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The dental pulp is critical for physiological vitality of the tooth, and dental pulp regeneration has great potential for rebuilding live pulp tissue after pulp disease. Schwann cells (SCs) play a critical role in the support, maintenance, and regeneration of nerve fibers in dental pulp. Extracellular vesicles (EVs), which possess cell homing and tissue repair potential, derived from SCs (SC-EVs), can regulate dental mesenchymal stem cell (MSC) proliferation, multipotency, and self-renewal. However, the role of SC-EVs in dental pulp tissue regeneration remains unclear. To address this question, we treated dental pulp stem cells (DPSCs) and bone marrow stem cells (BMSC) with SC-EVs, and the results showed an obvious increase in the proliferation, migration, and osteogenic differentiation of both cell types. SC-EVs also promoted neurite outgrowth and neuron migration of rat dorsal root ganglia, as well as vessel formation in vitro. In an in vivo model of subcutaneous, SC-EVs enhanced the recruitment of endogenous vascular endothelioid-like cells and MSCs, and promoted the formation of a pulpo-dentinal complex-like structure. Finally, mass spectrometry analyses and western blot revealed that stromal cell-derived factor 1 (SDF-1, also known as CXCL12) plays a dominant role in SC-EVs. Together, these data suggest that SC-EVs successfully recruit endogenous stem cells to promote dental pulp regeneration. Our results provide a cell-free strategy for pulp regeneration that avoids the risks associated with stem cell transplantation. Statement of Significance : Dental pulp is vulnerable to infections resulting from dental care, trauma, and multiple restorations, with such infections resulting in pulpitis and pulp necrosis. The current endodontic treatment of irreversible pulp disease cannot restore the function of dental pulp and tissue engineering strategies using cell-based approaches are limited by several disadvantages, including immune rejection and limited cell sources. In this study, we found that schwann cells-derived EVs facilitated dental pulp regeneration through endogenous stem cells recruitment via SDF-1/CXCR4 axis without exogenous cell transplantation. We believe that our study makes a significant contribution to describe a cell-free strategy to promote dental pulp regeneration.

Emerging clinical evidences highlight the association of Interleukin-8 (IL8) with endodontic pulpitis. Relatively higher expression of IL8 has been found in the pulp samples of pulpitis patients with moderate/severe pain. It is speculated that IL8 can be considered as a potential target for therapeutics of endodontic pulpitis. A library consisting of 3072 small molecules from the ZINC database was used to identify potential lead molecules with drug-like properties against the IL8. Based on the in-silico structure-assisted drug designing involving molecular docking, MD simulations, and MMPBSA analyses, we found a small molecule ZINC14613097 inhibits IL8. This study provides a new lead molecule than can be further validated in in-vitro, in-vivo, and ongoing clinical studies for the therapeutic management of endodontic pulpitis.

This study aimed to evaluate the pulpal responses of monkey's pulp after direct pulp capping (DPC) with the novel mineral trioxide aggregate containing phosphorylated pullulan-based material (MTAPPL). Seventy-two teeth were randomly divided into four groups: MTAPPL; Nex-Cem MTA (NX); TheraCal LC (TH); and Dycal (DY). Histopathological changes in the pulps were observed at days 3, 7 and 70. On day 3, mild inflammatory responses were observed in the MTAPPL, no to moderate inflammatory responses in the TH, whereas moderate inflammatory responses in the NX and DY. No mineralized tissue formation (MTF) was observed in all groups. On day 7, no or mild inflammatory responses were observed in all groups. Initial MTF was observed except for DY. No inflammation with complete MTF including presence of odontoblast-like cells was observed in the MTAPPL, NX and TH groups at day 70. These findings indicate that MTAPPL could be an efficient DPC material.

Introduction. Thumb fingertip injuries, often combined with phalanx fracture or torn ligament, are very common. The focus of treatment is on how to rebuild the function and shape of the thumb. Single thumb fingertip pulp injury is more common. However, due to the diverse type of injury, no uniform treatment guideline is described in the literature. Case report. A patient with extensive thumb fingertip pulp incisions, which looked like multiple parallel wounds, was admitted to our Emergency Department. We used the method of bundling to maintain the shape of the fingertip. A single suture to pass through all the incisions was performed and then the suture was tied outside the skin. After that, we bandaged them with sterile bandages. Finally, good contour and fingertip function were restored. Conclusion. We successfully used the bundling method to treat patient with extensive thumb fingertip pulp incisions.

The prognosis of traumatized teeth depends largely on the fate of the pulp and its treatment. This review aims to update the present status on the endodontic management of traumatic injuries to permanent teeth and to identify relevant research areas that could contribute to an improvement in diagnosis and treatment of traumatized permanent teeth. Future research should pay greater attention to (1) diagnostic methods to assess the perfusion of the pulp and enhance detection of tooth cracks and initial signs of root resorption; (2) improved materials for vital pulp treatment; (3) studies focusing on type and duration of splinting after root fractures; (4) antiresorptive intracanal medication in case of post-traumatic pulp necrosis and infection-related resorption and (5) long-term data on the apical barrier technique compared to revitalization.

Objective The concept of minimally invasive endodontics recommends less-invasive vital pulp therapy (VPT) modalities over more aggressive traditional endodontic approaches in mature permanent teeth with carious pulp exposure, including irreversible pulpitis (IP) cases. Consequently, VPT needs to be compared with root canal therapy (RCT) in terms of treatment outcomes. This randomized clinical trial compares the results of full pulpotomy using two calcium-silicate cements, i.e., mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement, with RCT in mature permanent teeth. Materials and methods A total of 157 carious pulp exposure cases in two academic centers with/without established IP were selected/included/randomly appointed to three study arms; (i) RCT (n = 51) as the reference treatment, (ii) pulpotomy with ProRoot MTA (PMTA; n = 55), and (iii) pulpotomy with CEM cement (PCEM; n = 51) as two alternative VPT treatments. Two-year clinical/radiographic results were the outcomes of interest. Data were statistically analyzed through the analysis of variance, chi-square, Fisher exact test, and Kruskal–Wallis. Results At 2-year recall, 147 teeth were examined (6.4% dropout). All molars, except for one, were clinically functional/symptom-free, and there was no statistical difference between the three study arms (p = 0.653). The radiographic success rates in RCT, PMTA, and PCEM arms were 98%, 100%, and 97.9%, respectively, without statistically significant differences (p = 0.544). Conclusion In the management of mature permanent teeth with/without established IP, all experimental groups exhibited equivalent/comparable results. Clinical relevance Simple VPT using MTA/CEM can be suggested/recommended as a viable advantageous alternative to RCT for the management of carious pulp exposures with/without sign/symptoms of IP.

AIM This prospective in vivo study aimed to optimize the assessment of pulpal contrast-enhancement (PCE) on dental magnetic resonance imaging (dMRI) and investigate physiological PCE patterns. METHODOLOGY In 70 study participants, 1585 healthy teeth were examined using 3-Tesla dMRI before and after contrast agent administration. For all teeth, the quotient of post- and pre-contrast pulp signal intensity (Q-PSI) was calculated to quantify PCE. First, pulp chambers were analysed in 10 participants to compare the coefficient of variation of mean versus maximum Q-PSI values (Q-PSImean versus Q-PSImax ). Second, dynamic PCE was evaluated in 10 subjects to optimize the time interval between contrast agent application and image acquisition. Finally, 50 participants (age groups: 20-29, 30-39, 40-49, 50-59 and 60-69 years) were examined to analyse age, gender, tooth types and maxilla versus mandible as independent factors of PCE. Statistical analysis was performed using Wilcoxon signed rank test and linear mixed models. RESULTS PCE assessment based on Q-PSImax was associated with a significantly smaller coefficient of variation compared with Q-PSImean , with median values of 0.17 versus 0.21 (p = .002). Analysis of dynamic PCE revealed an optimal timing interval for image acquisition 4 min after contrast media application. No significant differences in PCE were observed by comparing age groups, female versus male participants and maxillary versus mandibular teeth (p > .05). Differences between tooth types were small (median Q-PSImax values of 2.52/2.32/2.30/2.20 for molars/premolars/canines/incisors) but significant (p

Fixed partial dentures (FPDs) made of metal ceramic are a popular treatment option for missing teeth. Studies have shown that posterior abutments of FPDs had a higher pulp survival rate than anterior abutments. Postoperative sensitivity following the cementation of a fixed prosthesis is a frequent symptom, especially when the abutments include important pulp. Dentinal hypersensitivity affects between 4 and 74 percent of people. Females are found to have a somewhat greater DH incidence than males. While DH can affect individuals of any age, there have been several theories on what causes abutment sensitivity after tooth preparation and cementation. In this review we included some of it. Also, we discussed methods of management of postoperative sensitivity and Management of fractured abutment screw.

This study aimed to clarify the effect of mineral trioxide aggregate (MTA) on pulp healing in the infected pulp by direct pulp capping (DPC). Thirty-six male ICR mice were divided into infected and uninfected groups. The pulp tissue was exposed to the oral flora for 24 h after pulp exposure in the infected group, or not exposed in the uninfected group, followed by sealing with MTA, calcium hydroxide cement (CH), or no DPC. Pulpal healing process was analyzed by hematoxylin-eosin staining and immunohistochemistry for nestin and Ki67. The active cell proliferation occurred on 1 week in the both MTA and CH groups, followed by the differentiation of odontoblast-like cells on 2 weeks in the MTA group, whereas their differentiation were not facilitated in the CH group. MTA is suggested to be a useful material for DPC with the infected and uninfected pulp tissue.

Objective The aim of this study was to investigate the effect of immediate dentin sealing (IDS) technique using universal adhesive under simulated pulp pressure on microtensile bond strength (μTBS) of indirect resin composite restorations and dentin permeability. Materials and Methods Fifty extracted caries-free human third molars were used for specimens' preparation. Each molar's occlusal table was abraded flat and their roots were separated under continuous water cooling. Forty specimens were used for microtensile bond strength test (μTBST) evaluation. The μTBST specimens were randomly assigned to two groups according to the dentin sealing time; Immediate dentin sealing (IDS) and delayed dentin sealing (DDS). Each group was further subdivided into two subgroups according to the adhesive system used for dentin sealing: iBOND self-etch adhesive and GLUMA Bond Universal. All specimens were exposed to simulated pulp pressure for 1 week then restored using computer-aided design/computer-aided manufacturing (CAD/CAM) resin composite blocks. The μTBS was evaluated for all tested subgroups after 24 hours and 6 months of water storage. The remaining 10 teeth were used for the preparation of dentin discs for dentin permeability evaluation. They were divided into two groups according to type of self-etch adhesive used. Fluid filtration rate was evaluated after etching, with smear layer and after adhesive application. Results obtained were statistically analyzed using Shapiro–Wilk test and Weibull analysis. Results Statistically significant difference was recorded between µTBS mean values of both IDS and DDS techniques at 24 hours and after 6 months of water storage. GLUMA Bond Universal adhesive had significantly higher bond strength compared with iBond at both IDS and DDS techniques, but both adhesives showed a significant reduction in the Weibull characteristic strength after 6 months of water storage. Significant reduction in dentin permeability was recorded by both adhesives without any significant difference between them. Conclusions The IDS technique using universal adhesive in self-etch mode is an effective strategy for improving the final bond strength of CAD/CAM resin composite restorations and reducing dentin permeability.

Background: the main idea behind the pulpotomy of a primary tooth is to remove the infected or inflamed coronal pulp tissues and cover the pulp with a suitable medicament or dressing which promotes healing and preserve the vitality of the teeth especially in young permanent teeth. A medicament should be biologically compatible, have healing capabilities, should be non cytotoxic, or mutagenic and with no carcinogenic potential. Aim: the main aim of the study was to compare and evaluate the efficacy of commonly used two medicaments i.e. formocresol and sodium hypochlorite in pulpotomy of mandibular primary teeth. Material and methodology: a randomized controlled single blinded clinical trial was done on 50 subjects of age ranging from 3 to 6 years with bilateral mandibular first or second molar requiring pulpotomy. The subjects were randomly divided into two groups with 25 subjects in each. Group I, consisted of subjects on which formocresol medicament was used after extirpation of coronal pulp while in Group II, 3% sodium hypochlorite was used. Clinical along with the radiographic signs and symptoms were blindly recorded at an interval of 1, 3, 6 and 12 months respectively. Results: Statistically significant results were obtained in group II, when patients treated with 3% sodium hypochlorite. There was no major difference between the two medicaments used, but to the various adverse effects of formocresol, its usage has been limited. Conclusion: within the limitation of the study, it was concluded that sodium hypochlorite medicament proved to have better prognosis and can be suggested as a pulpotomy agent for primary teeth. Although formocresol was found to have similar significant results can also be used as a medicament. Keywords: Formocresol, Pulpotomy, Primary Teeth, Sodium Hypochlorite

Background: Radiographic visibility of the root pulp in lower third molars is one of the reliable methodologies for chronological age estimation. Objective: To evaluate the radiographic visibility of the lower third molar root pulp using digital panoramic radiographs of the Thai population, and determine the appropriation of this technique in age assessment, especially at the age of 18 years. Methods: A total of 746 digital panoramic radiographs of the Thai population aged from 16 to 26 years were recruited for the present study. The visibility of root pulp of lower third molars with completed root formation was recorded in the four stages. Descriptive statistics were performed for each stage in both males and females. Results: The first appearance of stage 0 is 16.71 years in males and 17.00 years in females. The minimum age of stage 1 was found at 17.08 years in males and 17.18 years in females. The beginning of stage 2 was 18.33 years in males and 18.17 years in females. For stage 3, the earliest presence was started at 18.58 years in males and 18.83 years in females. Conclusion: The occurrence of stages 2 or 3 in both males and females indicated that the subject is over 18 years of age. Further study on the Thai population should be conducted to confirm the results of the present study.

The volumetric change that occurs in the pulp space over time represents a critical measure when it comes to determining the secondary outcomes of regenerative endodontic procedures (REPs). However, to date, only a few studies have investigated the accuracy of the available domain-specialized medical imaging tools with regard to three-dimensional (3D) volumetric assessment. This study sought to compare the accuracy of two different artificial intelligence-based medical imaging programs namely OsiriX MD (v 9.0, Pixmeo SARL, Bernex Switzerland, https://www.osirix-viewer.com) and 3D Slicer (http://www.slicer.org), in terms of estimating the volume of the pulp space following a REP. An Invitro assessment was performed to check the reliability and sensitivity of the two medical imaging programs in use. For the subsequent clinical application, pre- and post-procedure cone beam computed tomography scans of 35 immature permanent teeth with necrotic pulp and periradicular pathosis that had been treated with a cell-homing concept-based REP were processed using the two biomedical DICOM software programs (OsiriX MD and 3D Slicer). The volumetric changes in the teeth’s pulp spaces were assessed using semi-automated techniques in both programs. The data were statistically analyzed using t-tests and paired t-tests (P = 0.05). The pulp space volumes measured using both programs revealed a statistically significant decrease in the pulp space volume following the REP (P 0.05). The mean decreases in the pulp space volumes measured using OsiriX MD and 3D Slicer were 25.06% ± 19.45% and 26.10% ± 18.90%, respectively. The open-source software (3D Slicer) was found to be as accurate as the commercially available software with regard to the volumetric assessment of the post-REP pulp space. This study was the first to demonstrate the step-by-step application of 3D Slicer, a user-friendly and easily accessible open-source multiplatform software program for the segmentation and volume estimation of the pulp spaces of teeth treated with REPs.

Introduction Age-at-death estimation is an essential part of the identification process of individuals in many forensic dentistry cases where identity of the individual cannot be resolved by visual recognition or other means. Dental age estimation in adults is more of a challenge as most teeth complete their development by the age of 18 years. Aim This study aims at using the mesio-distal (MD) pulp-to-tooth ratio taken at the cervix of upper third molars (UM3) to estimate age at the time of radiographic imaging. Materials and Methods A set of 135 Cone-beam computed tomography (CBCT) radiographs of UM3s for a random sample of 135 Jordanian adults (65 females, 70 males; age range = 18–63 years, mean age = 34.4 years, SD = 11.2 years) were used. Both pulp and tooth MD diameters were measured at the cervix. MD pulp-to-tooth ratios for UM3s were correlated with age. Results Statistically significant negative moderate correlation was found between the age of the individual and the cervix MD pulp/tooth ratio (r = −0.516). This indicates that only 26.6% of the variation in age can be explained by the cervix MD pulp-to-tooth ratio. Conclusions This study concludes that cervix MD pulp-to-tooth ratio of UM3s, although apparently stronger than that of lower M3s (r = −0.361), is not a sufficiently reliable estimator of age in adults, and this is perhaps attributed to the greater variability in the time line of third molars development.

Background and aims Teeth extracted are usually disposed as bio-waste whereas they could serve as an autologous tissue for culturing multipotent dental pulp cells which have application potential in regenerative medicine. This study aimed to examine the feasibility of cryopreserving dental pulp tissue at teeth extraction for later culturing of cells. Methods The pulp tissue from each of a total of 10 teeth was cut into small fragments which were then divided into two portions. One portion was directly used for culturing pulp cells using the explant method. The other portion was cryopreserved with 10% DMSO in liquid nitrogen for at least one month and then thawed for culturing pulp cells. Results Vital cells were obtained from all the 10 pulp fragment suspensions which went through cryopreservation. The cell outgrowth from the explants of cryopreserved pulp fragments was two days later than that of corresponding fresh pulp tissue. Otherwise, no difference was observed in proliferation, expression of stem cell markers and differentiation into adipose cells and osteoblasts between the two groups of cells cultured from the fresh or the cryopreserved pulp fragments. Conclusions Cryopreserving fragmented dental pulp tissue provides a feasible option for saving pulp tissues as autologous cell sources for possible later application.

As one of the natural resin materials produced by bees, propolis has been used as a traditional medicine for various diseases because of its biological and pharmacological activities. The purpose of this study was to analyze the potential of propolis as a healing agent for pulp injuries. A total of 35 journals from PubMed, Ebsco, ResearchGate, Wiley Online Library, and other international journal databases were analyzed. Propolis is very rich in active components such as flavonoids that have biological functions such as anti-inflammatory, antibacterial, antifungal and antioxidant which can act as a potential healing agent

Pedicle coverage during free flap reconstruction of the digit commonly presents complicated issues. As the finger is a cylindrical unit with small volume, it is difficult to secure ample soft tissue for relaxed coverage of the pedicle. We have applied full-thickness skin grafts (FTSGs) to loosely cover the pedicle of the free flap of the fingertip and report preliminary results. Seven patients who received free toe pulp flap and FTSG for soft tissue coverage of the pedicle were analyzed. Intraoperative parameters collected were defect, flap and graft area size and donor site. Patients were observed postoperatively for up to 2 months for graft take, necrosis, digit contour, and donor site complications. The average area of the free flap was 2.39±1.03 cm2 and the average graft area was 1.37±1.06 cm2. The FTSG survived without sloughing or necrosis in six patients. Early epithelial sloughing with dermis take was noted in one patient who healed with dressings. The pedicle and graft portion showed bulging immediately after the operation but decreased to normal contour by 4 weeks. FTSG is an option that can be safely used as a method of pedicle coverage during free flap reconstruction of digits.

Apexification procedures are frequently performed on immature permanent teeth with incomplete root formation, open apices and necrotic pulp status with or without periapical lesions in order to induce a calcific barrier prior to root canal therapy. The elimination and control of infection in the root canal space is critical to the success of these procedures. A healthy 21-year old male presented with pulpal necrosis, a large periapical lesion, incomplete root formation and an open apex on a maxillary right lateral incisor. Triple antibiotic paste was used to achieve antimicrobial control after traditional calcium hydroxide paste medicament failed to resolve the symptoms. Obturation was achieved using MTA and the conventional apexification technique. Excellent healing of the large periapical lesion was achieved without surgical intervention and the 4-year follow-up CBCT demonstrated complete bone fill of the lesion. Clinicians should be aware that alternative antimicrobial medicaments, such as triple antibiotic paste, may be beneficial in situations where conventional medicaments prove unsuccessful. The use of triple antibiotic paste may result in sufficient healing of the periapical lesion to justify placement of an MTA apical barrier without the need for surgical intervention

Outcome expectations of direct pulp capping in carious teeth are obscured by a clinically unknown infiltration and breakdown of the dental pulp tissue. Histologic studies showed that this soft tissue breakdown is related to the innate immune system. We hypothesized 1) that a neutrophil biomarker could predict the outcome of direct pulp capping and 2) that using sodium hypochlorite (NaOCl) as a lavage solution to remove necrotized infected pulp tissue could improve it. In this randomized trial in mature posterior teeth causing no or mild discomfort with carious pulpal exposures, pulpal fluid was collected to assess neutrophil gelatinase (matrix metalloproteinase 9 [MMP-9]) per total protein (TP) levels as a predictive local biomarker. Subsequently, the dentin-pulp wound was randomly washed with a 2.5% NaOCl or a physiologic saline solution (1:1 allocation), capped with mineral trioxide aggregate, and the tooth was immediately restored with a resin-based composite restoration. Ninety-six patients were included, and 84 individuals could be followed up to treatment failure or clinically confirmed pulp survival after a minimum of 1 y. The entire data were fitted to a Cox proportional hazards model to assess the influence of the observational variables MMP-9/TP and discomfort with the randomized lavage treatment on pulp survival. The Kaplan-Meier pulp survival rates after 1 y were 55% for saline and 89% for NaOCl lavage. The inflammatory state of the pulp tissue as reflected by MMP-9/TP levels and NaOCl lavage had a highly significant ( P

The dental pulp is critical for the production of odontoblasts to create reparative dentin. In recent years, dental pulp has become a promising source of mesenchymal stem cells that are capable of differentiating into multiple cell types. To elucidate the transcriptional control mechanisms specifying the early phases of odontoblast differentiation, we analysed the DNA demethylation pattern associated with 5-hydroxymethylcytosine (5hmC) in the primary murine dental pulp. 5hmC plays an important role in chromatin accessibility and transcriptional control by modelling a dynamic equilibrium between DNA methylation and demethylation. Our research revealed 5hmC enrichment along genes and non-coding regulatory regions associated with specific developmental pathways in the genome of mouse incisor and molar dental pulp. Although the overall distribution of 5hmC is similar, the intensity and location of the 5hmC peaks significantly differs between the incisor and molar pulp genome, indicating cell type-specific epigenetic variations. Our study suggests that the differential DNA demethylation pattern could account for the distinct regulatory mechanisms underlying the tooth-specific ontogenetic programs.

The objective was to report the injuries on liver and kidney promoted by experimental colorectal carcinogenesis induction in rats and evaluate the effect of supplementation with Euterpe edulis M. pulp products on resolution of this injuries. Colorectal carcinogenesis with 1,2-dimethylhydrazine was induced in young male rats, allocated into: C - induced to carcinogenesis; CJ - induced to carcinogenesis and supplemented with juçara fruit pulp; and CE - induced to carcinogenesis and supplemented with juçara fruit lyophilized extract. Nine animals were a negative control. Supplementation occurred three times a week, totaling 54 days of administration with 1 mg of cyanidin-3-glycoside per kilogram live weight. The hepatic and renal histopathological injuries were assessed at 10 and 23 weeks. In liver, at 10-week biliary hyperplasia was more evident in colorectal cancer induced groups compared to N group (p = 0.0230), as well as megalocytosis (p = 0.0269), and juçara fruit-based product do not promote cytoprotection. At 23-week biliary hyperplasia continued present, and liver necrosis was evident in C group and CJ group. Hepatic degeneration was greater in C group, and megalocytosis was evident in the cancer-induced groups, without cytoprotection by juçara fruit-based product. In kidney, at 23-week, renal congestion was more evident in CJ group, and tubular degeneration in C and CE groups. Important hepatic and renal injuries were observed in rats induced to colorectal cancer and the supplementation with juçara fruit-based product, in the dose used, did not interfere in the prevention and resolution of these injuries, mainly with the chronic use.

Objetivo. El objetivo de esta revisión bibliográfica es analizar la evidencia científica existente, sobre los diferentes tratamientos regenerativos pulpares, en dientes permanentes jóvenes con necrosis pulpar, para conocer las diversas alternativas de materiales y técnicas utilizadas. Materiales y métodos Se realizó una búsqueda electrónica biomédica avanzada en base de datos PubMed, utilizando palabras clave MeSh Terms (Medical Subject Headings), para identificar la cantidad de artículos científicos disponibles, en la que se encontraron estudios sobre tratamientos de regeneración pulpar en dientes permanentes jóvenes inmaduros, con el fin de identificar los diferentes tratamientos, materiales, técnicas, y resultados obtenidos con dichas maniobras clínicas. Resultados Se encontraron 30 artículos, en los que se identificaron los diversos tratamientos en regeneración pulpar de dientes permanentes jóvenes inmaduros, investigaciones de ensayos clínicos aleatorios, utilizando 11 artículos. Conclusiones En las diversas investigaciones se encuentran diferentes tratamientos, materiales y técnicas a utilizar de para la regeneración pulpar, encontrando variaciones en soluciones irrigadoras, medicaciones intraconductos, número de citas y material de sellado coronal, sin embargo el Trióxido Mineral Agregado MTA es el utilizado con mayor frecuencia; se necesitan más investigaciones que puedan destacar un protocolo de atención.

Pulp chamber enlargement impacts endodontic treatment planning. The aim of this study was to evaluate alterations in pulp chamber size of posterior teeth in individuals born with cleft lip with or without cleft palate. Ninety individuals were treated at the Cleft Lip and Palate Service of the University Hospital Lauro Wanderley, Federal University of Paraiba, between the ages of 4 and 15 years born with cleft lip with or without cleft palate were selected. Ninety-nine patients from the archives of the residency program in Orthodontics of the Brazilian Dental Association (ABO) were paired by sex and age as a comparison group. Radiographs were evaluated by a single examiner, observing the presence/absence of an enlarged pulp chamber in the first and second permanent molars of all quadrants. Chi square or Fisher’s exact tests were used (α = 0.05) in all comparisons. Pulp enlargement was more frequently found among individuals born with cleft lip with or without cleft palate (p = 0.0005). However, pulp enlargement frequency was different among subjects born with clefts (p = 0.0006). Pulp enlargement was more common in the maxilla, in both groups. Individuals born with cleft lip with or without cleft palate more often had six or more teeth affected (p = 0.02). Furthermore, individuals with a bilateral cleft more often had six or more teeth affected in comparison to unilateral cases (p = 0.002). Pulp enlargement is a frequent finding, particularly among individuals born with cleft lip with or without cleft palate, with a higher prevalence in the maxilla.

Introduction. Maintaining good health and working capacity of the population is one of the main tasks of the healthcare system. Living under adverse climatic conditions of the North and being exposed to dangerous production factors of the pulp and paper industry, strongly represented in the Arkhangelsk Region, can significantly reduce the adaptive capacity of the body. Major role in providing an adequate response to the action of irritators and initiating the adaptation process is played by the neuroendocrine, cardiovascular, and circulatory systems, which reflect qualitative and quantitative changes in the body while being reliable markers of homeostasis. The aim was to study the adaptive potential of workers showing the level of functioning of the circulatory system and to evaluate their endocrine profile depending on the revealed functional capabilities of the body. Materials and methods. The study involved 50 men aged 22–60 years working in the production departments of Solombala Pulp and Paper Mill (Arkhangelsk) with a body mass index of 19–25 and without earlier history of endocrine pathology. Serum levels of thyroxine-binding globulin and oestradiol were determined by means of radioimmunoassay, while serum concentrations of total cortisol, thyrotropin, thyroxine, triiodothyronine, progesterone, testosterone, insulin, C-peptide, and somatotropin were determined by enzyme-linked immunosorbent assay. Results. The research demonstrated that in 2/3 of the examined employees of the pulp and paper mill the adaptation mechanisms were under strain, while the condition of two subjects corresponded to the physiological norm, which is characterized by good and satisfactory adaptation. Workers with decreased adaptive capabilities to the point of unsatisfactory adaptation showed increased levels of cortisol, thyroxine-binding globulin, oestradiol, C-peptide, and insulin against the background of a decrease in testosterone, progesterone, and the testosterone/oestradiol ratio. The authors recommend conducting periodic medical examinations of pulp and paper workers, including endocrine profile assessment, and monitoring changes that occur over time.

Context: Mandibular first molar frequently requires endodontic treatment. Understanding age-related changes in pulp-dentin complex and root canal morphologies is essential for successful endodontic and restorative treatments. Aim: This study aimed to compare pulp/tooth area ratio (PTAR) and dentin thickness (DT) in mandibular first molars in different age groups through cone-beam computed tomography (CBCT) imaging. Subjects and Methods: One hundred CBCT images of mandibular first molar were divided into five groups; age 20–29, 30–39, 40–49, 50–59, and 60 years old and older. Axial images were used to determine PTAR at Level A (furcation), Level B (between Levels A and C), and Level C (half distance between the furcation and apex of the root). The minimum DT of the distal wall of mesiobuccal (MB) and mesiolingual (MLi) canal and mesial wall of distal canal at 2 and 3 mm under the furcation was measured. Statistical Analysis Used: Analysis of variance was used to determine differences among age groups. Results: PTAR was determined to reduce as age increases, showing a significant difference among the age groups at Levels A, B, and C of both roots (P < 0.05). The minimum DT was found to increase with age, demonstrating a significant difference among the age groups of MB and MLi canal at 2 and 3 mm (P < 0.05). No statistically significant difference was observed in the mesial DT of distal canal. Conclusions: The reduction of PTAR and the increasing DT were confirmed with advanced age.

Objectives: The purpose of this study was to evaluate the pulpal response of dogs’ teeth after direct pulp capping using Biodentine (BD) and compared it with Mineral Trioxide Aggregate (MTA). Materials and Methods: Following the split-mouth design, forty intact teeth in two healthy Mongrel dogs were randomly assigned to two experimental groups; group I: BD and group II: MTA. Standardized Class V cavities were prepared on the vestibular surface of each tooth where the pulp exposure was performed with a dental explorer. The pulp-exposed teeth were immediately capped with one of the tested materials. The prepared cavities were then finally restored with glass-ionomer cement. After termination of the observation periods (one week and three months), the animals were euthanized. Then, teeth were extracted for histopathological evaluations. Data collected and statistically analyzed by using Fisher’s exact test. The significance level was set at P ≤ 0.05. Results: Histopathological analysis showed complete dentin bridge formation and an absence of inflammatory pulp response. Statistical analysis showed no significant differences between the BD and MTA experimental groups during the observation periods. However, a significantly higher thickness of the dentin bridge was found in the group of teeth treated with BD at three months. Conclusion: BD may be considered an interesting alternative to MTA. Both materials produced favorable pulpal responses that were similar in nature.

Background/purpose MTA is used to induce hard tissue regeneration in various procedures. This study evaluated the biocompatibility and mineralization potential of mineral trioxide aggregate (MTA) containing calcium fluoride (CaF2). To verify if the change of components affected physical properties, the setting time, solubility, and surface roughness were measured. Materials and methods Human dental pulp cells (HDPCs) were treated with powder and set MTA containing CaF2 (0, 1, 5, and 10 wt %). The proliferation of HDPCs was investigated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The mineralization potential of HDPCs was investigated with the relative gene expression of alkaline phosphatase (ALP), collagen type I (ColI), osteocalcin (OCN), and runt-related transcription factor 2 (Runx2) using real-time reverse transcription polymerase chain reaction (RT-PCR). For investigating the physical properties, setting time and solubility were tested. Surface profiles of material were analyzed by a non-contact surface profiler and a scanning electron microscope (SEM). Results MTA-5% CaF2 mixtures increased the proliferation and the mineralization-related gene expression of HDPCs to a greater degree than pure MTA. The addition of CaF2 to MTA delayed the setting, but the difference was only significant in the MTA-10% CaF2. Solubility and surface roughness was not altered. Conclusion The addition of more than 5% CaF2 can be considered to increase the regeneration potential of pulp cells without adverse effects on physical property.

Background The importance of evaluating the pulpal threshold to electrical stimulation, as a side effect of probable neuropathy in Multiple Sclerosis (MS) patients is a novel issue. This study aimed to investigate electrical pulp test thresholds in MS patients without a history of trigeminal neuralgia compared to healthy individuals. Methods Sixty-nine maxillary central incisors, belonging to 34 relapsing-remitting MS patients, and 35 healthy individuals were included in this survey. The MS patients matched for intended variables, were 22–50 years old, had a more than 1-year history of MS, no history of trigeminal neuralgia and/or other neuropathy. The electric pulp sensibility test was performed on all samples. Electric pulp testing (EPT) results were recorded based on the pulp tester’s grade that evoked a response. Data were analyzed with paired T-test, Mann-Whitney test, and Spearman correlation (P Results According to the results of this study, the mean values of response to EPT were 1.2 ± 0.5 and 1.8 ± 0.5 in MS patients and healthy individuals, respectively. The pulpal response to EPT between the two groups was significantly different (P Conclusions MS patients showed a significantly reduced response to the electric pulp test in their maxillary central incisors in comparison to matched healthy persons.

Aim and objective To compare the fracture resistance in teeth managed by root canal treatment after restoring with different types of onlays, inlays, and endocrowns prepared with hybrid ceramics and pulp chambers restored with fiber-reinforced composite and resin composite that were radiopaque, light-cured, and flowable. Materials and methods The present study was carried out on 252 extracted mandibular molars. All the specimens were divided into six groups randomly. Each group consisted of 42 specimens. Group 1 consisted of intact teeth without any access cavity. It was the control group. Group 2 consisted of teeth with endocrown and empty pulp chamber. Group 3 consisted of teeth with mesio-occlusal-distal (MOD) onlay prepared with hybrid ceramics and pulp chamber filled with flowable, light-cured, radiopaque resin composite. Group 4 consisted of teeth with MOD onlay and pulp chamber filled with fiber-reinforced composite. Group 5 consisted of teeth with MOD inlay and pulp chamber filled with flowable, light-cured, radiopaque resin composite. Group 6 consisted of teeth with MOD inlay and pulp chamber filled with fiber-reinforced composite. Inlay, onlay, and endocrowns were prepared with computer-aided design (CAD) and computer-aided machine (CAM) using hybrid ceramics. Universal testing machine was used for the measurement of the fracture resistance of each specimen. Inferential statistics were performed by applying Fisher's exact test and chi-square test. Results Fracture strength was found to be maximum in the intact teeth group followed by the endocrown. The fracture strength was minimum in the inlay group. The fracture strength was intermediate in the onlay groups. Conclusion Endocrown showed maximum fracture resistance as compared to the inlay and onlay restorations. Clinical significance Proper management of root canal-treated teeth is one of the greatest challenges for endodontists. It has been observed that tooth preparation design and the material used for the restoration of root canal-treated teeth play a vital role in the resistance against fracture in the teeth.

AIM To prospectively investigate the outcome of partial pulpotomy after 1 year, using a hydraulic calcium silicate cement (HCSC) on symptomatic cariously exposed pulps in adult teeth. To compare the traditional American Association of Endodontists (AAE) pulpitis classification with the recently proposed Wolters classification system in predicting the likelihood of treatment failure. METHODOLOGY Sixty-two symptomatic adult teeth with deep and extremely deep carious lesions were classified according to the Wolters (mild/moderate/severe pulpitis) and the traditional pulpitis classification (reversible/irreversible pulpitis). Eleven teeth were excluded intraoperatively as there was no pulp exposure after non-selective caries removal. The remaining 51 teeth, regardless of diagnosis, were treated by partial pulpotomy, pulpal lavage with 2.5% sodium hypochlorite solution, haemostasis and HCSC application (Biodentine™) as a pulp capping material. A permanent restoration was placed during a second appointment 1-2 weeks later. Preoperative tenderness to percussion (TTP), bleeding time and material setting time were recorded as was preoperative and postoperative tooth colour under standardized conditions. Clinical review occurred at regular intervals with clinical/radiographic analysis at 12 months. Chi-square analysis and Fisher's exact test assessed different outcomes amongst the diagnostic categories; the Kruskal-Wallis and Wilcoxon rank-sum test assessed influence of pulp bleeding time, TTP or variation in setting time (p

Although root canal therapy is the most common and widely used treatment at clinical presentation, there are still some postoperative complications. As cell biology and tissue engineering techniques advance rapidly, the use of biological therapy to regenerate dental pulp has become a new trend; Relevant literatures in recent five years were searched using key words such as “root canal therapy”, “Dental pulp stem cells”, “Dental pulp regeneration”, and “Cell homing” in PubMed, Web of Science, etc; Dental pulp stem cells (DPSCs) have multi-differentiation potential, self-renewal capability, and high proliferative ability. Stem cell-based dental pulp regeneration has emerged as a new research hot spot in clinical therapy. Recently, dental pulp-like structures have been generated by the transplantation of exogenous DPSCs or the induction of homing of endogenous DPSCs. Studies on DPSCs are important and significant for dental pulp regeneration and dental restoration; In this review, the existing clinical treatment methods, dental pulp regeneration, and DPSC research status are revealed, and their application prospects are discussed. The stem cell-based pulp regeneration exerts promising potential in clinical therapy for pulp regeneration.

Objectives: During the light-curing process of composite restoration, excessive heat can be produced, which can potentially lead to pulp necrosis (death). In this study, we aimed, based on the Finite Element Method (FEM), to assess the risk of pulp damage during the light-curing process by investigating the influence of light-curing devices, under various irradiation regimes, on the temperature increase at the pulp-dentin junction, during a one-layer or multi-layered deep composite restoration. Methods: A Three-dimensional finite element method model of typical geometry and material properties, as commonly reported in the literature, was employed in COMSOL Multiphysics simulations in order to determine the temperature increase in the pulp. Various combinations of light intensities, durations, and irradiation regimes were investigated for the two cases, of shallow and deep multi-layered composite restoration. Results: Results of light-curing composite resins within enamel; indicate that the temperature rise during the curing process was within the safety margins. Results of light-curing composite resin restorations closer to the pulp with thin remaining dentin, indicate a temperature increase that could be sufficient to cause thermal injury in the pulp. Modulating the light output marginally, reduced the temperature rise while reducing the intensity and increasing the curing duration which was consistently more effective in this respect. Conclusion: The results clearly demonstrate that with currently adopted standard procedures, there exists a risk of thermal injury during multi-layered composite restorations with thin remaining dentin; it is thus important to establish appropriate curing regimes that would lead to minimal temperature increase during deep composite restorations and hence reduce the risk of thermal injury to the pulp.

Vital pulp therapy (VPT) is deliberated as an ultraconservative/minimally invasive approach for the conservation of vital pulpal tissues, preservation of dental structure, and maintenance of tooth function in the oral cavity. In VPT, following the exposure of the dental pulp, the environment is prepared for the possible healing and probable refunctionalisation of pulpal connective tissue. However, to succeed in VPT, specific biomaterials are used to cover and/or dress the exposed pulp, lower the inflammation, heal the dental pulp, provoke the remaining odontoblastic cells, and induce the formation of a hard tissue, i.e., the dentinal bridge. It can be assumed that if the employed biomaterial is transferred to the target site using a specially designed micro-/nanosized local drug delivery system (LDDS), the biomaterial would be placed in closer proximity to the connective tissue, may be released in a controlled and sustained pattern, could properly conserve the remaining dental pulp and might appropriately enhance hard-tissue formation. Furthermore, the loaded LDDS could help VPT modalities to be more ultraconservative and may minimise the manipulation of the tooth structure as well as pulpal tissue, which could, in turn, result in better VPT outcomes.

Background In the area of oral and maxillofacial surgery, regenerative endodontics aims to present alternative options to conventional treatment strategies. With continuous advances in regenerative medicine, the source of cells used for pulp tissue regeneration is not only limited to mesenchymal stem cells as the non-mesenchymal stem cells have shown capabilities too. In this review, we are systematically assessing the recent findings on odontoblastic differentiation induction with scaffold and non-scaffold approaches. Methods A comprehensive search was conducted in Pubmed, and Scopus, and relevant studies published between 2015 and 2020 were selected following the PRISMA guideline. The main inclusion criteria were that articles must be revolving on method for osteoblast differentiation in vitro study. Therefore, in vivo and human or animal clinical studies were excluded. The search outcomes identified all articles containing the word “odontoblast”, “differentiation”, and “mesenchymal stem cell”. Results The literature search identified 99 related studies, but only 11 articles met the inclusion criteria. These include 5 odontoblastic differentiation induction with scaffold, 6 inductions without scaffolds. The data collected were characterised into two main categories: type of cells undergo odontoblastic differentiation, and odontoblastic differentiation techniques using scaffolds or non-scaffold. Conclusion Based on the data analysis, the scaffold-based odontoblastic induction method seems to be a better option compared to the non-scaffold method. In addition of that, the combination of growth factors in scaffold-based methods could possibly enhance the differentiation. Thus, further detailed studies are still required to understand the mechanism and the way to enhance odontoblastic differentiation.

Objectives The aim of this study was to evaluate the influence of inlays/onlays with or without pulp extension from different materials on stress distribution in endodontically treated molars by three-dimensional finite element analysis (3D FEA). Materials and Methods We used 3D mandibular molar models in this study. The models represented mesio-occluso-distal (MOD) cavities restored by inlays, onlays that covered buccal cusps, and onlays that covered all cusps with pulp extension (modified inlay/onlay) or without pulp extension (conventional inlay/onlay). Three materials (L: lithium disilicate glass-ceramic, P: polymer-infiltrated ceramic network [PICN], and C: nanofilled composite resin) were utilized. A force of 600 N was applied vertically and obliquely. Stress distribution in FEA models was analyzed using the von Mises theory. Results The results revealed that an oblique load generated higher stresses than vertical load. Composite resin restorations transmitted almost all the stress to the neighboring tooth structures, while lithium disilicate ceramic restorations absorbed most of the stresses. Moreover, modified inlays and onlays with pulp extension proved better than conventional inlays/onlays in terms of stress redistribution in dental structures. Onlays showed a better pattern of stress distribution than inlays within the restoration and the restored tooth. Conclusions According to stress distribution in dental structures, modified lithium disilicate ceramic onlays with pulp extension have been found to be the best choice to restore endodontically treated molars among the studied restorations.

Background During the process of deep decay, when decay approaches the pulp, an immune response is triggered inside the pulp, which activates the complement cascade. The effect of complement component 5a (C5a) on the differentiation of dental pulp mesenchymal stem cells (DPSCs) is related to dentin reparation. The aim of the present study was to stimulate DPSCs with different concentrations of C5a and evaluate the differentiation of odontoblasts using dentin sialoprotein (DSP). Methods DPSCs were divided into the following six groups: (i) Control; (ii) DPSCs treated with 50 ng/ml C5a; (iii) DPSCs treated with 100 ng/ml C5a; (iv) DPSCs treated with 200 ng/ml C5a; (v) DPSCs treated with 300 ng/ml C5a; and (vi) DPSCs treated with 400 ng/ml C5a. Flow cytometry and multilineage differentiation potential were used to identify DPSCs. Mineralization induction, Real-time PCR and Western blot were conducted to evaluate the differentiation of odontoblast in the 6 groups. Result DPSCs can express mesenchymal stem cell markers, including CD105, CD90, CD73 and, a less common marker, mesenchymal stromal cell antigen-1. In addition, DPSCs can differentiate into adipocytes, neurocytes, chondrocytes and odontoblasts. All six groups formed mineralized nodules after 28 days of culture. Reverse transcription-quantitative PCR and western blotting indicated that the high concentration C5a groups expressed higher DSP levels and promoted DPSC differentiation, whereas the low concentration C5a groups displayed an inhibitory effect. Conclusion In this study, the increasing concentration of C5a, which accompanies the immune process in the dental pulp, has demonstrated an enhancing effect on odontoblast differentiation at higher C5a concentrations in vitro.

Introduction: Vital pulp therapy has been known as one of the treatment optionsto preserve pulp vitality after being exposed by trauma or caries. Aim: This experimentexplored the effect of injectable-Platelet Rich Fibrin on marginal adaptation of two pulp capping agents (Mineral Trioxide Aggregate and Bioactive Bone Graft). Materials andmethods: A total of 64 teeth were used out of 8 healthy male beagle dogs. The teethwere randomly assigned into four groups, they were exposed and capped with differentcapping agents. Group A; capped with Mineral Trioxide Aggregate (MTA), Group B;capped with MTA+ i-PRF, Group C; capped with Bioactive Bone Graft (BBG), Group D; capped with BBG+i-PRF. Finally the access cavity was restored with IntermediateRestorative Material (IRM). At each predetermined interval, the dogs were sacrificed(1 month, and 3 months). The samples were then prepared for electron microscopicscanning evaluation. To compare between the gap percentage of four groups at eachinterval, Kruskal-wallis test; was used. Mann-Whitney U test; was used to pair-wisecomparison when Kruskal-wallis test is significant. Bonferroni’s correction was utilizedfor the pair-wise comparisons. Statistical significance was considered at P area between the capping materials and dentin, followed by group C (BBG), with theleast value recorded in group A (MTA). Conclusion: the findings from the current studysuggested that i-PRF provided a better marginal adaptation of either MTA or BBG tothe pulp and dentin, which improved with time from one month to three months.

Introduction: intracanal medicaments have an important role in disinfecting ofthe pulp space and in endodontic regenerative procedures. These medications comein close contact with the periradicular tissue, thus their degradation products must bebiocompatible with the periapical tissue. Otherwise, these medicaments will resultin intense inflammatory reaction. Aim of the study: The purpose of this in vitrostudy was to evaluate and compare the cytotoxicity of three intracanal medications;Neem oil, double antibiotic paste (DAP) and calcium hydroxide (Ca(OH)2).Materials and Methods: Immortalized human gingival fibroblast cells were retrievedfrom the cell bank and then cultured. Three different intracanal medications (Neemoil, DAP, Ca(OH)2) were added to the cultured cells. Cell viability was evaluatedusing 3-(4, 5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) andApoptosis/necrosis assays. Statistical analysis was performed using One-way ANOVAand post-hoc Tukey test. Results: Ca(OH)2 recorded the highest significant cytotoxicityfollowed by Neem oil, then DAP which recorded the lowest significant cytotoxicity.Cytotoxicity of the three intracanal medicaments used were directly proportional totheir concentrations Conclusion: DAP could be better recommended as intracanalmedicament in regenerative endodontic procedures because of its biocompatibilitycompared to the other tested medications.

Arsenic trioxide used in endodontic treatments has been shown to cause severe damages to surrounding bone and periodontal tissues. This report describes a case of alveolar osteomyelitis triggered by arsenic trioxide pulp devitalization and associated with mycotic infestation. Following clinical and radiological examinations, the concerned tooth was extracted, bone sequestrum was removed and granulation tissue was debrided. Histopathological biopsy examination, stained with hematoxylin/eosin, Grocott’s silver methenamine and periodic acid-Schiff, confirmed the diagnosis of chemical osteomyelitis associated with fungal infestation. Six months postoperatively, normal bone healing was observed.

Introduction: Radiotherapy is one of the methods used as a treatment for ma-lignant tumors in the head and neck region and it can cause tissue damage in the irradiated areas. In head and neck radiotherapy, teeth are often included within the irradiation area and, consequently, the dental pulp; which receives high doses of radiation. Objective: To evaluate the effects of ionizing radiation on the pulp tissue of rat teeth. Methodology: A double-blind experimental as-say with 35 Albinus Wistar rats divided into seven groups was performed; one control group, three groups irradiated with 15 Gy, and three groups irradiated with 25 Gy. The irradiated groups were submitted to a single dose of radiation and sacrificed 24 hours, 7 days, and 22 days after irradiation, respectively. The samples were evaluated for the morphological presence of inflammatory infil-trate, edema, necrosis, fibrosis, and degeneration of blood vessels. Statistical analysis was performed using the Kruskal-Wallis and Dunn tests with p

Aim and objective This in vitro study evaluates and compares the changes in pulp chamber temperature during direct fabrication of provisional restorations in maxillary central incisors after using three different cooling techniques. Materials and methods Total of 60 samples of maxillary central incisors along with their putty indices were divided into four groups (one control and three experimental) and were prepared using a surveyor cum milling machine. Teeth were sectioned 2 mm below cementoenamel junction and a K-type thermocouple wire was inserted in the tooth and secured at the pulpal roof using amalgam. Putty index filled with DPI tooth molding resin material [polymethyl methacrylate (PMMA)] was placed on the tooth and temperature changes per 5 seconds were recorded by temperature indicating device for the control, on-off, precooled putty, and dentin bonding agent (DBA) group. Results The highest mean obtained was of the control (11.04°C), followed by DBA group (9.53°C), precooled putty group (6.67°C), and on-off group (1.94°C). Precooled putty index group took maximum time to reach the baseline temperature (847.5 seconds). Conclusion On-off technique is the most effective method to reduce the intrapulpal temperature during polymerization, as compared to the other techniques used in the study. Retardation in the polymerization process was seen in precooled putty group, which may make this technique clinically inadvisable. Clinical significance Thermal protection of pulp must always be considered during direct fabrication of provisional restoration when a PMMA-based resin is used. By using on-off technique, not only the thermal insult to the pulp can be effectively minimized but also the harmful effects of residual monomer (poor marginal fit and pulpal irritation) can be eliminated.

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Gumboil is inflammation reaction in the gum caused by pulp infection. Gumboil is seen as an oral lesion characterized by a soft erythematous papule where a periapical abcess is draining into the oral cavity. An adequate root canal treatment can cure gumboil and remove bacteria from the root canal. To support the success of root canal treatment, final restoration used in this case is composite resin restoration with reinforcing fiber (short fiber reinforced composite). The purpose of this treatment was to restore the functions of tooth in mastication and preserving the supporting tissue. A female patient age 23 years old came with complaints of pain in the lower right mandibular molar accompanied by swelling of the gums around the teeth since a week ago. Swelling is intermittent since last 3 months. The tooth have been restored for about 3 years ago. Clinical examination showed a positive percussion, positive palpation, negative vitality, and negative mobility. Radiographic examination showed bifurcation and periapical lesions. Root canal treatment is performed with crown down preparation technique and followed by direct composite resin restoration with short fiber reiforced composite. The success of root canal treatment followed by composite resin restoration with short fiber reinforced fiber is marked by the absence of complaints as well as the dissappearance of gumboil.

The endodontic-orthodontic interface is not well understood due to the limited scientific literature on the topic. This article aims to provide an overview of the orthodontic treatment and the risk of root resorption, the effects of orthodontic tooth movement on dental pulp and endodontically treated teeth, the role of orthodontics in endodontic-restorative treatment planning, and interdisciplinary patient management. Articles published in English from 1982 to 2021 were searched manually from google scholar using keywords ‘endodontic-orthodontic interface’ and ‘endodontic-orthodontic interrelationship’. Another search engine was MEDLINE/PubMed database using keywords ‘endodontics AND orthodontics’, ‘orthodontic tooth movement AND dental pulp’, 'orthodontic tooth movement AND endodontic treatment' and ‘orthodontics AND dental trauma’. Other relevant articles were obtained from the references of the selected papers. Alterations to the dental pulp following orthodontic tooth movement can be histologic and/or cell biological reactions as well as the increased response threshold to pulp sensibility tests. However, the occurrence of root resorption is complex and multifactorial, and can be linked to individual variation, genetic predisposition and orthodontic treatment-related factors. Endodontically treated teeth can move as readily and respond similarly to orthodontic forces as vital teeth, however with inadequate endodontic treatment, the risk of apical inflammation and bone destruction following orthodontic tooth movement is increased. Dental treatment that involves endodontic and orthodontic specialities should be carefully planned according to the individual case, taking into consideration the skills and experience of the clinicians while applying interdisciplinary patient management and available scientific data.

The inflammatory follicular cysts are cystic lesions associated with non-erupted permanent teeth and involve devitalized deciduous teeth. Products resulting from the necrotic pulp of deciduous teeth stimulate crown hood growth of successor permanent tooth radiographically shown as a unilocular, radiolucent area, associated with an impacted permanent crown. Treatment based on cyst decompression and maintenance of the deciduous tooth is a conservative approach to space maintenance. This case report describes the diagnosis, treatment, and post-surgery follow-up after 5 years of an extensive inflammatory follicular cyst in the mandible, in the region of tooth 75, with marsupialization being the method of treatment and emphasizing the importance of clinical and radiographic follow-up. How to cite this article: de Oliveira GAA, Limongi MC, Garcia HS, et al. Success in Conservative Treatment of an Inflammatory Follicular Cyst: A 5-year Follow-up. Int J Clin Pediatr Dent 2021;14(2):327–330.

Aim of the study: The present study assessed and compared the success of an IPT procedure both clinically and radiographically when Dycal and MTA were used as an IPT material on primary molars. Materials and Methods: Children aged 4-9 years were screened and those who fulfilled the inclusion criteria were selected. Accordingly fiftychildren were divided into 2 groups with 25 patient in each group. Cavity preparation was done and the two test materials (Dycal and MTA) were placed at the base in their respective groups and restored with RMGIC. Post-operative radiograph was taken for baseline data. Patients were assessed at Subsequent at 1 and 6 months both clinically and radiographically. Results: Both the test materials had formed a good biological seal, arrested further caries progression and did not cause any adverse pulpal reaction. However the amount of reparative dentin formed was highest in the Dycal group followed by MTA group. Conclusion: Both the experimental materials Dycal and MTA showed reparative dentin formation at the end of 1 and 6 months and also formed a good biological seal and maintained vitality of the pulp which indicates both are good IPT material. Keywords : Dycal, MTA, Indirect pulp capping, Reparative dentine, Pulp vitality

Aim and objective This study was carried out to compare the effectiveness of biodentine, calcium hydroxide, and 2% chlorhexidine gluconate used along with resin-modified glass ionomer cement (RMGIC) as indirect pulp capping (IPC) materials in young permanent molars. Materials and methods In this study, 54 patients were selected. Among these patients, 72 young permanent molars were selected randomly in which IPC was required. These teeth were randomly categorized into three different groups and each group consisted of 24 teeth. The first group was group A consisting of teeth treated with biodentine, the second group was group B consisting of teeth treated with 2% chlorhexidine gluconate being followed by RMGIC, while the third was group C consisting of teeth treated with calcium hydroxide. All cases were subjected to follow-up for clinical and radiographic evaluation at 4, 8, and 16 months. The data were recorded and analyzed statistically by utilizing the Chi-square test. Results After 16 months, 95.83% of cases in group A consisting of teeth treated with biodentine showed successful results both clinically and radiographically. While 87.5% of cases in group B consisting of teeth treated with 2% chlorhexidine gluconate being followed by RMGIC showed successful results. And finally, 91.66% of cases in group C consisting of teeth treated with calcium hydroxide showed successful results. Conclusion Biodentine can be efficiently used as an IPC agent in young permanent molars although all three materials were effective in IPC with a nonsignificant difference statistically. This study highlights the success of IPC in young permanent molars and the choice of better IPC material can be biodentine. Clinical significance Indirect pulp capping is one of the procedures in which preservation of carious affected dentin nearest to the pulp is carried out to protect the pulp. Several new IPC agents like biodentine have been introduced. Hence, it is necessary to evaluate their effectiveness. How to cite this article: Kaul S, Kumar A, Jasrotia A, et al. Comparative Analysis of Biodentine, Calcium Hydroxide, and 2% Chlorhexidine with Resin-modified Glass Ionomer Cement as Indirect Pulp Capping Materials in Young Permanent Molars. J Contemp Dent Pract 2021;22(5):511-516.

The effect of Watermelon (Citrullus lanatus) Pulp Juice (WPJ) on scopolamine (SCOP) induced memory deficits is due to the involvement of oxidative stress and AChE activity. The juice was obtained by crushing the pulp in blender and three different concentrations of 100%, 50% and 25% was administration to prevent memory deficit by evaluating changes of AChE activity and oxidative stress indicators (SOD, CAT, LPO and GPx) induced by scopolamine. These results provide evidence that WPJ is an alternative to protect SCOP induced memory deficits in mice by involvement of oxidative stress and AChE activity.