Clastogenic activity of seven endodontic medications used in dental practice in human dental pulp cells

Numerous and varied chemical agents are used for endodontic treatments in dental practice. Endodontic medications are administered directly to the teeth in relatively high concentrations and chemical agents applied to enamel or dentin can penetrate the dental pulp tissue and circulate through the body in the bloodstream. In the present study, to assess safety regarding mutagenicity, we investigated the ability of seven endodontic medications to induce chromosome aberrations in human dental pulp cells. Chromosome aberrations were induced in cells treated with each of six endodontic medications, eugenol, guaiacol, modified phenol, phenol, thymol, and zinc oxide. The other endodontic medication, zinc chloride, failed to induce chromosome aberrations in the presence or absence of exogenous metabolic activation. The percentages of cells with polyploid or endoreduplication were not enhanced by any of the endodontic medications tested. Our results indicate that the endodontic medications that exhibited a positive response are potentially mutagenic to human cells.     

慢性根尖周炎应用氢氧化钙根管内封药的临床疗效观察

目的:观察慢性根尖周炎患牙用氢氧化钙根管内封药的临床疗效。方法:选择100例慢性根尖周病变患者随机分为实验组和对照组各50例;观察组用氢氧化钙做根管内封药;对照组用甲醛甲酚做根管内封药,观察术后1周的临床及X线片表现,并分析评定临床疗效。结果:术后1周有效率比较,观察组为96%,对照组为86%;两组间疗效差异具有统计学意义。结论:氢氧化钙是较理想的根管内消毒剂。     

Assessment of genotoxicity of 14 chemical agents used in dental practice: ability to induce chromosome aberrations in Syrian hamster embryo cells

To assess the genotoxicity of 14 chemical agents used as locally applied agents in dental practice, the ability of these agents to elicit chromosome aberrations was examined using Syrian hamster embryo (SHE) cells. Chromosome aberrations in SHE cells were induced by treatment with three of eight chemical agents used as endodontic medicaments, i.e. ethylenediaminetetraacetic acid (EDTA), formocresol (a mixture of formalin and tricresol), and sodium arsenite. The other five chemical agents, i.e. chloramphenicol, p-chlorophenol, p-phenolsulfonic acid, sodium hypochlorite, and tetracycline hydrochloride exhibited a negative response for chromosome aberrations. Assessment of three dyes used for disclosing dental plaque showed chromosome aberrations induced by basic fuchsin but not by acid fuchsin and erythrosine B. Three local anesthetics, lidocaine hydrochloride, prilocaine hydrochloride, and procaine hydrochloride, were negative for chromosome aberrations. Among the ten chemical agents that exhibited a negative response in the assay, p-chlorophenol, sodium hypochlorite, and erythrosine B induced chromosome aberrations in SHE cells when treated in the presence of exogenous metabolic activation. The percentages of cells with polyploidy or endoreduplication were enhanced by formocresol, sodium arsenite, p-chlorophenol, p-phenolsulfonic acid, sodium hypochlorite, erythrosine B, prilocaine hydrochloride, and procaine hydrochloride in the absence or presence of exogenous metabolic activation. Our results indicate that the chemical agents that had a positive response in the present study are potentially genotoxic to mammalian cells.     

奥硝唑用于感染根管消毒的细菌学研究

目的　观察和探讨新型抗厌氧菌药物奥硝唑消毒感染根管的抗菌效果。方法　选择感染根管患牙98颗,常规根管预备后,随机分为试验组(奥硝唑组)和对照组(甲醛甲酚组)各4 9颗。分别在根管预备前、预备后及封药后进行根管内细菌标本采样、培养、分离与鉴定,测定根管内细菌变化及检出情况,并观察封药后临床症状和体征的变化。结果　2组封药后,根管内细菌数量及检出率均较封药前明显降低( P<0 .0 5 ) ,根管内细菌数量及检出率比较,差异无显著性( P>0 .0 5 ) ,奥硝唑的近期临床疗效优于甲醛甲酚。结论　奥硝唑是一种较安全、有效的根管消毒药物     

高频电对感染根管消毒作用的初步实验研究

目的:初步验证高频电对感染根管是否具有较理想的消毒作用,并且与氢氧化钙药尖的消毒作用进行初步比较分析。方法:本实验制作10只家兔40颗门齿的感染根管动物模型,其中20颗用高频电消毒为实验组。20颗用氢氧化钙药尖消毒为对照组,消毒前后分别作需氧菌和厌氧菌培养并比较其消毒效果。结果:消毒前实验组和对照组各20个根管的需氧及厌氧菌培养全部阳性。实验组消毒后需氧菌3个阳性根管、厌氧菌2个阳性根管,消毒前后对需氧和厌氧菌杀灭作用的差异均具有极显著性(P<0.005)。对照组消毒后需氧菌13个阳性根管消毒作用的差异有显著性(P<0.05)。对照组消毒后厌氧菌11个阳性根管消毒作用的差异有极显著性(P<0.005)。实验组和对照组分别对需氧和厌氧2个菌种之间消毒作用的差异均无显著性(P>0.05)。实验组和对照组对需氧菌的消毒作用和对厌氧菌的消毒作用的组间差异均具有极显著性(P<0.005)。结论:高频电对感染根管内容物的消毒作用优于氢氧化钙药尖,具有临床应用的可行性。值得进一步研究。     

The role of preameloblast-conditioned medium in dental pulp regeneration

Pulp regeneration using human dental pulp stem cells (hDPSCs) maintains tooth vitality compared with conventional root canal therapy. Our previous study demonstrated that preameloblast-conditioned medium (PA-CM) from murine apical bud cells induces the odontogenic differentiation of hDPSCs and promoted dentin formation in mouse subcutaneous tissue. The purpose of the present study is to evaluate the effects of PA-CM with human whole pulp cells on pulp regeneration in an empty root canal space. Human pulp cells were seeded in the pulp cavities of 5 mm-thick human tooth segments with or without PA-CM treatment, and then transplanted subcutaneously into immunocompromised mice. In the pulp cell-only group, skeletal muscle with pulp-like tissue was generated in the pulp cavity. A reparative dentin-like structure with entrapped cells lined the existing dentin wall. However, in the PA-CM-treated group, only pulp-like tissue was regenerated without muscle or a reparative dentin-like structure. Moreover, human odontoblast-like cells exhibited palisade arrangement around the pulp, and typical odontoblast processes elongated into dentinal tubules. The results suggest that PA-CM can induce pulp regeneration of human pulp cells with physiological structures in an empty root canal space.     

Antibiotic resistance genes in anaerobic bacteria isolated from primary dental root canal infections

Fourty-one bacterial strains isolated from infected dental root canals and identified by 16S rRNA gene sequence were screened for the presence of 14 genes encoding resistance to beta-lactams, tetracycline and macrolides. Thirteen isolates (32%) were positive for at least one of the target antibiotic resistance genes. These strains carrying at least one antibiotic resistance gene belonged to 11 of the 26 (42%) infected root canals sampled. Two of these positive cases had two strains carrying resistance genes. Six out of 7 Fusobacterium strains harbored at least one of the target resistance genes. One Dialister invisus strain was positive for 3 resistance genes, and 4 other strains carried two of the target genes. Of the 6 antibiotic resistance genes detected in root canal strains, the most prevalent were blaTEM (17% of the strains), tetW (10%), and ermC (10%). Some as-yet-uncharacterized Fusobacterium and Prevotella isolates were positive for blaTEM, cfxA and tetM. Findings demonstrated that an unexpectedly large proportion of dental root canal isolates, including as-yet-uncharacterized strains previously regarded as uncultivated phylotypes, can carry antibiotic resistance genes.     

超声波对感染根管消毒作用的实验研究

目的:通过与氢氧化钙药尖消毒作用的比较,验证超声波对感染根管的消毒作用并判断其消毒作用的临床应用价值。方法:10只3月龄的小型健康实验家兔随机分成二组后,制备成感染根管动物模型。对模型进行术前细菌培养后,分别做超声根管内消毒和氢氧化钙药尖消毒,术后细菌培养。结果:超声波和氢氧化钙对需氧菌和厌氧菌的杀灭作用无菌种之间的差别;但杀菌效果存在显著差异。实验发现超声波消毒的特点是:第一,无抗菌谱的差异。第二,无热效应,根管壁表面升温不明显。第三,作用无方向性,对任何角度方向上的有机物均能使其失活。第四,越是细小根管作用越强。这些正是根管消毒所要求的特殊条件。结论:1)超声波对感染根管的消毒作用明显优于氢氧化钙药尖。2)超声波对感染根管的消毒作用无抗菌谱的差异。3)超声波对感染根管具有较可靠的消毒作用,作为一种根管消毒手段值得进一步研究。     

不同赋形剂调制氢氧化钙对粪肠球菌消毒效果影响的体外评价

目的通过应用离体牙根管模型进行根管消毒模拟试验,就应用不同赋形剂调制的氢氧化钙糊剂对根管的消毒作用进行评价。方法选取因正畸拔除的单根管下颌第一前磨牙并进行根管预备,自釉牙骨质界处将离体牙截去牙冠,在距截冠处5 mm去除根尖,仅留5 mm长牙根,筛选获得经制备的模拟根管120个,随机分为4个试验组和2个对照组(空白对照组和阳性对照组),每组各20颗牙齿。将4个试验组及阳性对照组共100个根管建立粪肠球菌根管感染模型,4个试验组根管内分别放置使用生理盐水、甘油、葡萄糖酸氯己定、樟脑苯酚等4种赋形剂调制的氢氧化钙糊剂,阳性对照组20个感染根管中仅放置生理盐水,而空白对照组20个根管不接种细菌,仅置入无菌生理盐水。所有标本牙置5%CO2,95%N2,37℃环境下培养,每组分别于第3、7天取10个根管使用G钻均匀磨取根管内层牙本质粉末,置BHI液体培养基中培养72 h后,测定并分析各根管中残留细菌量。结果使用氢氧化钙糊剂消毒3 d时,4个试验组根管中残留细菌量均较阳性对照组有明显减少(P<0.01),葡萄糖酸氯己定组、甘油组和樟脑苯酚组的消毒效果好于生理盐水组;使用氢氧化钙糊剂7 d时,试验各组均有消毒效果,但生理盐水-氢氧化钙组牙本质小管中有少量均残留细菌,葡萄糖酸氯己定组、樟脑苯酚组的消毒效果差异无统计学意义。结论在离体牙根管消毒实验中,使用4种赋形剂调制的氢氧化钙糊剂均能有效抑制粪肠球菌生长,葡萄糖酸氯己定组、甘油组和樟脑苯酚组的消毒效果好于生理盐水组。     

Three-dimensional observations of accessory canals in mature and developing rat molar teeth.

The structure, distribution and formation of accessory canals in the developing and mature molar teeth of rat mandibular jaws were investigated with scanning electron microscopy and with three-dimensional image analysis using serial light-microscopic sections. In the initial stage of the accessory canal formation, most of the canals appeared in the gaps of the epithelial root sheaths formed by their approaching each other in the initial stage of the root formation. However, some of the canals appeared in the slits which may be formed by the destruction of the epithelial root sheath in the root apex regions. When the gaps and slits were invaded by blood vessels, the regions surrounding the vessels did not mineralize but became accessory canals. Usually, an accessory canal with one blood vessel connected the periodontal ligament to the dental pulp; however, in some cases, the canals were broken off midway following the destruction of the vessels.     

Bactericidal action of carbon dioxide laser radiation in experimental dental root canals

The ability of a carbon dioxide laser to sterilize the root canal of human teeth has been investigated. Three oral bacteria, Streptococcus sanguis, Streptococcus mutans, and Actinomyces viscosus, and three other bacteria, Bacillus cereus, Staphylococcus aureus, and Pseudomonas aeruginosa were used as experimental organisms. Exposure of cells on glass slides to laser radiation showed there was little difference in the exposure required to kill these six organisms. Complete recovery of bacteria from the root canal was initially a problem and was only achieved when bacterial manipulations and removal were carried out in rapid succession, within 5 min of inoculation. However, the geometry of the instrumented canal and the laser alignment were major factors in achieving consistent cell death of oral bacteria in the root canals. Using sets of 10 teeth, four repeated exposures of 10 W for 1 s was found to sterilize 4 or more of the teeth.     

Lethal photosensitisation of oral bacteria and its potential application in the photodynamic therapy of oral infections.

Chemical antibacterial agents are increasingly being used in prophylactic and therapeutic regimes for dental plaque-related diseases, which are among the most common human infections. As these agents are difficult to maintain at a therapeutic concentration in the oral cavity and can be rendered ineffective by resistance development in the target organisms, there is a need to develop alternative antimicrobial approaches. Bacteria and other microbes can be sensitised to light through prior treatment with a chemical photosensitising agent. Lethal photosensitisation of a wide range of bacteria responsible for caries, periodontal diseases and root canal infections has been demonstrated using red light in conjunction with a number of photosensitisers, including Toluidine Blue, phthalocyanines and chlorins. The advantages of this approach are that bacteria can be eradicated in very short periods of time (seconds or minutes), resistance development in the target bacteria is unlikely and damage to adjacent host tissues and disruption of the normal microflora can be avoided. This approach may be a useful alternative to antibiotics and antiseptics in eliminating cariogenic and periodontopathogenic bacteria from disease lesions and for the disinfection of root canals. Not only would this be of benefit for the treatment of these diseases but, by replacing the antimicrobial agents that are currently used for such purposes, it would help to conserve our dwindling supply of antimicrobial agents that are effective in the treatment of serious systemic infections.     

The development of semicircular canals in the inner ear: role of FGFs in sensory cristae

In the vertebrate inner ear, the ability to detect angular head movements lies in the three semicircular canals and their sensory tissues, the cristae. The molecular mechanisms underlying the formation of the three canals are largely unknown. Malformations of this vestibular apparatus found in zebrafish and mice usually involve both canals and cristae. Although there are examples of mutants with only defective canals, few mutants have normal canals without some prior sensory tissue specification, suggesting that the sensory tissues, cristae, might induce the formation of their non-sensory components, the semicircular canals. We fate-mapped the vertical canal pouch in chicken that gives rise to the anterior and posterior canals, using a fluorescent, lipophilic dye (DiI), and identified a canal genesis zone adjacent to each prospective crista that corresponds to the Bone morphogenetic protein 2 (Bmp2)-positive domain in the canal pouch. Using retroviruses or beads to increase Fibroblast Growth Factors (FGFs) for gain-of-function and beads soaked with the FGF inhibitor SU5402 for loss-of-function experiments, we show that FGFs in the crista promote canal development by upregulating Bmp2. We postulate that FGFs in the cristae induce a canal genesis zone by inducing/upregulating Bmp2 expression. Ectopic FGF treatments convert some of the cells in the canal pouch from the prospective common crus to a canal-like fate. Thus, we provide the first molecular evidence whereby sensory organs direct the development of the associated non-sensory components, the semicircular canals, in vertebrate inner ears.     

UV-induced chromatid aberrations in cultured Chinese hamster cells after one, two, or three rounds of DNA replication

Synchronized G₁ or G₂ Chinese hamster cells were irradiated with UV light or X-rays and analyzed for chromosomal aberrations after one, two, or three replications. The cells were treated with Colcemid to induce polyploidy so that 2N, 4N, and 8N cells were scored. UV irradiation of G₁ cells induces mainly chromatid aberrations, whereas X-rays induce chromosome aberrations. After both types of radiation chromatid aberrations appear in the polyploid cells. These results can be interpreted as indicating that UV and X-rays induce lesions at the subchromatid level that cannot be expressed until one or two replications have occurred. Since UV can induce long-lived lesions, the UV data do not allow us to choose between mononemic and polynemic models of the chromosome. X-rays, however, are ionizing radiations that might not produce long-lived lesions. The X-ray data, therefore, are more easily interpretable in terms of lesions being induced in the subunits of a polynemic chromosome.     

Ethanol and acetaldehyde potentiate the clastogenicity of ultraviolet light, methyl methanesulfonate, mitomycin C and bleomycin in Chinese hamster ovary cells

Ethanol itself did not induce any apparent chromosome aberrations in Chinese hamster ovary cells. However, posttreatment with ethanol potentiated the chromosome aberrations induced by ultraviolet light (UV), methyl methanesulfonate (MMS), mitomycin C (MMC) or bleomycin (BLM). Chromatid exchanges were predominantly increased in cultures treated with UV, MMS or MMC and then with ethanol, whereas chromosome breaks and chromatid exchange were the major types of aberrations increased in the cultures treated with BLM and ethanol. Posttreatment with acetaldehyde, the major metabolite of ethanol, also potentiated the chromosome aberrations induced by UV, MMS, MMC or BLM. The main types of aberrations potentiated by posttreatment with acetaldehyde were similar to those by posttreatment with ethanol.     

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.     

联合方法测量工作长度应用于颌骨囊肿受累牙根管治疗的研究

目的：研究颌骨囊肿受累牙根管治疗中采用联合方法测量根管工作长度的效果。方法：选取36 例颌骨囊肿受累患牙需术前 根管治疗的患者,共135 颗患牙,186 个根管,随机分为两组,实验组（93 个根管）采用电测法联合纸尖法测量根管工作长度,对照 组（93 个根管）则采用电测法联合X 线法测量根管工作长度。对比两组根管充填后的充填效果。结果：实验组的根管恰填率为 90.32%,高于对照组的79.57%（P＜0.05）。结论：采用电测法联合纸尖法测量颌骨囊肿受累牙根管工作长度,准确率高,根管充填 效果好且安全。     

The effect of fluoride on chromosome aberration and sister-chromatid exchange frequencies in cultured human lymphocytes

Sodium fluoride, at concentrations of up to 60 times the level normally used in drinking water for the prevention of dental decay, was compared with 2 other inorganic salts for its ability to induce chromosome aberrations and sister-chromatid exchanges (SCE) in cultured human lymphocytes. No significant increases in the frequencies of aberrations of SCEs were found.     

Electrochemical engineering approach to the irrigation of tooth canals under the influence of a vibrating file

Doubt exists concerning the irrigation of secondary tooth canals when the vibration of a file introduced into the main root canal is superimposed on flow-through irrigation of the main canal. Depending on the type of commercial equipment used, the vibrations of the file are sonic or ultrasonic. We use the methodology of an electrochemical engineering approach in a study of the intensity of the irrigation of the secondary canals under the influence of sonic and ultrasonic vibrations of a file located at various heights in the main canal. The tooth canals are simulated by small electrochemical cells containing electrodes located at the end of cavities simulating the secondary canals. An electrochemical method is used to measure the mass transfer coefficients at these electrodes, a classical method in electrochemical engineering laboratories. The values of the mass transfer coefficients are representative of the importance of the irrigation of the electrodes. Thus they give a quantitative idea of the vibrations on the irrigation of secondary tooth canals. The work demonstrates the usefulness of the electrochemical engineering approach in contributing to the solution of a biomedical problem.     

Deciduous dental pulp stem cells are involved in osteoclastogenesis during physiologic root resorption

Multipotent mesenchymal stem cells are derived from the dental pulps of permanent teeth and exfoliated deciduous teeth, and are known to induce bone and dentin generation. However, the role of deciduous dental pulp stem cells (DDPSCs) in physiologic root resorption remains unclear. In this study, dental pulp stem cells (DPSCs) in permanent teeth (P) were retrieved and compared to DDPSCs from deciduous incisors at different root resorption stages: stable (S), middle (M), and final (F). Decalcified teeth sections showed that osteoclasts and resorption lacunae were most prevalent in the M resorption stage. DDPSC proliferation rate was also highest in the M stage. DDPSCs in the F stage produced more calcified nodules than those in the S or M stages. Alkaline phosphatase (ALP) expression was highest in the F stage, indicating that DDPSCs promote mineralization. In addition, the ratio of receptor activator of nuclear factor kappa B ligand (RANKL) and osteoprotegerin (OPG) expression was significantly higher in the M stage, indicating that DDPSCs promote resorption. Dickkopf 1 (Dkk1) expression was remarkably higher in the F and P groups, suggesting that the Wnt pathway is inhibited during the resorption process. Interestingly, despite the fact that Wnt3a down‐regulated OPG in osteogenic induction medium and up‐regulated RANKL in medium with 1,25‐dihydroxy vitamin D3 (VD₃), the RANKL/OPG ratio was reduced only with VD₃. Collectively, our data indicate that DDPSCs influence osteoclastogenesis during the physiologic root resorption process, and that the canonical Wnt pathway can change the RANKL/OPG expression ratio in DDPSCs. J. Cell. Physiol. 228: 207–215, 2013. © 2012 Wiley Periodicals, Inc.