Alexandra Stoica

Biocompatibility of Calcium Hydroxide - Based Root Canal Sealers: A Histological Study

Biocompatibility has been defined as the ability of a material to function in a specific site, in contact with host tissues but without inducing any undesirable local or systemic reaction.The aim of this study is to evaluate the biocompatibility of calcium hydroxide-based endodontic sealers and to compare it with a resin-based material, by measuring the degree of inflammation induced by these products after subcutaneous implantation in rats. We used 12 animals divided in 3 study groups and 1 control group; implants with Mineral Trioxide Aggregate (MTA), AH26 and Sealapex were placed in subcutaneous tissue and histological evaluation was carried out after 7, 14 and 21 days. We obtained comparable results between MTA and Sealapex, which demonstrates that these materials have similar degrees of biocompatibility. Based on this experimental study, calcium hydroxide containing cements express similar biocompatibilities. Further clinical studies are necessary in order to evaluate the healing properties and apical seal of these materials.

An Insight into Histopathologic Examination as a Gold Standard for the Diagnosis of Chronic Apical Periodontitis

Abstract Objective: The purpose of our study was to determine the level of correlation between histopathologic results after surgery for chronic apical periodontitis and the radiographic and clinical diagnosis. The status of gold standard technique of histologic examination was evaluated in the diagnosis of apical radiolucency in necrotic teeth. Methods: Out of 154 patients with incorrect root fillings and apical radiolucency included in an endodontic retreatment protocol, 87 patients (108 teeth) were scheduled for apical surgery at 3-6 months control recall. Clinical and radiographic exams were completed prior to surgery and compared to the histological results of apical biopsies. The collected data were statistically analyzed with the SPSS version 20.0 and the Chi-square test was used to determine the associations between clinical and histologic diagnosis. A value of p <0.05 was considered statistically significant. Results: There was a statistically significant difference between the number of cases diagnosed as granulomas or cysts during clinical and radiological evaluation compared to histologic evaluation of tissue samples, with 40.9% to 75.9% and 54.2% to 16.8% respectively (p<0.05). Conclusions: The final diagnosis was obtained only after histologic examination of apical tissue samples, which means that the observations made based on radiologic investigations must be confirmed by biopsy.

Original Research. The Influence of Desquamative Gingivitis on Periodontal Health

Abstract Background: Desquamative gingivitis (DG) is a non-plaque-induced, blistering and painful condition occurring most frequently on the labial aspect of the attached gingiva of anterior teeth. The incidence of DG is highest around 50 years of age, and usually indicates the presence of oral or systemic diseases. The purpose of our study was to determine the impact of DG on periodontal health by recording the plaque index, gingival index and gingival bleeding index in a group of patients with DG, compared to healthy controls. Materials and methods: Recordings of specific indices were performed in a group of 26 patients with DG and compared with 24 healthy individuals. These were followed by radiographic examinations in order to assess the loss of marginal alveolar bone. Results: The results showed that patients with DG had a statistically significant increase in periodontal indices, with more gingival inflammation and plaque retention compared to the control group (p <0.05). The highest scores for gingival inflammation were recorded in patients with DG, but on radiographic evaluation the difference was related only to gender, men being more affected by alveolar bone loss in both groups (p <0.05). Conclusions: The incidence and severity of gingival inflammation proved to be higher in patients with DG, which calls for better preventive and maintenance treatment protocols in this group of patients. Early diagnosis and initial-phase periodontal treatment are very important in preventing further tissue breakdown.

Histologic Evaluation of Tertiary Dentine after Indirect Pulp Capping Procedures

Early carious lesions induce odontoblast stimulation in tertiary dentine formation even before the lesion reaches the dentine. The most used material for these procedures was calcium hydroxide, which was recently replaced by Mineral Trioxide Aggregate (MTA).The purpose of our study was to assess the histological characteristics of tertiary dentine induced by these materials in permanent molar teeth.We used 23 molars scheduled for extraction due to orthodontic reasons, in patients of 17-24 years of age. In a time interval of 4-8 weeks prior to extraction, occlusal cavities were prepared and filled with MTA or calcium hydroxide and glass ionomer cement.In teeth filled with MTA we noticed an early development of tertiary dentin layer, with a tubular structure, similar to secondary dentine. In the case of calcium hydroxide, the process of new dentine deposition was delayed and diffuse calcification, with formation of pulp stones was noticed.MTA proved to be superior to calcium hydroxide in inducing tertiary dentine formation, which appeared early after treatment. In time the differences in the amount of tertiary dentine between these materials are reduced, but there is a tendency of diffuse mineralization induced by calcium hydroxide.