution of symptoms.

Influence of the severity of periodontal disease on the outcome of non-surgical endodontic therapy: A prospective cohort study.

To investigate the influence of severity of periodontal disease on periapical healing after non-surgical endodontic therapy (NSET). In this prospective study, subjects (n = 45) requiring NSET in a mandibular molar tooth with the diagnosis of pulp necrosis and asymptomatic apical periodontitis exhibiting radiographic periapical index (PAI) score ≥ 3 and concomitant endodontic periodontal lesion (CEPL) without communication were enrolled. After dividing as per the classification of Periodontal and Peri-Implant Diseases and Conditions, subjects were equally allocated into three groups. Group I- only endodontic lesion {control: healthy periodontium (n = 15)}, Group II- CEPL having stage I and II periodontitis (n = 15) and Group III- CEPL having stage III periodontitis (n = 15). Standardized two-visit NSET was performed with 2% chlorhexidine gel as an intracanal medicament. Periodontal therapy was instituted wherever required. Subjects were recalled at 6-and 12-months for clinical and radiographic assessment. Chi-square test was performed to evaluate the difference between the groups. At 12-month follow-up, all teeth in the three study groups were asymptomatic. On radiographic evaluation of the periapical region, healing was observed in 80%, 47% and 50% of teeth in Groups I, Group II and Group III, respectively. However, the difference was not statistically significant between the groups (p = 0.150). The severity of periodontal disease had no influence on periapical healing after NSET in teeth with concomitant endodontic periodontal lesions without communication. Periodontal disease has significant impact on apical periodontitis however severity of the periodontitis does not negatively impact the apical periodontitis.

Assessment of the Smear Layer Removal Efficacy of Three Different Agents on Periodontally Compromised Tooth: An In Vitro Study.

The purpose of the present study was to evaluate the smear layer removal efficacy of three various agents on periodontally compromised tooth. The current study included 75 molar teeth that were extracted due to periodontal disease. After that, 25 samples were randomly assigned using a simple random technique to the three different agent groups, group A: Scaling and root planing (SRP) and application of SofScale agent, group B: SRP and application of QMix agent, group C: SRP and application of MTAD agent. Using a diamond circular saw, the treated portions were divided into horizontal and vertical halves. All samples were viewed under Scanning Electron Microscope. Every tooth was focused at the coronal third, middle third, and apical third portion with a magnification of 1000×. Data were recorded and statistically analyzed. The smear layer removal efficacy was more in the QMix agent (3.06 ± 0.04) group followed by MTAD agent (3.28 ± 0.09) and SofScale agent (4.14 ± 0.10) group on the root surface. On intra group comparison, there was a statistically significant difference found in all the intra group agents with all the three levels. On inter group evaluation, at coronal third, there was no significant difference found between the different agents. There was a significant difference found between the different agents at middle and coronal third. On conclusion, the current investigation found that, the root surfaces treated with QMix shown a greater ability to remove smear layers compared to tooth surfaces treated with MTAD and SofScale agent. Conventional therapies such as SRP effectively eliminate calculus, plaque, and necrosed cementum; nevertheless, they leave behind a smear layer that could impede normal healing. In an effort to overcome this, root conditioning agents were applied on the root surface to remove the smear layer. The traditional root conditioning agents such as citric acid have certain disadvantages, though, such as an acidic pH that could harm the root surface. As a result, researchers have been looking for biocompatible root conditioning treatments that are more effective. How to cite this article: Singh DK, BS Raj H, Soans CR, et al. Assessment of the Smear Layer Removal Efficacy of Three Different Agents on Periodontally Compromised Tooth: An In Vitro Study. J Contemp Dent Pract 2024;25(2):156-159.

Accuracy of Extraoral Bitewing Compared with Histopathology in Proximal Caries Detection of Primary Molar Teeth

An accurate diagnosis of dental caries leads to a suitable treatment plan and prevents premature loss of primary teeth. Intraoral bitewing radiography helps caries determination but has limitations in pediatric patients with severe gag reflexes while the extraoral bitewing radiograph resolved the patients who refused to undergo intraoral radiographs. The research objective was to compare the accuracy of extraoral bitewing radiography and the gold standard histopathological examination for proximal caries detection in the primary molars. Twenty-four extracted primary molars with and without proximal caries were divided into three groups and arranged in the mimetic alveolar sockets of a 3D-printed skull and mandible. Two observers evaluated extraoral bitewing images separately twice at one-week intervals. The weighted kappa coefficients showed excellent intra-observer and inter-observer agreements between each session of the extraoral bitewing radiographic assessments. The Mann-Whitney U test showed no difference between the radiographic grading scores of extraoral bitewing images and the gold standard. The sensitivity, positive predictive value (PPV), negative predictive value (NPV), and the area under the receiver operating characteristic (ROC) curve in cavitated carious lesions were higher than in non-cavitated carious lesions. In conclusion, extraoral bitewing is an alternative radiography for pediatric patients who are either uncooperative or intolerant to intraoral radiography.

Efficacy of Glass Ionomer Cement as Pit and Fissure Sealant in Permanent First Molars.

Background/Objectives Pit and fissure caries constitute a predominant portion, approximately 90% in permanent posterior teeth and 44% in primary teeth among children and adolescents. Among various preventive modalities, pit and fissure sealants play a pivotal role in safeguarding these vulnerable areas. Categorized by materials such as glass ionomer, composites, and polyacid-modified glass ionomers, these sealants offer effective protection. This study aims to evaluate the efficacy of glass ionomer-based pit and fissure sealants in terms of retention rate at 12-month post-procedure period in permanent first molars. Methodology This study was conducted at the Department of Operative Dentistry, Nishtar Institute of Dentistry, Multan, Pakistan. Fifty-six children, aged 7 to 12 years, presenting with pit and fissure caries in permanent first molar teeth were enrolled. Glass ionomer sealantwas meticulously applied to the affected pits and fissures. The efficacy was assessed after 12 months based on predefined criteria. Results The age of participants ranged from 7 to 12 years, with a mean age of 9.24 ± 1.38 years. Among the 56 patients, 23 (41.2%) were male and 33 (58.8%) were female. Sealant retention was noted in 31 (55.35%) patients, while 25 (44.65%) experienced sealant loss. In the 7 to 9-year age group, 19 demonstrated complete sealant retention, whereas in the 10 to 12-year age group, 12 exhibited complete retention. Concerning gender distribution, 17 males and 14 females exhibited complete sealant retention. Conclusion Glass ionomer-based sealants demonstrate excellent properties for pit and fissure sealing owing to their low technique sensitivity, cost-effectiveness, and favorable retention rates. Therefore, they represent an optimal choice for this preventive dental procedure.

Furcation Involvement in Periodontal Disease: A Narrative Review.

Furcation-involved teeth, commonly seen in dental practice, have a higher likelihood of needing extraction as the severity of periodontal furcation involvement increases. Studies consistently show that periodontitis in teeth with multiple roots significantly increases the risk of tooth loss, especially in the area where the furcation is involved. These furcation defects pose a major problem for dentists because of their location, accessibility issues, and the unpredictable healing process. The biggest hurdle in treating furcation defects is their irregular shape, which makes it hard to achieve complete debridement. While various treatments have been explored, non-surgical methods have not shown much success. This article comprehensively provides a review and discussion on the classification, assessment, and treatment options, including surgical and non-surgical management of furcation-involved molar teeth. Properly understanding the severity of the disease and its confounding factors and managing and treating the lesions appropriately have been shown to impart satisfactory survival rates for these teeth. Enhancing the understanding of managing these teeth can also lead to better outcomes for patients.

Comparative evaluation of hand and rotary file systems on dentinal microcrack formation during pulpectomy procedure in primary teeth: an in vitro study.

Pulpectomy can be used for the management of deep dentinal carious lesions in primary teeth which can be restored. Mechanical preparation of root canals can be performed using hand or NiTi rotary files. However, this may cause dentinal stress and consequently dentinal microcracks. Hence, the aim was comparative evaluation of hand and rotary file systems on dentinal microcrack formation during pulpectomy procedure in primary teeth. 60 extracted primary molar teeth were selected comprising of 80 root canals. Simple random sampling was used to divide root canals into four groups (n = 20): Group A-Hedstrom file, Group B-Pro AF Baby Gold rotary, Group C-ProTaper Next rotary, and Group D-unprepared group. Assessment was conducted on presence or absence of microcracks using Chi square test (p < 0.05). The total number of microcracks in Group A: one (5%), Group B: four (20%), Group C: nine (45%) and Group D: zero (0%) which was statistically significant (p = 0.002). At cervical third, the number of microcracks seen with Group A: one (5%), Group B: zero (0%), Group C: five (25%) and Group D: zero (0%) (p = 0.005). At the middle third, the number of microcracks seen in Group A: zero (0%), Group B: four (20%), Group C: four (20%) and Group D: zero (0%) (p = 0.029). The study concluded that dentinal microcracks are formed with both hand and rotary file systems in primary teeth. ProTaper Next showed significantly higher number of microcracks, followed by ProAF Baby Gold and H files.

Oxygen isotopes in orangutan teeth reveal recent and ancient climate variation

Studies of climate variation commonly rely on chemical and isotopic changes recorded in sequentially produced growth layers, such as in corals, shells, and tree rings, as well as in accretionary deposits—ice and sediment cores, and speleothems. Oxygen isotopic compositions (δ18O) of tooth enamel are a direct method of reconstructing environmental variation experienced by an individual animal. Here, we utilize long-forming orangutan dentitions (Pongo spp.) to probe recent and ancient rainfall trends on a weekly basis over ~3–11 years per individual. We first demonstrate the lack of any consistent isotopic enrichment effect during exclusive nursing, supporting the use of primate first molar teeth as environmental proxies. Comparisons of δ18O values (n=2016) in twelve molars from six modern Bornean and Sumatran orangutans reveal a high degree of overlap, with more consistent annual and bimodal rainfall patterns in the Sumatran individuals. Comparisons with fossil orangutan δ18O values (n=955 measurements from six molars) reveal similarities between modern and late Pleistocene fossil Sumatran individuals, but differences between modern and late Pleistocene/early Holocene Bornean orangutans. These suggest drier and more open environments with reduced monsoon intensity during this earlier period in northern Borneo, consistent with other Niah Caves studies and long-term speleothem δ18O records in the broader region. This approach can be extended to test hypotheses about the paleoenvironments that early humans encountered in southeast Asia.

Oxygen isotopes in orangutan teeth reveal recent and ancient climate variation.

Studies of climate variation commonly rely on chemical and isotopic changes recorded in sequentially produced growth layers, such as in corals, shells, and tree rings, as well as in accretionary deposits-ice and sediment cores, and speleothems. Oxygen isotopic compositions (δ18O) of tooth enamel are a direct method of reconstructing environmental variation experienced by an individual animal. Here, we utilize long-forming orangutan dentitions (Pongo spp.) to probe recent and ancient rainfall trends on a weekly basis over ~3-11 years per individual. We first demonstrate the lack of any consistent isotopic enrichment effect during exclusive nursing, supporting the use of primate first molar teeth as environmental proxies. Comparisons of δ18O values (n=2016) in twelve molars from six modern Bornean and Sumatran orangutans reveal a high degree of overlap, with more consistent annual and bimodal rainfall patterns in the Sumatran individuals. Comparisons with fossil orangutan δ18O values (n=955 measurements from six molars) reveal similarities between modern and late Pleistocene fossil Sumatran individuals, but differences between modern and late Pleistocene/early Holocene Bornean orangutans. These suggest drier and more open environments with reduced monsoon intensity during this earlier period in northern Borneo, consistent with other Niah Caves studies and long-term speleothem δ18O records in the broader region. This approach can be extended to test hypotheses about the paleoenvironments that early humans encountered in southeast Asia.

Use of Circularly Polarized Light on the Evaluation of Injectable Platelet Rich Fibrin in the Early Formation of Woven and Lamellar Bone: A Specific Method in the Study of Osseous Tissue

Purpose: In bone grafting, the goal is the formation of 100% vital bone. The ideal graft material is osteogenic, osteoconductive and osteoinductive and can be evaluated by histology and histomorphometric methods to calculate percentages of vital bone formation, residual graft material and connective tissue. Bone graft substitute materials currently used include allogeneic, xenogeneic and alloplastic materials. The goal of this study is a histological evaluation of the early effects of the liquid (injectable) form of Platelet Rich Fibrin (i-PRF) on the formation of woven and lamellar bone using Circularly Polarized Light (CPL). Patients and Methods: This is a retrospective cohort study of forty-two patients from 2021 to 2022 who completed bone grafting after a non-restorable endodontically treated molar tooth was extracted in preparation for future implant surgery. Each bone graft was augmented with i-PRF. To process i-PRF, Relative Centrifugation Force (RCF) was reduced from 2,700 RPM to 700 RPM (60 g). Centrifugation time was reduced from 12 minutes to 3 minutes. After an average bone graft healing time of 8 to 12 weeks, bone core samples were obtained at the time of implant surgery for histological and histomorphometric analysis. Bone cores were stained with Stevenel’s blue and van Gieson’s picrofuchsin for histologic analysis by means of brightfield and circular polarized light microscopic evaluation to evaluate the early effects of the liquid form of PRF on formation of woven and lamellar bone using allogeneic bone. Results: Forty-two bone cores were harvested at the time of implant surgery for histological and histomorphometric analysis. The liquid form of PRF resulted in greater percentages of vital bone formation (average 87.4 %) compared to the existing published literature. CPL analysis of forty-two bone core specimens showed the positive effects of i-PRF on de novo bone formation. Conclusion: The results of this study using circularly polarized light demonstrate that the liquid form of PRF (i-PRF) resulted in greater percentages of early, new vital bone formation compared to the published literature. Circularly polarized light should be considered as an adjunctive method to determine bone maturity and structure.

Evaluation of maxillary sinus changes following molar distalization using clear aligners: A three-dimensional study

ObjectiveTo evaluate the impact of molar distalization with clear aligners (CAs) on maxillary sinus parameters and its proximity to the root apices of maxillary molars using Cone Beam Computed Tomography (CBCT). MethodsThe study involved pre- and post-treatment CBCT images of 27 adult patients. MIMICS 21.0 software was used to measure maxillary sinus volume and surface area, while Invivo Dental 6.0 program was used to measure the sinus diameters and proximity of the maxillary molar root apices to the sinus floor. ResultsPost-treatment, there was a marked increase in the average volume and surface area of the maxillary sinus on both sides; however, changes in dimensions were not statistically significant. Sinus proximity to the root apices of the maxillary molars showed statistically significant differences, particularly on the left side for all roots. Gender and age impacted the outcomes, with males and younger individuals showing more pronounced changes. No significant differences were observed between the left and right sinuses in all parameters. ConclusionMolar distalization with CAs increases maxillary sinus parameters, more notably in younger and male patients. All molar teeth roots moved toward the sinus, particularly the mesiobuccal root of the maxillary second molar protruded to the sinus.

Stress Distribution on Prepared Tooth With Shoulder and Radial Shoulder Margin to Receive Crowns of Three Different Materials: A Finite Element Analysis.

Aim and background This study aims to determine the stress distribution on the prepared tooth at the margins with shoulder and radial shoulder finish lines when an occlusal load of 300N was applied to ceramic, zirconia, and polyether ether ketone (PEEK) crowns. Materials and methods Six models of mandibular first molar teeth were fabricated. The tooth models were subdivided into two groups with shoulder and radial shoulder margins, respectively (n = 18). The teeth were restored with three different prosthetic crown materials (ceramic, zirconia, and PEEK). To simulate the typical forces experienced by a prosthetic crown material in a lower posterior tooth during chewing and biting, an occlusal load of 300N was applied to each of the samples, and the maximum principal stress (Pmax) and von Mises stress were calculated, respectively. These samples were then compared and evaluated to determine the material best suited as a prosthetic crown material of choice for a lower posterior tooth. Results Among the materials used, the maximum principal stress value was the least in PEEK crowns. The von Mises stress value was highest for the zirconia crown with shoulder margin and was least for the PEEK crown with a similar margin. Conclusion PEEK as a crown material was found to be a better choice for lower posterior teeth as there was the least maximum principal stress at the margin, irrespective of either shoulder or radial shoulder finish line used.

Comparative Analysis of the Efficacy of Various Retreatment File Systems in the Removal of Gutta-Percha in Retreatment Cases and Time Taken During the Procedure: An In Vitro Cone Beam CT Study.

Background Removing gutta-percha manually can be a challenging task, especially when addressing densely packed root-filling material, particularly in cases where resin-based sealers are employed for obturation. The use of nickel-titanium (NiTi) rotary instruments not only effectively shapes the root canal but also efficiently removes the endodontic filling from the curved canal during retreatment. Hence, incorporating rotary NiTi instruments in retreatment cases can alleviate fatigue for both patients and operators. Objectives This study aims to compare the efficacy of Neo-Endo retreatment files, R-Endo retreatment files, and K and H files in the removal of endodontic filling material. Additionally, the remnants of gutta-percha in root canals are evaluated using cone beam computed tomography (CBCT). Materials and methods A total of 60 extracted first maxillary molar teeth were selected for this study. Canal preparation was conducted using the step-back method up to an apical size of 40 K-file. The obturation process involved the use of gutta-percha points and AH Plus sealer in a lateral compaction technique. Post-operative CBCT scans were taken. The samples were randomly divided according to the retreatment files used: group I included Neo-Endo retreatment files, group II included R-Endo retreatment files, and group III included conventional K-files and Hedstroem files (H-Files). The retreatment procedure was considered complete when the last instrument easily reached the working-length range and was physically clean. A stopwatch was used to record the time taken by each file to remove the obturating material. T1 represented the total time (including irrigation and change of file) required to reach the apex, while T2 indicated the complete removal of materials from the canal with the last instrument. The overall time recorded (TT) was calculated as T1 + T2. The removal process was analyzed with CBCT scans. Results The Neo-Endo retreatment files removed the filling materials better and more quickly than the other files. Conclusions Despite the presence of residual filling material in all samples, the Neo-Endo retreatment files left the least amount of residual filling material and achieved the shortest completion time.

Accuracy of maxillary full-arch digital impressions of tooth and implant models made by two intraoral scanners.

Limited studies are available on the accuracy of intraoral scanners (IOSs) for full-arch implant and tooth models. This study aimed to assess the accuracy of maxillary full-arch digital impressions of tooth and implant models made by two IOSs. This in vitro, experimental study was conducted on two maxillary dentiform models: one with six prepared natural teethand the other with six implants at the site of canine, first premolar, and first molar teeth, bilaterally. A highly accurate industrial scanner was used for actual measurements on the models that served as the reference scan. TS (Trios3) and CO (CEREC Omnicam) IOSs were then used to scan each model 10 times according to the manufacturer's instructions. All scans were saved in STL format. The GOM Inspect software was used according to the best-fit algorithm to compare the accuracy of measurements in the groups with the reference scan. The trueness and precision were calculated. Statistical analyses were carried out using SPSS by one-way analysis of varianceand t-test (α = .05). TS showed a significantly higher trueness than CO for both tooth and implant models (p < .05). TS also revealed significantly higher precision than CO for the tooth model; however, the difference in precision for the implant model was not significant between the two IOSs (p > .05). TS showed higher accuracy than CO in both tooth and implant models.

Prediction of extraction difficulty for impacted maxillary third molars with deep learning approach

ObjectiveThe aim of this study is to determine if a deep learning (DL) model can predict the surgical difficulty for impacted maxillary third molar tooth using panoramic images before surgery. Materials and MethodsThe dataset consists of 708 panoramic radiographs of the patients who applied to the Oral and Maxillofacial Surgery Clinic for various reasons. Each maxillary third molar difficulty was scored based on dept (V), angulation (H), relation with maxillary sinus (S), and relation with ramus (R) on panoramic images. The YoloV5x architecture was used to perform automatic segmentation and classification. To prevent re-testing of images, participate in the training, the data set was subdivided as: 80 % training, 10 % validation, and 10 % test group. ResultsImpacted Upper Third Molar Segmentation model showed best success on sensitivity, precision and F1 score with 0,9705, 0,9428 and 0,9565, respectively. S-model had a lesser sensitivity, precision and F1 score than the other models with 0,8974, 0,6194, 0,7329, respectively. ConclusionThe results showed that the proposed DL model could be effective for predicting the surgical difficulty of an impacted maxillary third molar tooth using panoramic radiographs and this approach might help as a decision support mechanism for the clinicians in peri-surgical period.

Does Maxillomandibular Fixation Technique Affect Occlusion Quality in Segmental LeFort I Osteotomy?

BackgroundSegmental maxillary osteotomies require precise occlusal control due to variability in individual segment positioning. The role of maxillomandibular fixation (MMF) technique on occlusal control has not been validated. PurposeThe purpose is to measure and compare the accuracy of occlusal positioning among MMF techniques. Study design, setting, sampleThis was a double-blinded in vitro study on experiment models to simulate a 3-piece LeFort I osteotomy. The models were constricted posteriorly and expanded using 3 different MMF techniques and compared to the unaltered baseline occlusion. Based on sample size calculation, 32 separate attempts were made for each MMF technique. Predictor variableThe predictor variable was MMF technique (brackets, MMF screws, embrasure wires). Main outcome variablesThe primary outcome variable was the visual occlusal analysis score (VOAS), a 1.00 to 4.00 continuous scale measuring the similarity of the achieved occlusion to the planned (control) occlusion assessed by an oral and maxillofacial surgeon and an orthodontist. High VOAS indicated greater occlusal accuracy, with 3.50 defined as the threshold for accuracy. The secondary outcome variable was the linear error of the achieved occlusion at the canine and first molar teeth, with lower error indicating greater accuracy. An a priori accuracy threshold of 0.5mm was set for this variable. CovariatesNone. AnalysesKruskal-Wallis test with post hoc testing was used to analyze the difference in the outcome variables of interest. P-value < 0.05 was considered statistically significant. ResultsThirty-two attempts for each technique showed that brackets had higher VAOS than MMF screws and embrasure wires (median differences 1.49 and 0.48, P<0.001), and had lower linear occlusal error (median differences 0.35 to 0.99mm, P<0.001). Conclusions and RelevanceMMF technique influences the quality of occlusal control, with greater visual rating scores and lower linear errors seen with brackets than with embrasure wires or MMF screws.

Remineralization potential of varying concentrations of two plant-based extracts of Cocos nucifera on white spot lesions using SEM and EDAX analysis: An in vitro study.

To evaluate the remineralization potential of varying concentrations of two plant-based extracts of Cocos nucifera on white spot lesions using SEM and EDAX in vitro testing methods. The pulp was freshly obtained from coconut and divided into two. Then, coconut milk was obtained by blending, while the next portion was freeze-dried and lyophilized. Third molar teeth were processed into tooth slabs (N = 40) and split equally into five groups by block randomization. After demineralization, one tooth slab was taken from each, and SEM analysis was done. Remineralization was then performed among the various groups that included Group 1, which acted as a control and consisted of the remineralization solution. Groups 2 and 3 comprised 1:1 and 2:1 concentrations of the coconut milk, whereas Groups 4 and 5 consisted of 1:1 and 2:1 concentrations of the lyophilized extract. SEM and EDAX testing were done post-remineralization. Ca and phosphate values were tabulated, and statistical significance was determined for the obtained values using ANOVA. Among the control and treatment groups, surface remineralization was better observed in 1:1 coconut milk and 2:1 coconut milk than in the 2:1 lyophilized coconut, control, and 1:1 lyophilized coconut. Between the control and treatment groups, Ca and phosphate percentages (P < 0.001) showed statistical differences. The lowest value of 2.3% was noted in the 2:1 lyophilized coconut group. Coconut extracts exhibit remineralization potential on the artificial carious lesion. Coconut milk exhibited significant improvement in the surface properties than lyophilized coconut.

Clinical observations of iRoot BP Plus in the restorative treatment of pulp floor perforation with root bifurcation lesions in primary molar teeth.

Clinical observations of iRoot BP Plus in the restorative treatment of pulp floor perforation with root bifurcation lesions in primary molar teeth.

Isolation and Culture of Primary Human Dental Pulp Cells-A Description of Technical and Methodological Steps to Maximise Predictability and Yield.

The dental pulp has critical functions in tooth development as well as an ongoing role in promoting and maintaining the vitality of teeth. In particular, its regenerative ability allows dental tissues to be restored following damage caused by traumatic injury or caries. Regenerative endodontic procedures aim to utilise these processes to stimulate dental pulp repair in a minimally invasive manner and reduce the need for more invasive procedures such as root canal treatment. Dental pulp is a source of dental pulp cells (DPCs), which has a subpopulation of dental pulp stem cells (DPSCs), which are attractive for use in regenerative medicine due to their high proliferation rate, ability to differentiate into multiple cell types, and their preserved vitality following cryopreservation. The development of next-generation clinical therapeutics that maximise the potential of dental pulp relies on strong empirical evidence arising from in vitro experimentation. Here, we describe a modified method for the efficient isolation of primary human DPCs from sound third molar teeth for culture using an explant outgrowth method on basement membrane-coated flasks, as well as using high-resolution macro-photography to illustrate the methods. Critically, steps are taken to minimise potential physical and mechanical trauma to the cells and maximise yield. Human DPCs cultured using this method can be further expanded in cell culture flasks to facilitate their use in various in vitro experimental procedures.