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Concentrated platelet-rich plasma used in root canal revascularization: 2 case reports.

AIM To present two case reports describing the treatment of immature teeth with necrotic pulps using concentrated platelet-rich plasma (cPRP) with 12-month clinical and radiographic follow-up. SUMMARY Root canal revascularization was performed on immature permanent teeth clinically and radiographically diagnosed as requiring root canal treatment. Following disinfection of the canal space with triple antibiotic paste (1 : 1 : 1: ciprofloxacin, metronidazole and cefaclor), a tissue scaffold was created with cPRP prepared using 2-step centrifugation. The final restoration was completed with white mineral trioxide aggregate and composite resin. The patients were recalled for clinical and radiographic evaluations every 3 months. At the 12-month follow-up apical closure by narrowing of the apical foramen and convergence of the apical walls in the treated teeth was observed.

Efficacy of Platelet-rich Plasma as a Scaffold in Regenerative Endodontic Treatment

INTRODUCTION Current research is concerned with discovering better scaffolds for use in regenerative endodontic treatment. This study aimed to clinically and radiographically evaluate the efficacy of platelet-rich plasma (PRP) used as a scaffold in regenerative endodontic treatment and compare it with that of a conventional blood clot (BC) scaffold. METHODS A total of 20 necrotic, single-rooted immature teeth were randomly distributed into 2 groups. After disinfecting the root canal space with triple antibiotic paste (1:1:1 ciprofloxacin, metronidazole, and cefaclor), a tissue scaffold was created by using either PRP or BC and covered with white mineral trioxide aggregate. Clinical and radiographic follow-up examinations were performed once every 3 months during an 18-month period. Differences in root area were calculated from preoperative and postoperative radiographs. Fisher exact and Mann-Whitney U tests were used to evaluate differences between groups, with P value <.05 considered to be statistically significant. RESULTS All 20 teeth were clinically asymptomatic during 18-month follow-up period; however, 1 tooth in the BC group exhibited periapical pathosis and was judged radiographically unsuccessful. Complete apical closure was observed in a mean of 8.1 months in the PRP group compared with 9 months in the BC group. The PRP group exhibited 9.86% increase in root area, compared with 12.6% increase in the BC group. The difference in success rates between the groups was not statistically significant (P > .05). CONCLUSIONS PRP successfully created a scaffold for regenerative endodontic treatment; however, treatment outcomes did not differ significantly between PRP and conventional BC scaffold.

Review of current concepts of revascularization/revitalization

This review focuses on the current concepts on revascularization/revitalization therapy. Revascularization/revitalization procedures performed under current protocols have reportedly achieved successful clinical and radiographical outcomes for immature permanent teeth with non-vital pulps; however, randomized prospective studies are needed to develop evidence-based methodologies for regenerative endodontic treatment.

Comparative evaluation of Ca(OH)2 plus points and Ca(OH)2 paste in apexification.

AIM  The aim of this study was to compare calcium hydroxide plus points (CHPPs) with the conventional calcium hydroxide paste (CHP) clinically and radiographically as materials used in apexification treatment. MATERIAL AND METHODS  Sixteen children, each with at least one necrotic permanent central incisor requiring apexification treatment, were selected for this study. Twenty-two selected teeth were divided into two test groups (10 CHP and 12 CHPP). The children were recalled for clinical evaluations every 3 weeks, and their radiographical evaluations were carried out every 3 months. Mann-Whitney U and Fishers exact tests were used to evaluate the differences between the groups. RESULTS  The follow-up evaluations revealed that the success rate was 100% for CHP and 92% for CHPP. No statistically significant difference between the groups was observed (P > 0.05). CONCLUSIONS  CHPP-treated central incisors requiring apexification demonstrated good success. CHPP can be used for cases in which traditional Ca(OH)(2) apexification is indicated as it has a similar outcome with CHP.

Effect of Toothbrushing on Color Changes of Esthetic Restorative Materials

PURPOSE The aim of this study was to evaluate the effects of various drinks and toothbrushing on the color changes of esthetic restorative materials used in pediatric dentistry. MATERIALS AND METHODS Forty specimens were prepared from each of three restorative materials (compomer [Dyract AP], glass ionomer cement [Ionofil Molar AC, Voco], composite resin [Filtek Z 250]). Specimens were divided into four groups for immersion in three different staining solutions (cherry juice, cola, chocolate milk) and distilled water. Each group was subdivided into brushing and non-brushing groups. The specimens in the brushing subgroups were brushed with toothpaste once a day using an electric toothbrush. Color was measured using a colorimeter, and color changes were calculated between baseline and 1, 7, 30, 60 days. Data was analyzed using Kruskal-Wallis, Mann-Whitney U, Wilcoxon, and Wilcoxon Signed Rank tests. RESULTS All the solutions evaluated yielded color changes, and these changes were significantly greater for composite resin than for glass ionomer cement or compomer (p < 0.006). Brushing significantly decreased the color changes of restorative materials (p < 0.004). CONCLUSION Brushing significantly influenced the color stability of esthetic restorative materials. The results of this study also showed that glass ionomer cements and compomers had higher color stability than composite resins. CLINICAL SIGNIFICANCE The color stability values after brushing may better reflect the discoloration of the esthetic restorative materials. Any color stability study model should consider the effects of toothbrushing that can remove the adsorbed colorants. The results of this study also showed that glass ionomer cements and compomers can be used in anterior restorations of children with their higher color stability than composite resins.

Root canal filling in primary molars without successors: Mineral trioxide aggregate versus gutta-percha/AH-Plus.

The aim of this study was to compare the clinical and radiographical success of mineral trioxide aggregate (MTA) and gutta-percha/AH-Plus used as a root canal filling material in primary second molars without successors. A total of 16 patients (9 girls, 7 boys) aged 6-13 years (mean: 10.5) were selected and randomly distributed into the treatment groups. Children were recalled for clinical and radiographic examination at 6, 12, 18, 24 and 36 months. Differences in treatment outcomes were analysed using chi-squared and Fishers exact tests. Clinically, there was no significant difference in the success rates between the groups at the end of a 3-year follow-up period (MTA: 100%; Gutta-percha/AH-Plus: 70%) (P > 0.05). However, radiographically, there was a significant difference between the groups (MTA: 80%; gutta-percha/AH-Plus: 30%) (P < 0.05). The present study showed that MTA can be recommended for use in root canal treatment of primary molars without successors based on better radiographic success.

How effective is a chewable brush in removing plaque in children? A pilot study

The aim of this pilot study was to evaluate the plaque removal efficiency of a chewable toothbrush (CB) in children. A total of 20 patients aged 10-12 years who attended to the Department of Pediatric Dentistry were enrolled in the study. This was a single-blinded crossover study which examined plaque removal efficiency of a CB compared to a manual toothbrush (MB) following a consecutive use. After professional prophylaxis had been given, participants refrained from brushing and chewing for 48 h. Supragingival plaque was examined using the Turesky modification of the Quigley-Hein Index (TQHI) and the simplified oral hygiene index (OHI-S). For statistical comparison, the difference (prebrushing minus postbrushing) in average scores was calculated. Data were evaluated by Mann-Whitney U-test, with a P < 0.05 considered to be statistically significant. The mean plaque reduction score with TQHI for CB and MB were 1.91 ± 0.54 and 1.96 ± 0.52, respectively. The mean plaque reduction score with OHI-S for CB and MB were 1.31 ± 0.288 and 1.34 ± 0.403, respectively. Differences in scores between the two brushes were not statistically significant (P > 0.05). Within the limits of this study, the experimental chewable brush was found to be as effective as a manual brush in removing plaque. The chewable brush may be an appropriate oral hygiene adjunct for school children, including children with disabilities.

Late Developing Supernumeraries in a Case of Nonsyndromic Multiple Supernumerary Teeth

Objective. This case report presents 3-year follow-up of a case of nonsyndromic multiple supernumerary teeth (NSMST) with 11 supernumerary teeth, 2 of which showed subsequent formation. Case Report. A 10-year-old girl was referred to the dental clinic with the chief complaint of delayed eruption. Radiographic examination showed 9 retained supernumerary teeth. The treatment plan consisted of extraction of the supernumerary teeth and associated primary teeth in order to allow the permanent teeth to erupt. After 2 years of follow-up, 2 additional supernumerary teeth were observed. Conclusion. Regular follow-up for late forming supernumeraries is crucial for NSMST cases.

Resin Nanoceramic CAD/CAM Restoration of the Primary Molar: 3-Year Follow-Up Study

This case report presents the clinical use of a resin nanoceramic CAD/CAM restoration of a primary second molar without successor in the form of a permanent second premolar tooth in a patient. Three-year follow-up of the case revealed that resin nanoceramic CAD/CAM restoration of the primary molar without successor achieved both aesthetics and function. Despite the high cost of treatment, this type of restoration should be considered if the retained tooth is expected to maintain functionality over the long term.

What to wear when practicing on pediatric dental patients

Background: The appearance of the clinician is considered to have an effect on a patient′s impression of the dental environment and to affect the doctor-patient relationship. Aim: The aim of this study was to identify children′s and parents′ preferences regarding dentist′s attire and their relationship to dental anxiety, previous experiences, and socioeconomic levels. Methods: The study was conducted with 500 patients between 5 and 11 years of age and their parents. Participants were asked to respond a questionnaire, and preference of dental attire was determined by showing photographs of either a female or a male pediatric dentist in the three different modes of attire. Statistics: Chi-square test, Mann-Whitney U-test, and Spearmen Rho correlation test were used for statistical analysis. Results: The majority of children and their parents were found to prefer pediatric dentists to wear white coats; however, children with a systemic disease, dental anxiety, and previous negative dental experience preferred casual dress (P < 0.05). Conclusion: Previous experiences and general health have a strong effect on children′s preferences related to their dentist′s attire.