Zinc Oxide-eugenol Research Articles

Clinical and Radiographic Evaluation of Zinc Oxide-ozonated Oil, Zinc Oxide-eugenol, Antioxidant Mix, and Probiotic Mix as Obturating Materials in Primary Teeth: An In Vivo Study

Clinical and Radiographic Evaluation of Zinc Oxide-ozonated Oil, Zinc Oxide-eugenol, Antioxidant Mix, and Probiotic Mix as Obturating Materials in Primary Teeth: An In Vivo Study

Clinical Success of Pulpotomies Using Intermediate Restorations and Preformed Metal Crowns in the Context of a Developing Country: A Retrospective Questionnaire-Based Investigation

Background: Dental caries is one of the most prevalent dental illnesses in children. Untreated severe caries can damage teeth, requiring pulpotomy to save them. Objective: To evaluate the clinical success rate of treatments involving pulpotomies + IRM (Intermediate Restorative Material, composed of reinforced zinc oxide–eugenol polymers) + preformed metal crowns (PMCs) in primary teeth of children treated at a public university in Mexico. Materials and Methods: A cross-sectional ambispective study was conducted on children aged 10 years or younger, treated at a public university in Mexico. A total of 1281 medical records from February 2018 to June 2023 were reviewed, yielding a sample of 199 children treated with pulpotomy + IRM + PMC. Information was collected via telephone interviews with parents/caregivers to inquire about any symptoms following the pulpotomy and metal crown treatments. Success was defined as the absence of pain, inflammation, or infection. Results: During the study period, the number of teeth treated with pulpotomy + IRM + PMC was 414, with follow-ups ranging from 6 to 69 months. Most participants were girls (54.3%), while 45.7% were boys. Out of the 167 pulpotomy + IRM + PMC treatments included in the study, the clinical success rate was 98.2%. Conclusions: The clinical success rate of primary teeth treated with pulpotomy + IRM + PMCs was high, close to 100%, based on evidence and symptom reports from parents/caregivers. It would be beneficial to implement its use in public health institutions in countries such as Mexico.

Clinical Outcome Evaluation of The Effectiveness of Calcium Hydroxide as A Root Canal Sealer Constituent

Background: The objective of this study was to evaluate the clinical outcomes of using calcium hydroxide-containing sealer (Sealapex) compared to zinc oxide eugenol (ZOE) sealer in single-visit root canal treatments.Methods: This cross-sectional observational study was conducted at different private clinics, Dhaka, Bangladesh during the period from January 2018 to December 2018. A total of 60 permanent teeth with periradicular pathosis were selected and randomly assigned into two groups. Group 1 (ZOE group) comprised 30 teeth treated with a ZOE sealer, while Group 2 (Sealapex group) included 30 teeth treated with a calcium hydroxide-containing sealer. Clinical evaluations were performed at 3 months and 12 months post-treatment, with patient complaints recorded and analyzed using SPSS version 22 and Microsoft Excel.Results: Group 2 had a higher proportion of younger participants (40.00% aged 11-20) compared to Group 1 (26.67%). Group 1 had more males (66.67%) compared to Group 2 (56.67%). Trauma was the leading etiological factor in both groups. Maxillary teeth were more frequently affected, with 56.67% in Group 1 and 63.33% in Group 2. Pre-operative pain was higher in Group 2 (90.00%) compared to Group 1 (76.67%). At the 3-month follow-up, percussion pain was more prevalent in Group 1 (76.67%) than in Group 2 (46.67%, p = 0.016). By the 12-month follow-up, percussion pain persisted in 13.33% of Group 1 but was absent in Group 2. Group 2 achieved a 100.00% success rate, significantly higher than Group 1’s 86.67% (p = 0.038).Conclusion: The use of calcium hydroxide-containing sealer (Sealapex) in single-visit root canal treatments resulted in superior clinical outcomes compared to zinc oxide eugenol sealer. These findings suggest that calcium hydroxide-containing sealers offer better pain management and higher long-term success rates, making them a more effective alternative for endodontic treatments. Further research is recommended to confirm these results in broader clinical settings.

Radiological Outcome of Calcium Hydroxide as A Root Canal Sealer Constituent

Background: The effectiveness of root canal sealers plays a crucial role in the success of endodontic treatments by preventing microbial leakage and promoting periapical healing. This study aimed to compare the radiological outcomes of calcium hydroxide-based sealers and zinc oxide eugenol sealers in treating teeth with periradicular pathosis.Methods: This cross-sectional observational study was conducted at different private clinics, Dhaka, Bangladesh during the period from January 2019 to December 2019. A total of 60 permanent teeth with periradicular pathosis were randomly assigned into two groups: Group 1 (n=30), treated with zinc oxide eugenol sealer, and Group 2 (n=30), treated with calcium hydroxide-based sealer. Clinical evaluations were conducted on days 2 and 7 post-treatment, and radiological evaluations were performed at 3, 6, and 12 months. Data were analyzed using SPSS version 22.Results: The majority of participants were aged 11-30 years, with a higher proportion of males in both groups. Trauma was the leading etiological factor, with maxillary teeth being more frequently affected. Group 2 showed significantly better radiological outcomes, with 80.00% exhibiting reduced periapical pathosis size at 3 months, compared to 26.67% in Group 1 (p < 0.001). At 6 months, 93.33% of Group 2 showed reduced pathosis size, compared to 60.00% in Group 1 (p = 0.002). At 12 months, 96.67% of Group 2 and 83.33% of Group 1 showed reduced pathosis size (p = 0.194). The final success rate was 96.67% in Group 2 and 86.67% in Group 1, with no statistically significant difference (p = 0.353).Conclusion: Calcium hydroxide-based sealers provide superior radiological outcomes compared to zinc oxide eugenol sealers in the treatment of teeth with periradicular pathosis. These findings support the use of calcium hydroxide sealers for enhanced endodontic treatment outcomes.

Assessment the bioactivity of zinc oxid eugenol sealer after the addition of different concentrations of nano hydroxyapatite-tyrosine amino acid

Aim: Zinc oxide eugenol sealer has been used till now in endodontic obturation. However, despite many improvements in its formula, it still does not have, the essential root canal sealer’s properties which is the apatite forming ability. The aim of the present study is to assess the effect of the incorporation of nano Hydroxyapatite- tyrosine amino acid at different concentrations in the zinc oxide eugenol sealer formula in terms of bioactivity analysis. Methods: The nano hydroxy apatite-tyrosine amino acid was incorporated into the original zinc oxide eugenol (endosell) at different concentrations starting from (10 – 20)%. The chemical changes in zinc oxide eugenol before and after addition were characterized using FTIR and XRD. The setting time test was done according to ADA specification no. 57. The bioactivity analysis for the zinc oxide eugenol before and after the addition was evaluated according to ISO/FDIS 23317:2007(E) by using 28 days of storage in phosphate buffer saline, and then the hydroxyapatite precipitation and Ca/P ratio was evaluated using FESEM/EDX. Results: The FTIR and XRD confirmed the setting reaction occurrence among the (original ZOE, nHAP, and Tyr). The XRD and FESEM/EDX analyses confirmed the HAP precipitation on the ZOE sample surfaces after the addition of (nHAP-Tyr a.a) and this precipitation was increased with increased concentrations of additions. Conclusion: Incorporated (20) % of equal amounts of “nHA-Tyr a.a” can convert the ZOE to bioactive sealer as confirmed by XRD and FESEM/EDX. However, other characteristic analyses like Nuclear magnetic resonance, atomic force microscopy, and in vivo animal study were needed to further confirm the results.

Comparison of conventional and digital impression approaches for edentulous maxilla: clinical study

BackgroundThe expectations for the clinical and laboratory phases of tissue-supported complete dentures (TSCDs) are changing. Currently, there is a trend towards fast, comfortable, reliable, and low-cost methods. In TSCD impressions, simplified impression and digital impression methods involving the use of an intraoral scanner (IOS) are becoming preferable. Given this situation, this study aims to compare different conventional and digital impression methods used in TSCDs.MethodsPatients with maxillary complete edentulism and healthy oral mucosa were included in this study. In the digital group, two different impressions were made using an IOS (Trios4) without (D1) and with (D2) artificial intelligence scanning (AI-Scan). In addition, a modified impression (D3) was made using the IOS in two steps, including the occlusal rim. In the conventional group, a two-step impression (C1) using an individual tray with zinc oxide eugenol and a one-step simplified impression (C2) using a stock tray with irreversible hydrocolloid were made. The comparison groups were determined to be C1-C2, C1-D1, D1-D2, and D1-D3. The best-fit algorithm was used to superimpose the impressions to be compared. The right and left vestibular areas, postdam area, palatal area, right and left matching area, entire surface, and borders were evaluated separately.ResultsFifteen patients were included in this study. In the C1-C2 group, the mean deviation at the borders was statistically significant (p = 0.01). No regions in the C1-D1 and D1-D3 groups exhibited significant differences in the mean amount of deviation (p > 0,05). In the D1-D2 group, the mean deviation in the palatal area was significant (p = 0,03).ConclusionIn maxillary edentulism, digital impressions have shown comparable results to conventional impressions, suggesting promising implications for clinical applications.Trial RegistrationThe clinical trial has been registered (ClinicalTrials.gov ID NCT06400277, registration date 06/05/2024, ‘retrospectively registered’).

Remineralizing capacity of zinc oxide eugenol sealer following the addition of nanohydroxyapatite-tyrosine amino acid: An in vivo animal study

ObjectiveAlthough several sealers have been developed, the zinc oxide eugenol (ZOE) sealer is still used in many private dental clinics. This study aimed to compare the biocompatibility and remineralizing capacity οf ZOE sealer with the addition of nanohydroxyapatite-tyrosine amino acid. MethodsThis study was conducted on Twenty rabbits. The rabbits were divided into four groups based on the test observation period (3, 7, 21, and 28 days) following surgical implantation. General anesthesia was administered to each rabbit, and a subcutaneous incision of approximately 1 ± 0.5 cm was made along the symphyseal area of the mandible of each rabbit. Four bone cavities were generated in the interdental space of the lower jaw between the central and molar teeth of each rabbit, with one longitudinal subcutaneous incision. The ZOE sealers were mixed according to the manufacturer's guidelines and directly inserted within the cavities generated at the end of each test period. The animals were sacrificed, and bone biopsy was carried out at the site of testing. The biopsy samples were obtained and subjected to histological analysis using a low-power light microscope (Olympus C ⅹ 21, Japan) and immunohistochemistry using Ki67 antibody. ResultsThe collected information was examined by parametric statistical tests using SPSS software version ‘‘22.” One-way ANOVA and post-hoc Duncan's tests were used to measure the significance among various groups, with statistical significance set, when “P ≤ 0.01”. ConclusionThe 20% mixed endodontic sealer displayed excellent outcomes compared to other experimental groups, as identified by higher new bone formation at every evaluation period.

Comparative Evaluation of Mechanical Properties and Bond Strength of Glass Ionomer Cement reinforced with three different concentrations of Silver Nanoparticles as against Conventional Glass Ionomer Cement in Primary Teeth.

Introduction: Restorative dental materials are defined as substances that are used to repair, replace, or enhance a patient’s teeth. Various materials used in paediatric dentistry are zinc oxide eugenol, glass ionomer cement, resin composite, calcium hydroxide, silver amalgam, giomers etc. GIC is a biocompatible material having a low thermal expansion coefficient and fluoride release property. There are still a few drawbacks of GICdue of their poor mechanical properties therefore addition of Silver Nanoparticles demonstrated improved mechanical and bactericidal capabilities. There hasn’t been much study on the quality of the bond contact between silver nanoparticles and dentin, as well as the color’s durability. Aim: To evaluate and compare the mechanical properties and bond strength of Glass ionomer cement reinforced with three different concentrations of silver nanoparticle as against conventional glass ionomer cement in primary Teeth. Materials and Method: Silver nanoparticles will be prepared using three chemicals namely, silver nitrate, sodium citrate and tannic acid. Traditional GIC (GC Fuji II, GC Corporation, Tokyo, Japan) will be purchased. Three different concentrations of silver nanoparticles will be prepared i.e., 0.2, 0.4, and 0.6%. The GIC specimens will then be divided into 4 groups: GIC without silver nanoparticles (AgNPs),0.2%,0.4% and 0.6% AgNPs. Mechanical properties will be checked such as compressive, tensile, and bond strength using Universal Testing Machine. Expected Results: GIC reinforced with silver nano particles is expected to have better mechanical strength, less microleakage and wear resistance, greater fracture resistance and adhesive bond strength. Conclusion: GIC reinforced with silver nano particles will be expected to have better mechanical and physical properties than conventional Type II GICs and is expected to be a promising material for restoration in primary teeth.

Effect of zinc oxide-eugenol endodontic paste on planktonic aggregates and biofilm of Enterococcus faecalis - An atomic force microscopy evaluation

ObjectiveThis work aimed to evaluate the in vitro effect of zinc oxide-eugenol paste (ZOE) on planktonic aggregates (EfPA) and biofilm (EfBio) of Enterococcus faecalis, focusing on their morphological aspects observed and analyzed using atomic force microscopy (AFM). DesignThe eugenol and paste were characterized by Gas Chromatography coupled with Mass Spectrometry (GC-MS) and Fourier Transform Infrared Spectroscopy (FTIR), respectively. The effect of ZOE on EfPA and EfBio was evaluated by a direct-contact test through colony counting and crystal violet staining protocol. AFM images of untreated and treated EfPA and EfBio growth on bovine dentin were obtained to analyze the morphological damage caused by the treatments. ResultsThe characterization showed high purity in the eugenol composition and chemical interaction between the components of the paste. A bactericidal effect on aggregates was observed after 6 h of exposure, and on biofilm after 24 h of treatment (p < 0.001). A disruptive effect on the biofilm was also evident. AFM images revealed the formation of EfPA, with a notable presence of an exopolysaccharide matrix. After 6 h of ZOE treatment, there was a significant increase in the size and surface roughness profile of treated cells (p < 0.05). Loss of typical cell morphology was observed after 24 h. The effect on the biofilm showed a tendency towards a less condensed biofilm pattern in the treated group, with no differences in surface roughness. ConclusionZOE presents bactericidal action on EfPA and EfBio, promoting significant morphological changes after treatment, especially in the aggregates.

Comparative In Vitro Analysis of Push-Out Bond Strength of Different Root Canal Sealers to Root Dentin

ABSTRACT Aim: The study’s objective is to assess the bond strengths of four different endodontic sealers to root dentin using a push-out test technique. Material and Method: Sixty single-rooted teeth were selected and decoronated. Canal instrumentation was done using rotary files and divided into four groups (n = 15) based on the sealer used. Group 1: zinc oxide eugenol (ZOE)-based, Group 2: epoxy resin-based, Group 3: methacrylate-based, and Group 4: bioceramic. Following obturation with Gutta Percha, each tooth was prepared with root portions that were 2 mm thick at the apical and middle 1/3 so that universal testing equipment could measure the push-out bond strength. Tukey’s post hoc tests and one-way ANOVA were used to examine the data. Result: According to the results, group 4 had the strongest push-out relationship, followed by groups 3, 2, and 1, respectively. It can be concluded that the bioceramic sealers have superior bond strengths. Conclusion: Bioceramic sealers demonstrated the highest bond strengths to root dentin, outperforming methacrylate, epoxy resin, and zinc oxide eugenol sealers in the push-out test.

Retrospective radiographic study comparing unintentional extrusion of gutta-percha versus sealer on teeth with periapical radiolucency.

The purpose of the present study was the radiographic evaluation of endodontically treated teeth presenting periapical radiolucency and unintentional overfilling with gutta-percha or sealer on treatment outcome and persistence of the extruded materials. After assessment using periapical index (PAI), 202 roots filled with gutta-percha and zinc oxide-eugenol sealer (Roth 811, Roth International), exhibiting unintentional overfilling and periapical radiolucency were selected. All cases had at least 1 year of follow-up. Type of extruded material, periapical status, and removal/persistence of the extruded material were evaluated by two independent observers. Data were statistically analyzed using logistic and linear regression analysis. Tooth location (P .001), follow-up period (P .001), and type of extruded material (P &#61; .004) significantly influenced treatment outcomes. Specifically, posterior roots exhibited better outcomes compared to anterior, and cases with overfilling of sealer showed superior healing potential compared to those with gutta-percha overfilling. Additionally, longer recall periods were associated with improved treatment success. The type of extruded material (P .001) and follow-up period (P .001) significantly affected the presence of extruded material in the follow-up radiograph. The persistence of extruded material was greater when gutta-percha was extruded, and extruded materials were less detected when the follow-up period was longer. Teeth with periapical radiolucency and unintentional overfilling require longer follow-up intervals for effective monitoring of healing. Treatment outcome was associated with the type of extruded materials used in the present study. The persistence of those materials in the periapex did not affect healing.

Tissues response and bone-forming capacity of zinc oxide–eugenol sealer following the addition of nanohydroxyapatite-tyrosine amino acid: An in vivo animal study

Abstract Introduction: The zinc oxide–eugenol (ZOE) sealer is used till now in many private dental clinics although many sealers have been developed. The current study aimed to compare the biocompatibility and remineralizing capacity of ZOE sealer following the addition of nanohydroxyapatite-tyrosine amino acid. Materials and Methods: Twenty rabbits were used in this investigation, and they were divided into four groups based on the test observation period (3, 7, 21, and 28 days) following surgical implantation. General anesthesia was given for each rabbit with a subcutaneous incision of about 1 cm ± 0.5 cm made along the symphyseal area of the mandible of each rabbit. Each rabbit had four bone cavities generated in the interdental space of the lower jaw between the central and molar teeth, with one longitudinal subcutaneous incision. The ZOE sealers were mixed and directly inserted within the cavities as follows: ZOE alone on the central area of the right side of the jaw (Group A), 10% nHAp and Tyrosine mixed ZOE at the molar area (Group B), empty cavity (−ve control) located at the central area of the left side of the jaw (Group C) and 20%/nHAp and Tyrosine mixed ZOE located at the molar area on the left side of the jaw (Group D). Animals were scarified and bone biopsy samples from the tested parts were collected. Histological analysis was performed using a low-power light microscope and immunohistochemistry using runt-related transcription factor 2 (Runx2) antibody. Data were statistically analyzed utilizing the SPSS software. One-way analysis of variance was used and the post hoc test Duncan’s test was utilized to measure the significance among various groups at P ≤ 0.01. Results: The inflammatory process decreased over time for all experimental groups, associated with an increase in granulation tissue formation which was gradually decreasing over time to permit an increase in new blood vessels and new bone formation for all experimental groups that increased with time. Group D displayed the highest levels of new bone formation. Runx2 antibody expression declined progressively, particularly in Group D on 28 days. Conclusion: Superior new bone formation and biocompatible properties were demonstrated by the 20% nHAp and tyrosine mixed ZOE sealer.

Adrenaline in pulp capping treatment of reversible pulpitis.

The role of epinephrine in the treatment of pulp capping in patients with reversible pulpitis is not clear. To explore the role of epinephrine in the treatment of pulp capping in patients with reversible pulpitis. A total of 100 patients with reversible pulpitis who were treated in Anhui Jieshou People's Hospital from January 2020 to December 2021 were included in the study. They were categorized into an observation group (n = 50; treatment with adrenaline) and a control group (n = 50; treatment with zinc oxide eugenol paste). The 24-h postoperative pain, regression time of gingival congestion and redness, clinical efficacy, and incidence of adverse reactions were compared between the groups. Patients were further categorized into the ineffective and effective treatment groups based on clinical efficacy. Logistic multiple regression analysis explored factors affecting the efficacy of pulp capping treatment. A significant difference in 24-h postoperative pain was observed between the groups (P < 0.05), with a higher proportion of grade I pain noted in the observation group than in the control group (P < 0.01). The regression time of gingival congestion and swelling was lower in the observation group (2.61 ± 1.44 d and 2.73 ± 1.36 d, respectively) than in the control group (3.85 ± 1.47 d and 4.28 ± 1.61 d, respectively) (P < 0.05). The 2-wk postoperative total effective rate was lower in the control group (80.00%) than in the observation group (94.00%) (P < 0.05). The incidence of adverse reactions was not significantly different between the control (14.00%) and observation (12.00%) groups (P > 0.05). The proportion of adrenaline usage was lower (P < 0.05) and that of anaerobic digestion by Streptococcus and Fusobacterium nucleatum was higher in the ineffective treatment group than in the effective treatment group (P < 0.05). Logistic multiple regression analysis revealed adrenaline as a protective factor (P < 0.05) and anaerobic digestion by Streptococcus and F. nucleatum as risk factors for pulp capping in reversible pulpitis (P < 0.05). Adrenaline demonstrated therapeutic efficacy in pulp capping treatment for reversible pulpitis, reducing pain and improving clinical symptoms safely. It is a protective factor for pulp capping, whereas Streptococcus and F. nucleatum are risk factors. Targeted measures can be implemented to improve clinical efficacy.

A Novel Combination of Zinc Oxide with Two Essential Oils Exerts Antimicrobial Effect against Endodontic Pathogens In Vitro.

Evaluating the antimicrobial efficacy of the novel combinations of zinc oxide mixed with ajwain oil (ZNOA) and combination of ajwain and eugenol (ZNOAE) vs conventionally used zinc oxide eugenol (ZNOE) against endodontic pathogens like Escherichia coli and Enterococcus faecalis. The pure cultures of E. coli (MTCC 443) and E. faecalis (MTCC 439) were revived and grown on selective cultural media. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the test materials were determined correspondingly through sequential dilution and agar well diffusion methods, as per Clinical and Laboratory Standard Institute (CLSI) guidelines. The data values were presented as mean ± standard deviation (SD). The comparisons among groups were completed through the one-way analysis of variance (ANOVA) test, whereas intragroup pairwise comparisons were completed using the unpaired t-test (p < 0.05). Minimum inhibitory concentration values against E. coli and E. faecalis of ZNOE were 250 and 500 µg/mL, ZNOA was 250 µg/mL, and ZNOAE were 125 and 250 µg/mL, correspondingly. MBC values in the form of inhibition zone against E. coli by ZNOE were 21.33 ± 1.53 mm, ZNOA 18.67 ± 1.53 mm, and ZNOAE 20.33 ± 1.53 mm. The E. faecalis inhibition zone for ZNOE was 14.33 ± 2.08 mm, ZNOA 18.67 ± 2.08 mm, and ZNOAE 24.33 ± 1.53 mm. All test materials demonstrated good antibacterial efficacy. However, between the novel combinations of test materials, ZNOA showed better antimicrobial efficacy against resistant endodontic pathogens than ZNOE. Dahake PT, Joshi SS, Kale YJ, et al. A Novel Combination of Zinc Oxide with Two Essential Oils Exerts Antimicrobial Effect against Endodontic Pathogens In Vitro. Int J Clin Pediatr Dent 2024;17(S-1):S11-S16.

To Evaluate and Compare Platelet-rich Fibrin and Mineral Trioxide Aggregate as Direct Pulp Capping Agents in Primary Molars: A Randomized Prospective Clinical Study.

This study aimed to evaluate and compare the clinical and radiographic success of platelet-rich fibrin (PRF) and mineral trioxide aggregate (MTA) as direct pulp capping (DPC) agents in primary molars. In this study, 50 primary first and second molars from healthy children aged 5-9 years requiring pulp therapy were randomly allocated into two groups. In the PRF group, after coronal pulp removal and hemostasis, the remaining pulp tissue was covered with PRF preparation. In the MTA group, after coronal pulp removal and hemostasis, MTA was placed, followed by a zinc oxide eugenol (ZOE) base and glass ionomer cement (GIC) in both groups. Clinical and radiographic evaluations were undertaken at 1-, 3-, 6-, 9-, and 12-month intervals. By the end of the 12th month, the overall success rate was 82.6% in the PRF group, whereas it was 61.9% in the MTA group. Platelet-rich fibrin can be used successfully as an appropriate alternative material in DPC of primary teeth when compared with MTA. Tiwari T, Tyagi P, Tiwari S, et al. To Evaluate and Compare Platelet-rich Fibrin and Mineral Trioxide Aggregate as Direct Pulp Capping Agents in Primary Molars: A Randomized Prospective Clinical Study. Int J Clin Pediatr Dent 2024;17(S-1):S25-S29.

The Antibacterial Properties of a Reinforced Zinc Oxide Eugenol Combined with Cloisite 5A Nanoclay: An In-Vitro Study.

Pulpotomies and pulpectomies are the most common clinical approach for dental caries in the primary dentition. Reinforced zinc oxide eugenol (ZOE) is an ideal material for filling in the pulp chamber after pulp therapies. The aim of this study was to assess the addition of Cloisite 5A nanoclay material to ZOE and evaluate its antibacterial properties. In this case-control study, the nanoclay nanoparticles were dissolved using a solvent (Eugenol) in different concentrations and their antibacterial properties were assessed using the agar diffusion test and biofilm analysis of Streptococcus mutans (S. mutans), Enterococcus faecalis (E. faecalis), and Escherichia coli (E. coli) in in vitro conditions using the AATCC 100 standards. The diameter of the inhibition zone was measured and assessed statistically using the SPSS software (Version 28, IBM, Chicago, IL, USA) with a significance level of 0.05. The antibacterial properties of the ZOE with nanoclay particles were significantly greater in comparison to the plain ZOE against E. faecalis, S. mutans, and E. coli. The inhibition zone against E. coli under the effect of the ZOE and nanoclay particles combined was significantly higher than that against E. faecalis and S. mutans. The current study showed that the addition of Cloisite 5A nanoclay particles can improve the antibacterial properties of ZOE significantly at certain concentrations.

Effects of Chitosan as a Novel Obturation Material for Pulpectomized Teeth on Periapical Inflammation, Periodontal Ligament Widening, and Hard Tissue Resorption: A Preliminary Exploratory Study on Dogs.

Objectives: This preliminary animal study was conducted to assess the effects of chitosan as a novel obturation material for pulpectomized teeth on periapical inflammation, periodontal ligament (PDL) widening, and hard tissue resorption. Materials and Methods: Forty premolar root canals in two mature dogs were obturated with zinc oxide eugenol (ZOE) and an experimental 3% chitosan paste (n=20 in each group). The teeth were then restored with amalgam. After 28 days, the dogs were sacrificed, and histopathological assessment was performed. The amount of resorbed obturation material, degree of inflammatory response, degree of PDL widening, and the number of bone/cementum/dentin resorption defects were recorded under ×40 and ×200 magnifications. Data were analyzed using the Mann-Whitney U test, one-sample Wilcoxon signed-rank test, and Fisher's exact test (α=0.05). Results: Bone, cementum, and dentin resorption were seen in 6, 10, and 1 chitosan-obturated canals and 14, 15, and 0 ZOE-obturated canals, respectively. Only the bone resorption defects were significantly fewer in the chitosan group (P=0.026). Mild, moderate, and severe inflammation were observed in 17, 3, and 0 chitosan-obturated canals, and 7, 9, and 4 ZOE-filled canals, respectively (P=0.004). Mild, moderate, and severe PDL widening were seen around 15, 5, and 0 chitosan-filled canals and 7, 12, and 1 ZOE-filled canals, respectively (P=0.025). Conclusion: The 3% chitosan was superior to ZOE in terms of causing less inflammation and PDL widening. It also decreased bone resorption and acted similar to ZOE in terms of dentin and cementum resorption.

Histological evaluation of different concentrations of hyaluronic-acid-added zinc oxide eugenol on rat molar pulp.

Hyaluronic acid (HA), known for diverse properties, was investigated for its potential in dental pulp therapy. This study investigated the potential of HA in dental pulp therapy by examining the physical properties and effects of zinc oxide eugenol (ZOE) pulpotomy materials containing varying HA concentrations on rat molar teeth. In vitro tests assessed compressive strength and hardness of ZOE materials blended with HA (0.5%, 1%, 3%) and HA gels (0.54%, 0.8%). 120 samples, encompassing the control group, underwent compressive strength testing, while 60 samples were designated for hardness assessment. In vivo experiments on rat molars studied histological effects of HA-containing ZOE on dental pulp over 1week and 1month. Gels with HA concentrations of 0.5%, 1%, and 0.54% were used in pulpotomy on 22 rats. Each rat underwent the procedure on four teeth, with one tooth serving as a control, totaling 88 teeth subjected to the intervention. In the analyses, SPSS 22.0 was used and the significance level was set at P = 0.05. Findings showed that HA at 0.5% maintained compressive strength, but higher concentrations decreased mechanical properties significantly (P = 0.001). Histological assessments indicated better outcomes with lower HA concentrations in terms of odontoblast layer continuity (P = 0.005 at 1month) and pulp vitality (P = 0.001 at 1week and P = 0.018 at 1month). The study suggests HA holds promise for pulpotomy and regenerative endodontic treatments, but further research is needed to understand long-term clinical implications.

Synthetic high-density lipoprotein (sHDL): a bioinspired nanotherapeutics for managing periapical bone inflammation

Apical periodontitis (AP) is a dental-driven condition caused by pathogens and their toxins infecting the inner portion of the tooth (i.e., dental pulp tissue), resulting in inflammation and apical bone resorption affecting 50% of the worldwide population, with more than 15 million root canals performed annually in the United States. Current treatment involves cleaning and decontaminating the infected tissue with chemo-mechanical approaches and materials introduced years ago, such as calcium hydroxide, zinc oxide–eugenol, or even formalin products. Here, we present, for the first time, a nanotherapeutics based on using synthetic high-density lipoprotein (sHDL) as an innovative and safe strategy to manage dental bone inflammation. sHDL application in concentrations ranging from 25 µg to 100 µg/mL decreases nuclear factor Kappa B (NF-κB) activation promoted by an inflammatory stimulus (lipopolysaccharide, LPS). Moreover, sHDL at 500 µg/mL concentration markedly decreases in vitro osteoclastogenesis (P < 0.001), and inhibits IL-1α (P = 0.027), TNF-α (P = 0.004), and IL-6 (P < 0.001) production in an inflammatory state. Notably, sHDL strongly dampens the Toll-Like Receptor signaling pathway facing LPS stimulation, mainly by downregulating at least 3-fold the pro-inflammatory genes, such as Il1b, Il1a, Il6, Ptgs2, and Tnf. In vivo, the lipoprotein nanoparticle applied after NaOCl reduced bone resorption volume to (1.3 ± 0.05) mm3 and attenuated the inflammatory reaction after treatment to (1 090 ± 184) cells compared to non-treated animals that had (2.9 ± 0.6) mm3 (P = 0.012 3) and (2 443 ± 931) cells (P = 0.004), thus highlighting its promising clinical potential as an alternative therapeutic for managing dental bone inflammation.

Comparative Evaluation of the Quality of Obturation Between Three Obturation Techniques in Primary Canines: An In Vitro Study.

Aims This study compares three obturation techniques (rotary lentulo spiral, handheld lentulo spiral, and pressure syringe) for the quality of two filling pastes (zinc oxide eugenol (ZOE) paste and Metapex (Meta Biomed Co., Ltd., Chungcheongbuk-do, Korea). Methods and materials Sixty extracted primary canines were instrumented and obturated by filling materials. The obturation techniques were divided into three groups according to different obturation techniques.Obturation quality was evaluated for length, density, and presence of voids by using digital radiography. Results This study showed that the handheld lentulo spiral technique using Metapex and ZOE exhibited more optimal fillings for obturation length. The highest density obturation was achieved using the syringe injection approach with Metapex and ZOE. The highest incidence of both external and internal voids was observed in the group using ZOE with the handheld lentulo spiral technique Conclusions Based on the findings of this study, for both filling materials, the handheld lentulo spiral technique had the greatest number of optimal lengthsbut there were also more voids.