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A recent treatment option for non-vital immature teeth in young patients is revascularization with triple antibiotic paste (TAP). However, tooth discoloration was reported with the use of conventional minocycline-containing TAP. In this case report, amoxicillin-containing TAP was used for revascularization of non-vital immature teeth to prevent tooth discoloration. At the 1 yr follow up, the teeth were asymptomatic on clinical examination and showed slight discoloration of the crown due to mineral trioxide aggregate (MTA) filling rather than amoxicillin-containing TAP. Radiographic examination revealed complete resolution of the periapical radiolucency, and closed apex with obvious periodontal ligament space. However, the root growth was limited, and the treatment outcome was more like apexification rather than revascularization. These results may be due to unstable blood clot formation which could not resist the condensation force of MTA filling, whether or not a collagen matrix was in place. These cases showed that although revascularization was not successful, apexification could be expected, resulting in the resolution of the periapical radiolucency and the closure of the apex. Therefore, it is worthwhile attempting revascularization of non-vital immature teeth in young patients.
Amoxicillin ; Apexification* ; Collagen ; Crowns ; Follow-Up Studies ; Humans ; Periodontal Ligament ; Tooth Discoloration ; Tooth* ; Treatment Outcome ; Pemetrexed

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Management of apicomarginal defect in esthetic region associated with a tooth with anomalies.

Vinayak Venkoosa MEHARWADE ; Dipali Yogesh SHAH ; Pradyna Prabhakar MALI ; Vidya Vinayak MEHARWADE

Restorative Dentistry & Endodontics.2015;40(4):314-321. doi:10.5395/rde.2015.40.4.314

Tooth related factors such as palatoradicular groove can be one of the causes for localized periodontal destruction. Such pathological process may result in apicomarginal defect along with inflammation of pulp. This creates challenging situation which clinician must be capable of performing advanced periodontal regenerative procedures for the successful management. This case report discusses clinical management of apicomarginal defect associated with extensive periradicular destruction in a maxillary lateral incisor, along with histopathologic aspect of the lesion.
Guided Tissue Regeneration ; Incisor ; Inflammation ; Platelet-Rich Plasma ; Tooth*

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Identification of Enterococcus faecalis antigens specifically expressed in vivo.

Seok Woo LEE ; Uttom K SHET ; Sang Won PARK ; Hyun Pil LIM ; Kwi Dug YUN ; Seong Soo KANG ; Se Eun KIM

Restorative Dentistry & Endodontics.2015;40(4):306-311. doi:10.5395/rde.2015.40.4.306

OBJECTIVES: Molecular mechanism of the pathogenicity of Enterococcus faecalis (E. faecalis), a suspected endodontic pathogen, has not yet been adequately elucidated due to limited information on its virulence factors. Here we report the identification of in vivo expressed antigens of E. faecalis by using a novel immunoscreening technique called change-mediated antigen technology (CMAT) and an experimental animal model of endodontic infection. MATERIALS AND METHODS: Among 4,500 E. coli recombinant clones screened, 19 positive clones reacted reproducibly with hyperimmune sera obtained from rabbits immunized with E. faecalis cells isolated from an experimental endodontic infection. DNA sequences from 16 of these in vivo-induced (IVI) genes were determined. RESULTS: Identified protein antigens of E. faecalis included enzymes involved in housekeeping functions, copper resistance protein, putative outer membrane proteins, and proteins of unknown function. CONCLUSIONS: In vivo expressed antigens of E. faecalis could be identified by using a novel immune-screening technique CMAT and an experimental animal model of endodontic infection. Detailed analysis of these IVI genes will lead to a better understanding of the molecular mechanisms involved in the endodontic infection of E. faecalis.
Base Sequence ; Clone Cells ; Copper ; Enterococcus faecalis* ; Enterococcus* ; Housekeeping ; Membrane Proteins ; Models, Animal ; Pulpitis ; Rabbits ; Virulence ; Virulence Factors

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The effect of saliva decontamination procedures on dentin bond strength after universal adhesive curing.

Jayang KIM ; Sungok HONG ; Yoorina CHOI ; Sujung PARK

Restorative Dentistry & Endodontics.2015;40(4):299-305. doi:10.5395/rde.2015.40.4.299

OBJECTIVES: The purpose of this study was to investigate the effectiveness of multiple decontamination procedures for salivary contamination after curing of a universal adhesive on dentin bond strength according to its etch modes. MATERIALS AND METHODS: Forty-two extracted bovine incisors were trimmed by exposing the labial dentin surfaces and embedded in cylindrical molds. A universal adhesive (All-Bond Universal, Bisco) was used. The teeth were randomly divided into groups according to etch mode and decontamination procedure. The adhesive was applied according to the manufacturer's instructions for a given etch mode. With the exception of the control groups, the cured adhesive was contaminated with saliva for 20 sec. In the self-etch group, the teeth were divided into three groups: control, decontamination with rinsing and drying, and decontamination with rinsing, drying, and adhesive. In the etch-and-rinse group, the teeth were divided into four groups: control, decontamination with rinsing and drying, decontamination with rinsing, drying, and adhesive, and decontamination with rinsing, drying, re-etching, and reapplication of adhesive. A composite resin (Filtek Z350XT, 3M ESPE) was used for filling and was cured on the treated surfaces. Shear bond strength was measured, and failure modes were evaluated. The data were subjected to one-way analysis of variation and Tukey's HSD test. RESULTS: The etch-and-rinse subgroup that was decontaminated by rinse, drying, re-etching, and reapplication of adhesive showed a significantly higher bond strength. CONCLUSIONS: When salivary contamination occurs after curing of the universal adhesive, additional etching improves the bond strength to dentin.
Adhesives* ; Decontamination* ; Dentin* ; Fungi ; Incisor ; Saliva* ; Tooth

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Effect of dentin treatment on proliferation and differentiation of human dental pulp stem cells.

Minjeong PARK ; Nan Sim PANG ; Il Young JUNG

Restorative Dentistry & Endodontics.2015;40(4):290-298. doi:10.5395/rde.2015.40.4.290

OBJECTIVES: Sodium hypochlorite (NaOCl) is an excellent bactericidal agent, but it is detrimental to stem cell survival, whereas intracanal medicaments such as calcium hydroxide (Ca[OH]2) promote the survival and proliferation of stem cells. This study evaluated the effect of sequential NaOCl and Ca[OH]2 application on the attachment and differentiation of dental pulp stem cells (DPSCs). MATERIALS AND METHODS: DPSCs were obtained from human third molars. All dentin specimens were treated with 5.25% NaOCl for 30 min. DPSCs were seeded on the dentin specimens and processed with additional 1 mg/mL Ca[OH]2, 17% ethylenediaminetetraacetic acid (EDTA) treatment, file instrumentation, or a combination of these methods. After 7 day of culture, we examined DPSC morphology using scanning electron microscopy and determined the cell survival rate with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. We measured cell adhesion gene expression levels after 4 day of culture and odontogenic differentiation gene expression levels after 4 wk using quantitative real-time polymerase chain reaction. RESULTS: DPSCs did not attach to the dentin in the NaOCl-treated group. The gene expression levels of fibronectin-1 and secreted phosphoprotein-1 gene in both the Ca[OH]2- and the EDTA-treated groups were significantly higher than those in the other groups. All Ca[OH]2-treated groups showed higher expression levels of dentin matrix protein-1 than that of the control. The dentin sialophosphoprotein level was significantly higher in the groups treated with both Ca[OH]2 and EDTA. CONCLUSIONS: The application of Ca[OH]2 and additional treatment such as EDTA or instrumentation promoted the attachment and differentiation of DPSCs after NaOCl treatment.
Calcium Hydroxide ; Cell Adhesion ; Cell Differentiation ; Cell Survival ; Dental Pulp* ; Dentin* ; Edetic Acid ; Gene Expression ; Humans* ; Microscopy, Electron, Scanning ; Molar, Third ; Real-Time Polymerase Chain Reaction ; Sodium Hypochlorite ; Stem Cells*

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Influence of a glide path on the dentinal crack formation of ProTaper Next system.

Sevinc AKTEMUR TURKER ; Emel UZUNOGLU

Restorative Dentistry & Endodontics.2015;40(4):286-289. doi:10.5395/rde.2015.40.4.286

OBJECTIVES: The aim was to evaluate dentinal crack formation after root canal preparation with ProTaper Next system (PTN) with and without a glide path. MATERIALS AND METHODS: Forty-five mesial roots of mandibular first molars were selected. Fifteen teeth were left unprepared and served as controls. The experimental groups consist of mesiobuccal and mesiolingual root canals of remaining 30 teeth, which were divided into 2 groups (n = 15): Group PG/PTN, glide path was created with ProGlider (PG) and then canals were shaped with PTN system; Group PTN, glide path was not prepared and canals were shaped with PTN system only. All roots were sectioned perpendicular to the long axis at 1, 2, 3, 4, 6, and 8 mm from the apex, and the sections were observed under a stereomicroscope. The presence/absence of cracks was recorded. Data were analyzed with chi-square tests with Yates correction. RESULTS: There were no significant differences in crack formation between the PTN with and without glide path preparation. The incidence of cracks observed in PG/PTN and PTN groups was 17.8% and 28.9%, respectively. CONCLUSIONS: The creation of a glide path with ProGlider before ProTaper Next rotary system did not influence dentinal crack formation in root canals.
Axis, Cervical Vertebra ; Dental Pulp Cavity ; Dentin* ; Incidence ; Molar ; Root Canal Preparation ; Tooth

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Clinical and radiographical evaluation of mineral trioxide aggregate, biodentine and propolis as pulpotomy medicaments in primary teeth.

Bharti KUSUM ; Kumar RAKESH ; Khanna RICHA

Restorative Dentistry & Endodontics.2015;40(4):276-285. doi:10.5395/rde.2015.40.4.276

OBJECTIVES: The purpose of this study was to evaluate the efficacy of mineral trioxide aggregate (MTA), Biodentine and Propolis as pulpotomy medicaments in primary dentition, both clinically and radiographically. MATERIALS AND METHODS: A total of 75 healthy 3 to 10 yr old children each having at least one carious primary molar tooth were selected. Random assignment of the pulpotomy medicaments was done as follows: Group I, MTA; Group II, Biodentine; Group III, Propolis. All the pulpotomized teeth were evaluated at 3, 6, and 9 mon clinically and radiographically, based on the scoring criteria system. RESULTS: The clinical success rates were found to be similar among the three groups at 3 and 6 mon where as a significant decrease in success rate was observed in Group III (84%) compared to both Group I (100%) and Group II (100%) at 9 mon. Radiographic success rates over a period of 9 mon in Groups I, II, and III were 92, 80, and 72%, respectively. CONCLUSIONS: Teeth treated with MTA and Biodentine showed more favorable clinical and radiographic success as compared to Propolis at 9 mon follow-up.
Child ; Follow-Up Studies ; Humans ; Molar ; Propolis* ; Pulpotomy* ; Tooth ; Tooth, Deciduous* ; Pemetrexed

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