Mariusz Lipski

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

INTRODUCTIONnBiodentine 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.nnnMETHODSnPulps 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.nnnRESULTSnThe 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.nnnCONCLUSIONSnWithin 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.

Tomographic Evaluation of Reparative Dentin Formation after Direct Pulp Capping with Ca(OH)2, MTA, Biodentine, and Dentin Bonding System in Human Teeth

INTRODUCTIONnNew materials can increase the efficiency of pulp capping through the formation of a complete reparative dentin bridge with no toxic effects. The present study involved tomographic evaluations of reparative dentin bridge formation after direct pulp capping with calcium hydroxide, mineral trioxide aggregate (MTA), Biodentine (Septodont, Saint Maur des Fossés, France), and Single Bond Universal (3M ESPE, Seefeld, Germany) in human teeth.nnnMETHODSnForty-four caries-free, intact, human third molars scheduled for extraction were subjected to mechanical pulp exposure and assigned to 1 of 4 experimental groups depending on the pulp capping agent used: calcium hydroxide, MTA, Biodentine, or Single Bond Universal. After 6 weeks, the teeth were extracted and processed for cone-beam computed tomographic imaging and histologic examination. Tomographic data, including the density and volume of formed reparative dentin bridges, were evaluated using a scoring system.nnnRESULTSnThe reparative dentin formed in the calcium hydroxide, MTA, and Biodentine groups was significantly superior to that formed in the Single Bond Universal group in terms of thickness and volume. The dentin bridges in the Biodentine group showed the highest average and maximum volumes. The mean density of dentin bridges was the highest in the MTA group and the lowest in the Single Bond Universal group.nnnCONCLUSIONSnThe volume of reparative dentin bridges formed after direct pulp capping is dependent on the material used. Biodentine and MTA resulted in the formation of bridges with a significantly higher average volume compared with Single Bond Universal, and cone-beam computed tomographic imaging allowed for the identification of the location of dentin bridges.

Root Surface Temperature Rises in Vitro During Root Canal Obturation With Thermoplasticized Gutta-Percha on a Carrier or by Injection

The aim of this in vitro study was to measure the temperature rise on the outer root surfaces of teeth during four different root canal obturation techniques. Sixty extracted human maxillary and mandibular premolars with a single canal were used. After root canal cleaning and shaping, the teeth were randomly divided into four groups of 15 teeth each and obturated with Thermafil obturators or Soft-Core obturators using Ultrafil or Trifecta low-temperature thermoplasticized gutta-percha techniques. Temperature changes on the external mesial root surfaces were measured using a thermal imaging camera. Lower temperature rises were found for Ultrafil and Trifecta techniques (2.14 degrees C and 2.03 degrees C, respectively) than for Thermafil and Soft-Core techniques (3.87 degrees C and 3.67 degrees C, respectively). These findings suggest that solid core gutta-percha combined with low-temperature injectable gutta-percha obturation techniques may impose less risk for thermal damage to the surrounding periradicular tissues.

Surface electromyography in orthodontics – a literature review

Electromyography is the most objective and reliable technique for evaluating muscle function and efficiency by detecting their electrical potentials. It makes it possible to assess the extent and duration of muscle activity. The main aim of surface electromyography is to detect signals from many muscle fibers in the area of the detecting surface electrodes. These signals consist of a weighted summation of the spatial and temporal activity of many motor units. Hence, the analysis of the recordings is restricted to an assessment of general muscle activity, the cooperation of different muscles, and the variability of their activity over time. This study presents the main assumptions in the assessment of electrical muscle activity through the use of surface electromyography, along with its limitations and possibilities for further use in many areas of orthodontics. The main clinical uses of sEMG include the diagnostics and therapy of temporomandibular joint disorders, an assessment of the extent of stomatognathic system dysfunctions in subjects with malocclusion, and the monitoring of orthodontic therapies.

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.

Perforating Internal Root Resorption Repaired with Mineral Trioxide Aggregate Caused Complete Resolution of Odontogenic Sinus Mucositis: A Case Report

INTRODUCTIONnAn extensive perforating internal root resorption accompanied by apical periodontitis and odontogenic sinus mucositis was detected on preoperative cone-beam computed tomographic scans in a first maxillary molar.nnnMETHODSnAfter the chemomechanical debridement of the root canals, calcium hydroxide was placed as a temporary dressing for 7 days. Mineral trioxide aggregate was used to fill the perforation site with the aid of a surgical microscope. At the next visit, the root with the resorption defect was filled with warm vertical compaction of gutta-percha.nnnRESULTSnA control cone-beam computed tomographic scan acquired 6 months after the endodontic treatment revealed complete resolution of the sinus retention cyst. Moreover, the patients frequent otolaryngologic disturbances ceased. The tooth was functional with satisfactory clinical and radiographic results after 12 months.nnnCONCLUSIONSnBased on the results of this case, successful repair of an extensive, perforating internal resorption with mineral trioxide aggregate may lead to complete resolution of apical periodontitis and maxillary sinus retention cyst.

Tooth Discoloration Induced by Different Calcium Silicate–based Cements: A Systematic Review of In Vitro Studies

INTRODUCTIONnOn the basis of many clinical observations, some calcium silicate-based cements have a high potential for staining tooth tissue. This feature greatly limits the use of those cements, particularly for anterior teeth. This review aimed to provide a systematic evaluation of published inxa0vitro studies to determine the effect of different calcium silicate-based cements on dental tissue discoloration.nnnMETHODSnThis literature review was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The literature search was based on all publications without a year limit. The last search was performed on October 22, 2016. An electronic search was performed on MEDLINE (PubMed), Cochrane, and Scopus. The articles were selected to address the following research question: Which materials based on calcium silicate-based cements have hard tissue staining potential? The necessary information was extracted by 2 authors independently using a standardized form.nnnRESULTSnThe search resulted in 390 titles from all databases. Twenty-three studies met the inclusion criteria. Most of the studies exhibited a moderate risk of bias. The results indicated that some materials showed a strong potential for staining, including gray and white MTA Angelus (Londrina, PR, Brazil), gray and white ProRoot MTA (Dentsply, Tulsa, OK), and Ortho MTA (BioMTA, Seoul, Korea). Individual study results showed that Biodentine (Septodont, Saint Maur des Fosses, France), Retro MTA (BioMTA), Portland cement, EndoSequence Root Repair Material (Brasseler USA, Savannah, GA), Odontocem (Australian Dental Manufacturing, Brisbane, Australia), MM-MTA (Micro Mega, Besancon Cedex, France), and MTA Ledermix (Riemser Pharma GmbH, Greiswald-Insel Riems, Germany) were materials with the smallest staining potential.nnnCONCLUSIONSnThis review clearly showed that some calcium silicate-based cements have a high potential for staining hard tissue. On the other hand, some showed only a small change in color, which was nearly invisible to the human eye (ΔE <3.3). However, more long-term clinical studies are needed.

Effect of different water flows on root surface temperature during ultrasonic removal of posts

OBJECTIVEnThis in vitro study evaluated rises in temperature on the outer root surface of human incisors during ultrasonic post removal with different water flows.nnnSTUDY DESIGNnThirty-six extracted teeth (12 maxillary central incisors, 12 maxillary lateral incisors, and 12 mandibular incisors) were used. After root canal preparation, the teeth were obturated, and prefabricated posts were cemented into the prepared spaces. Posts were ultrasonically instrumented dry and with irrigation at 20 mL/min and 40 mL/min. Temperature changes on the entire mesial outer surfaces of the roots were measured at 10-second intervals using an infrared thermal imaging camera.nnnRESULTSnIncreases in root surface temperature were significantly lower when posts were instrumented with 40 mL/min water irrigation compared with dry vibration and 20 mL/min irrigation, which also significantly differed from each other. Statistical analysis among tooth groups showed differences in the mean temperature rise of maxillary central incisors and maxillary lateral incisors compared with mandibular incisors when posts were instrumented dry or with 20 mL/min irrigation. There were no significant differences in mean temperature rises between the studied groups when 40 mL/min irrigation was used.nnnCONCLUSIONSnWater cooling during ultrasonic post instrumentation significantly reduced temperature increases on the outer root surface; however, the intensity of the cooling was also important. Our results suggest that copious water irrigation during post removal is an effective method to protect the roots surrounding tissue.

Evaluation of alginate as a substitute for root-surrounding tissues in electronic root canal measurements.

Alginate as a substitute for root-surrounding tissue was investigated. The electronic working lengths of root canals under clinical conditions were compared with an in vitro simulation of the same teeth extracted and embedded in alginate. The working lengths in 26 teeth were determined on two occasions using an electronic apex locator, before extraction and after extraction with the same teeth embedded in an alginate mass. The apical 4u2003mm of the root canals were exposed following the measurements, and the distances between the apical constrictions and the tips of files repositioned in the canals were measured and recorded. The mean distance between the file tip and the constriction was +0.33u2003mm (±0.38) in vivo and +0.32u2003mm (±0.30) in vitro. The Wilcoxon signed-rank test indicated that these means were not significantly different. The apical constriction was assessed to be within the limits of 0.5u2003mm in 80.7% of in vivo cases and in 76.9% of extracted teeth. Statistical analysis demonstrated that there was no significant difference between the results recorded in vivo and in vitro regarding apical constriction localisation. Based on the results of this study, the alginate mass is a useful tool in evaluating the performance of electronic apex locators.

Influence of Water Cooling on Root Surface Temperature Generated During Post Space Preparation

INTRODUCTIONnThis in vitro study evaluated the temperature increases on the root surface of teeth during preparation of post space with and without water cooling.nnnMETHODSnThirty premolar teeth with a single canal were used. After root canal obturation, the teeth were divided into 2 groups, and post spaces were prepared by using a drill without cooling (dry group) and with water irrigation of 25 mL/min(-1) (wet group). Temperatures were measured on the entire root surface by using a thermal imaging camera.nnnRESULTSnRoot surface temperature increases were significantly lower when post spaces were created with water cooling compared with dry post preparation (P < .0001 for root canal filling removal and P < .0001 for post space preparation). In both groups, significantly higher temperatures were recorded during the post space preparation than during the filling removal (P < .001 for nonirrigated teeth and P < .001 for irrigated teeth).nnnCONCLUSIONSnIrrigation during post space preparation significantly influenced the outer root surface temperature. The risk of irreversible injury to the root surrounding tissues is potentially minimized when post space is prepared by using water cooling.