Effect of nanoparticle based intra-canal medicaments on root dentin micro-hardness

Complete eradication of bacterial infection from the root canal with minimum or no effect on the microhardness of the dentin is desirable for the success of endodontic treatment. The effect of nanoparticle based intracanal medicaments on the root dentine microhardness was assessed. The medicaments used were combination of calcium hydroxide - silver nanoparticles, Combination of graphene oxide - silver nanoparticles, Calcium hydroxide and a control group. Vickers hardness value were evaluated and compared at coronal, middle and apical third level. Graphene oxide - silver nanoparticles based intracanal medicament showed least effect on the microhardness of the root dentin compared to calcium hydroxide and calcium hydroxide combined with silver nanoparticle based intracanal medicaments.     

Variation in the developing root cone angle of the permanent mandibular teeth of modern man and certain fossil hominids

The radiographic appearance of the developing root apex of 461 mandibular teeth was studied using ellipsopantomographs of 77 individuals. The angle formed by the mesial and distal aspects of the developing root cone was measured for each quarter of root development in the permanent mandibular teeth of each subject. Large values for this angle in the more coronal part of the root gradually decreased towards the root apex where values were small in all teeth studied. This gradual decrease in the angle of the developing root cone is concordant with the faster increase in root length but slower rates of dentinogenesis reported for the apical region of human teeth in the literature, as the decrease is likely to reflect the increasing numbers of odontoblasts that become involved in root formation as it proceeds apically. The developing root cone angles of one of the five fossil hominid specimens studied (KMN-ER 820) fall outside the range for the developing root cone angle of the developing premolar and permanent second molar roots in modern Homo sapiens and is evidence of a faster rate of root elongation than is typical for modern man.     

Esthetic reconstruction of teeth in patient with dentinogenesis imperfecta--a case report

Dentinogenesis imperfecta (DI) is the result of a dominant genetic defect and affects both the deciduous and permanent dentitions. It is characterized by opalescent teeth composed of irregularly formed and undemineralized dentin which obliterates pulp chamber and root canal. DI can appear as a separate disorder or with osteogenesis imperfecta (OI). The teeth with DI show a grayish-blue to brown hue with dislodged enamel, dysplastic dentine with irregular dentinal tubules and interglobular dentine, short roots and pulpal obliteration, which all may lead to rapid and extensive attrition which require adequate crown reconstruction. The aim of this study was to show a reconstruction of frontal teeth in upper jaw with direct composite veneers in young adult patient with DI.     

Ability of root canal antiseptics used in dental practice to induce chromosome aberrations in human dental pulp cells

Root canal antiseptics are topically applied to root canals within the pulpless teeth to treat the root canal and periapical infections. Because the antiseptics that are applied to root canals can penetrate through dentin or leak out through an apical foramen into the periodontium and distribute by the systemic circulation, it is important to study the safety of these antiseptics. In the present study, we examined the ability to induce chromosome aberrations in human dental pulp cells of five root canal antiseptics, namely, carbol camphor (CC), camphorated p-monochlorophenol (CMCP), formocresol (FC), calcium hydroxide, and iodoform which are most commonly used in dental practice. Statistically significant increases in the levels of chromosome aberrations were induced by CC, FC, or iodoform in a concentration-dependent manner. Conversely, CMCP and calcium hydroxide failed to induce chromosome aberrations in the absence or presence of exogenous metabolic activation. The percentages of cells with polyploid or endoreduplication were enhanced by FC or iodoform. Our results indicate that the root canal antiseptics that exhibited a positive response are potentially genotoxic to human cells.     

MTA、iRoot BP Plus及氢氧化钙在年轻恒牙活髓切断术中临床疗效的比较分析

摘要 目的：研究三氧化矿物凝聚体（MTA）、iRoot BP Plus（iRooT）以及氢氧化钙（Ca(OH) ₂）三种材料在年轻恒牙活髓切断术中的临床疗效。方法：将60例需要接受年轻恒牙活髓切断术的患者（60颗患牙）按照使用材料不同随机分为三组：MTA组、iRooT组和Ca（OH）₂组,每组20例（20颗患牙）,比较三组患者术后3个月和6个月手术成功率、牙本质桥形成和牙齿变色发生率、牙根管壁厚度、牙齿功能和美观度、以及血清基质金属蛋白酶-3（MMP-3）和白细胞介素-8（IL-8）水平。结果：（1）三组患者仅术后6个月临床治疗成功率存在显著差异（P<0.05）;（2）Ca（OH）₂组术后牙本质桥形成率显著低于其他两组（P<0.05）,而牙齿变色发生率显著低于MTA组（P<0.05）和显著高于iRooT组（P<0.05）。（3）三组患者治疗后牙根管壁厚度均较治疗前显著增加,且治疗后Ca（OH）₂组患牙根管壁厚度增加显著低于MTA组和iRooT组（P<0.05）。（4）Ca（OH）2组患者术后6个月牙齿舒适功能、固定功能和咀嚼功能评分均显著低于MTA组和iRooT组（P<0.05）,而牙齿美观度评分显著低于iRooT组（P<0.05）和显著高于MTA组（P<0.05）。（5）三组患者术后6个月血清MMP-3和IL-8均显著低于术前（P<0.05）,并且MTA组患者血清MMP-3和IL-8水平显著高于iRooT组（P<0.05）和显著低于CaOH组（P<0.05）。结论：iRoot BP Plus和MTA材料应用于年轻恒牙活髓切断术均具有较高的远期成功率,但MTA材料远期牙齿变色率较高因而影响牙齿美观度。     

Reasons for extraction of permanent teeth in urban and rural populations of Croatia

The survey aimed to determine the reasons for extraction of permanent teeth by general dental practitioners in urban and rural population of the Senj region, Adriatic coast, Croatia. During a two-year period (1998-9), a total of 2006 teeth were extracted in both regions, in patients aged 15+. The causes were defined as follows: (1) decay or root without a crown (radix relicta), (2) periodontal disease, (3) endodontic or periapical diseases and (4) other reasons--orthodontics/prosthodontics and dental trauma. The statistical Chi-square-test was used to determine the significant difference between the populations and the sexes. Dental caries was the most frequent cause for extraction (over 50%), followed by endodontic and periapical diseases (23%) as the result of untreated caries and at the end periodontal disease (21%). Urban population more often lose teeth due to periodontal disease (22.75%) than rural (18.93%, p < 0.05). Similarly, this is more frequent in the urban male population (25.61%) than the female urban population (20%, p < 0.05). In rural areas, people more often lost teeth as a result of endodontic and periapical disease (25.85%) than in the urban locations (19.07%, p < 0.01) and this is more frequent in women from rural areas (28.37%) than the rural men (22.44%, p < 0.05). Periodontal disease was not the main cause of tooth loss in either the rural or the urban population. Dental caries and its sequel remain the most important challenge for the dental service. It also reveals the inadequacy of dental services. Education of both the population and the general dental practitioners must be conducted in order to improve oral hygiene and to insist on conservative rather than extraction therapy.     

Enterococcus faecalis infection in root canals – host‐derived or exogenous source?

Aims: Enterococcus faecalis is associated with a significant number of refractory endodontic infections. Previous studies report a prevalence of Ent. faecalis ranging from 24% up to 77% in teeth with failed endodontic treatment. The origin of the micro‐organism remains unclear, as enterococci do not belong to the normal oral microflora. The aim of this study was to determine whether these enterococci were of endogenous or exogenous origin. Methods and Results: Fifty consecutive patients with apical periodontitis in need of endodontic orthograde re‐treatment were included. Samples were collected from root canals, saliva and faeces and subjected to microbiological culturing. The genetic relationship between Ent. faecalis from root canals and isolates from the different host sources was determined using pulsed‐field gel electrophoresis. In 16% (8/50) of the patients, enterococci were collected from the root canal samples. The genetic analysis showed that the isolates from the root canals were not related to those from the normal gastrointestinal microflora. None of these patients had enterococci in their saliva samples. Conclusions: Endodontic infections with Ent. faecalis are probably not derived from the patient’s own normal microflora, which indicates that these infections ent. faecalis are of exogenous origin. Significance and Impact of the Study: This is the first study to genetically compare endodontic infectious Ent. faecalis isolates with isolates from the hosts’ own normal microflora.     

Distinction of Prevotella intermedia and Prevotella nigrescens from endodontic bacteremia through their fatty acid contents

Prevotella nigrescens has recently been recognized as a new species distinct from Prevotella intermedia. The distinction is based largely on DNA-DNA hybridization, electrophoretic migration of malate and glutamate dehydrogenase, and peptidase and lipase activities of type strains. Gas chromatography of cellular fatty acids can be a useful adjunct for characterization and identification of bacterial species. In the present study, cellular fatty acid profiles were determined for seven strains of P. intermedia and six strains of P. nigrescens. Six of these 13 strains were isolated from the root canal and blood of three patients during endodontic therapy of teeth with Asymptomatic apical periodontitis. The bacteria were cultivated anaerobically in 10 mL prereduced anaerobically sterilized peptone-yeast extract-glucose broth for 24 h. Dried cells of each isolate were methanolysed and their fatty acid contents determined by the Microbial Identification System software package by MIDI. The data were treated by principal component analysis, which distinguished P. nigrescensfromP. intermedia. Cellular fatty acid profiles of these strains of the species in blood matched the profiles of their respective root canal isolates, as demonstrated by Euclidean Distance Square assessment. This suggested that the organisms in the root canal had spread to the bloodstream during endodontic treatment.     

Metaproteome Analysis of Endodontic Infections in Association with Different Clinical Conditions

Analysis of the metaproteome of microbial communities is important to provide an insight of community physiology and pathogenicity. This study evaluated the metaproteome of endodontic infections associated with acute apical abscesses and asymptomatic apical periodontitis lesions. Proteins persisting or expressed after root canal treatment were also evaluated. Finally, human proteins associated with these infections were identified. Samples were taken from root canals of teeth with asymptomatic apical periodontitis before and after chemomechanical treatment using either NaOCl or chlorhexidine as the irrigant. Samples from abscesses were taken by aspiration of the purulent exudate. Clinical samples were processed for analysis of the exoproteome by using two complementary mass spectrometry platforms: nanoflow liquid chromatography coupled with linear ion trap quadrupole Velos Orbitrap and liquid chromatography-quadrupole time-of-flight. A total of 308 proteins of microbial origin were identified. The number of proteins in abscesses was higher than in asymptomatic cases. In canals irrigated with chlorhexidine, the number of identified proteins decreased substantially, while in the NaOCl group the number of proteins increased. The large majority of microbial proteins found in endodontic samples were related to metabolic and housekeeping processes, including protein synthesis, energy metabolism and DNA processes. Moreover, several other proteins related to pathogenicity and resistance/survival were found, including proteins involved with adhesion, biofilm formation and antibiotic resistance, stress proteins, exotoxins, invasins, proteases and endopeptidases (mostly in abscesses), and an archaeal protein linked to methane production. The majority of human proteins detected were related to cellular processes and metabolism, as well as immune defense. Interrogation of the metaproteome of endodontic microbial communities provides information on the physiology and pathogenicity of the community at the time of sampling. There is a growing need for expanded and more curated protein databases that permit more accurate identifications of proteins in metaproteomic studies.     

Histological and three dimensional organization of the odontogenic organ in the lower incisor of 100 gram rats.

A three dimensional reconstruction of the epithelial tissue at the apical end of the lower rat incisor was made from serial 1 mum thick cross sections. This tissue formed an elongated structure, called the odontogenic organ, which was composed of a bulbous and a "U"-shaped part. Both parts were joined to one another at the posterior aspect of the apical foramen. The bulbous part of the odontogenic organ was situated at the lingual side of the "U"-shaped part and protruded anteriorly over the pulp. It was formed by cells of the outer dental epithelium and stellate reticulum whose organization suggested that the bulbous part was important in the production of cells for renewal of all the epithelia of the incisor. The "U"-shaped part of the odontogenic organ was apparently derived from the bulbous part and delineated the pulp by forming the lateral, mesial and labial sidewalls around the apical foramen. It was composed of all the epithelial cell types recognizable as precursors to (a) cells of the enamel organ which form the enamel, and (b) Hertwig's epithelial root sheath, a part of the odontogenic organ which induces the formation of dentin on the lingual aspect of the incisor.     

Concentration of selected elements in the roots and crowns of both primary and permanent teeth with caries disease

We examined the differences between the concentrations of chemical elements in caries-changed primary teeth and permanent ones with a division into the root and the crown. The study comprised 27 children aged from 4 to 11 yr and 36 adults aged from 36 to 71 yr. We examined the elements with the total reflection X-ray fluorescence method. The lowest concentrations of calcium, manganese, strontium, lead, and copper were in the roots of primary teeth compared to the roots of permanent ones. The calcium, nickel, zinc, lead, and copper concentrations were significantly higher in the roots of primary teeth than in the roots of permanent teeth. However, the zinc concentration was higher both in the root and crown of primary teeth than in permanent teeth. On the basis of our investigations, we can conclude that the content of some elements (manganese, copper, strontium, and lead) is higher in caries permanent teeth than in primary ones. The nickel and zinc concentrations are higher in the teeth of the children than the adults. However, the content of other elements (calcium, chromium, iron) is similar in both kinds of teeth.     

Endodontic considerations in the elderly

Tooth retention has increased significantly in older adults, and dentists are now challenged by the need to preserve critical teeth. There will be a need to consider endodontic therapy, and this paper describes how successful endodontics can be provided for elderly patients. Strategic treatment planning is essential, and preservation of key teeth will facilitate satisfactory oral function for elderly patients. These teeth may be important in achieving and maintaining an intact anterior dental arch, for removable partial denture retention or preservation of alveolar bone. In some cases, this can only be achieved if endodontic procedures are undertaken. When infection of a root canal is present, there is no reason why good quality endodontic therapy should not work in a healthy elderly patient. Elimination of infection can be challenging in narrow root canals, and a systematic approach for improving access into and negotiating these canals is outlined.     

The influence of tooth wear on root canal dimensions

The objective was to investigate the relations between tooth wear and root canal dimensions. The experimental group comprised 100 cuspids (canines), 50 of which had advanced abrasion and 50 were without it The dimensions of root canal were investigated at the light microscope level in order to define their vestibulo-oral and mesio-distal diameters in all three thirds. In the groups of teeth without abrasion the MD diameters of root canaliculi in their cervical thirds were greater than in the teeth with advanced abrasion. In the apical third the MD diameters of canaliculi were highly variable in teeth with no signs of abrasion. In the group of teeth with abrasion the MD and VO diameter values of the cervical thirds were significantly smaller than in the group of teeth without abrasion. In the mid-thirds the values of MD diameters were highly variable in the group of teeth with abrasion, whereas the VO diameter values were much greater than in the teeth without abrasion. As regards to the apical thirds, the VO diameter values were greater than in the control teeth. The data presented herewith contribute to better knowledge about tooth wear and are highly useful in restorative and reconstructive dental procedures.     

Modeling AC current conduction through a human tooth

Impedance between the electrode inserted in a root canal of a human tooth and the outer electrode placed on the oral mucosa serves as a measure of the root canal length, a vital parameter necessary for efficient endodontic procedure in dentistry. For better understanding of current conduction through the tooth, the impedance has been measured on extracted teeth (in vitro) and further used to develop corresponding electrical lumped element models. For modeling the metal/solution interface and complex structure of the tooth, Fricke's constant phase elements are employed. More detailed insight into current conduction is given by numerical simulation. Numerical simulation demonstrates the influence on the impedance of several important parameters, such as dentin conductance, canal preparation, and solution conductance.     

X-linked hypophosphatemia: the mutant gene is expressed in teeth as well as in kidney.

Mutation at a locus (HPDR) on the X chromosome (McKusick 30780 [HPDR1]; 30781 [HPDR2]) causes impaired renal phosphate transport, hypophosphatemia, and an associated impairment in the process of mineralization in bone and teeth (X-linked hypophosphatemia [XLH]). We measured the dental pulp profile area (PRATIO [= pulp area/tooth area]) and serum phosphorus (Pi) values in uniformly treated XLH patients (six males, 81 teeth, 1,457 Pi values; 11 females, 129 teeth, 1,439 Pi values). Serum Pi values, reflecting the metabolic environment of tooth development, were obtained by repeated measurement between 1 mo and 26 years of age during treatment. PRATIO values calculated from standardized Rinn radiographs were used as outcome measurements of tooth development in XLH patients and in age-matched controls (12 males, 100 teeth; 27 females, 275 teeth). Age-dependent serum Pi values were not different in the treated XLH males and females. In teeth forming primary dentin there was no gene dosage effect on PRATIO values apparent in subjects below 15 years of age. However, in teeth forming secondary dentin a gene dosage was found in the subjects aged 15 to 25 years: XLH male teeth (n = 65) mean +/- SD = 0.163 +/- 0.046; XLH female teeth (n = 75) mean +/- SD = 0.137 +/- 0.039; control teeth (n = 209) mean +/- SD = 0.116 +/- 0.023; (higher PRATIO values mean less development or mineralization of secondary dentin); differences in these PRATIO values (males vs. female and XLH vs. control) were significant by mixed-model analysis of variance.(ABSTRACT TRUNCATED AT 250 WORDS)     

Recovery of Enterococcus faecalis in root canal lumen of patients with primary and secondary endodontic lesions

The presence of Enterococcus faecalis in root canal teeth affected by primary and secondary periapical lesions was studied using polymerase chain reaction (PCR) assays. The association between presence of E. faecalis with clinical signs of apical lesions was assessed to evaluate a possible relationship between clinical findings. Microbial samples were obtained from healthy patients affected by different periapical lesions, 79 teeth with primary periapical lesion and 23 with secondary periapical lesion. For each tooth, clinical symptoms and X-ray appearance were examined. E. faecalis was detected in 6 of 79 samples with primary lesion (7.6%), and in 9 of 23 with secondary lesion (39.1%). Suggested association was found between E. faecalis and secondary apical lesions. As regard specific signs and symptoms E. faecalis was more associated with asymptomatic lesions (all p<0.05) than with symptomatic apical lesions. The study confirms the high presence of E. faecalis in secondary apical lesions. However, its effective role in endodontic pathogenesis such as bone periapical lesions needs to be clarified.     

Dentition in Pacific walrus (Odobenus rosmarus divergens) calves of the year

The oral cavity and teeth were examined in Pacific walrus calves of the year that died or were harvested on Cape Vancarem and Koluchin Island, the Chukchi Sea, in September to October 2010. The order of gingival eruption of teeth, the resultant dental formula in calves of the year and 1.5-year-old animals, and the dental formula after alveolar eruption of teeth were determined. The number of teeth after gingival eruption in calves of the year did not depend on their body length and sex. The loss of some teeth, mainly incisors, was recorded in individuals aged 5?C6 months. Already at early developmental stages, functional teeth were found to differ significantly from other (rudimentary) teeth in their weight, total size, and the size of apical foramen. Some individuals had milk teeth, which were either gingivally erupted or partly remained within soft tissues. Cases of aberration in dentition that require additional studies were recorded.     

Reconstructing infant weaning histories at Roman period Kellis, Egypt using stable isotope analysis of dentition

Studies of infant feeding and weaning patterns in past populations that rely on a cross-sectional approach must make the assumption that no infant mortality bias exists. Previous investigations of infant weaning patterns at the Dakhleh Oasis, Egypt, relied on cross-sectional isotope data. In this study, we re-examine this weaning pattern, using a simulated longitudinal approach, which does not require any assumptions regarding potential infant mortality biases. This involves examining the dental isotopic signatures of individuals who survived the weaning process. Stable isotope signatures from juveniles and adults (102 individuals, 297 teeth) were examined to reconstruct the weaning history of those that survived the weaning process. Both deciduous and permanent teeth were sampled. Homogenized enamel and dentin samples were isolated from each tooth and analyzed for delta(13)C(ap) and delta(18)O(ap) from the enamel and delta(15)N(coll) and delta(13)C(coll) from dentin collagen. We investigate differences between in utero versus postbirth, preweaning versus postweaning, and juvenile versus adult stable isotope values as reflected in the dentition. A random permutation procedure was used to test for statistically significant differences in stable isotope values between tooth types. Statistically significant differences were observed in all stable isotopes between permanent and deciduous teeth, and between early and later forming permanent teeth in delta(13)C(ap) and delta(15)N(coll) isotopes. These results indicate dietary change between in utero and postbirth, and changes occurring during the weaning period. These results provide a more comprehensive picture of infant weaning practices at Kellis and provide further support that complete weaning occurred by 3 years of age.     

<Emphasis Type="Italic">In vivo</Emphasis> assessment of the impedance ratio method used in electronic foramen locators

Background  

The results of an in vivo study on the "ratio method" used in electronic foramen locators (EFL) are presented. EFLs are becoming widely used in the determination of the working length (WL) during the root canal treatment. The WL is the distance from a coronal reference point to the point at which canal preparation and filling should terminate. The "ratio method" was assessed by many clinicians with the aim of determining its ability to locate the apical foramen (AF). Nevertheless, in vivo studies to assess the method itself and to explain why the "ratio method" is able to locate the apical foramen and is unable to determine intermediate distances were not published so far.