Damian Lichota

Response of Human Dental Pulp Capped with Biodentine and Mineral Trioxide Aggregate

INTRODUCTION Biodentine is a new bioactive cement that is similar to the widely used mineral trioxide aggregate (MTA). It has dentin-like mechanical properties, which may be considered a suitable material for clinical indications of dentin-pulp complex regeneration such as direct pulp capping. The purpose of the present study was to compare the response of the pulp-dentin complex in human teeth after direct capping with this new tricalcium silicate-based cement with that of MTA. METHODS Pulps in 28 caries-free maxillary and mandibular permanent intact human molars scheduled for extraction for orthodontic reasons were mechanically exposed and assigned to 1 of 2 experimental groups, Biodentine or MTA, and 1 control group. Assay of periapical response and clinical examination were performed. After 6 weeks, the teeth were extracted, stained with hematoxylin-eosin, and categorized by using a histologic scoring system. RESULTS The majority of specimens showed complete dentinal bridge formation and an absence of inflammatory pulp response. Layers of well-arranged odontoblast and odontoblast-like cells were found to form tubular dentin under the osteodentin. Statistical analysis showed no significant differences between the Biodentine and MTA experimental groups during the observation period. CONCLUSIONS Within the limitations of this study, Biodentine had a similar efficacy in the clinical setting and may be considered an interesting alternative to MTA in pulp-capping treatment during vital pulp therapy.

Endodontic Treatment of a Maxillary Canine with Type 3 Dens Invaginatus and Large Periradicular Lesion: A Case Report

Dens invaginatus type 3 is an anomaly characterized by an infolding of enamel and dentin that can extend up to the root apex and might present difficulties with respect to its diagnosis and treatment because of canal morphology. This article describes an unusual case of the maxillary canine having a type 3 dens invaginatus, necrotic pulp, and an associated large periradicular lesion treated by conventional root canal therapy. After gaining access to the pulp chamber, the primary canal and the invagination were localized, negotiated, enlarged, and filled with calcium hydroxide. Three weeks later the canal and the invagination were obturated with gutta-percha and restored. At 24-month recall satisfactory bone healing had occurred.

Muscle Fatigue in the Temporal and Masseter Muscles in Patients with Temporomandibular Dysfunction

The aim of this study is to evaluate muscle fatigue in the temporal and masseter muscles in patients with temporomandibular dysfunction (TMD). Two hundred volunteers aged 19.3 to 27.8 years (mean 21.50, SD 0.97) participated in this study. Electromyographical (EMG) recordings were performed using a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany). Muscle fatigue was evaluated on the basis of a maximum effort test. The test was performed during a 10-second maximum isometric contraction (MVC) of the jaws. An analysis of changes in the mean power frequency of the two pairs of temporal and masseter muscles (MPF%) revealed significant differences in the groups of patients with varying degrees of temporomandibular disorders according to Di (P < 0.0000). The study showed an increase in the muscle fatigue of the temporal and masseter muscles correlated with the intensity of temporomandibular dysfunction symptoms in patients. The use of surface electromyography in assessing muscle fatigue is an excellent diagnostic tool for identifying patients with temporomandibular dysfunction.

Pulpo-dentin complex response after direct capping with self-etch adhesive systems

The purpose of the present study was to evaluate morphologically the response of feline teeth pulp to direct pulp capping with two different self-etch adhesive systems. Twenty-four cavities in feline teeth were mechanically exposed and assigned to one of two experimental groups: AdheSE + Tetric Ceram (the ASE group), or Adper Prompt L-Pop + Filtek Supreme (the APLP group). There was also a control group Dycal Ca(OH)2 liner + Amalgam (the CH group eight teeth), and six teeth were used as an intact control group. The animals were sacrificed after 40 days. The teeth were removed and processed for standard histological evaluation, using a scoring system for inflammatory cell response, pulp tissue disorganisation, reparative tissue formation, and the presence of bacteria. Statistical analysis revealed no significant differences between the ASE and APLP selfetching resin systems during the observation period. The majority of the specimens presented inflammatory pulp response with tissue disorganisation and a lack of dentinal bridge formation. CH capping resulted in a significantly smaller inflammatory pulp response and a considerably higher incidence of reparative dentin formation. ASE and APLP were comparably effective as direct pulp capping materials, but their application resulted in significantly greater pulp tissue damage than CH capping. Further in vivo human studies are necessary to determine which adhesive resin systems should be clinically used for direct pulp capping without incurring severe damage to the pulpal tissue.

The Electrical Activity of the Temporal and Masseter Muscles in Patients with TMD and Unilateral Posterior Crossbite

The aim of this study was to assess the influence of unilateral posterior crossbite on the electrical activity of the temporal and masseter muscles in patients with subjective symptoms of temporomandibular dysfunctions (TMD). The sample consisted of 50 patients (22 female and 28 male) aged 18.4 to 26.3 years (mean 20.84, SD 1.14) with subjective symptoms of TMD and unilateral posterior crossbite malocclusion and 100 patients without subjective symptoms of TMD and malocclusion (54 female and 46 male) aged between 18.4 and 28.7 years (mean 21.42, SD 1.06). The anamnestic interviews were conducted according to a three-point anamnestic index of temporomandibular dysfunction (Ai). Electromyographical (EMG) recordings were performed using a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany). Recordings were carried out in the mandibular rest position and during maximum voluntary contraction (MVC). Analysis of the results of the EMG recordings confirmed the influence of unilateral posterior crossbite on variations in spontaneous muscle activity in the mandibular rest position and maximum voluntary contraction. In addition, there was a significant increase in the Asymmetry Index (As) and Torque Coefficient (Tc), responsible for a laterodeviating effect on the mandible caused by unbalanced right and left masseter and temporal muscles.