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Introduction Marginal adaptability of composite resins is one of the prime factors for the success of class II cavity restoration. Materials and Methodology: Forty non-carious extracted mandibular molar with fully formed apices were collected and Class II box type cavities were prepared on both mesial and distal surfaces of every tooth using a new straight fissure diamond bur and high-speed airrotor handpiece. According to the type of restorative materials used, teeth were divided into Group I (n=20): Restored with SDR (Smart Dentin Replacement) and Group II (n=20): Restored with Tetric Eva Flow Bulk Fill. After 24 hours of storage in distilled water at 37˚C, the restored specimens were subjected to artificial aging by thermocycling. The teeth were then immersed in a 2% methylene blue dye for 24 hours. All samples were cut longitudinally through the center of the restorations with the help of an isomet diamond saw. The sections were then observed under a stereomicroscope at 25X for scoring the depth of dye penetration at cervical and axial walls toward the pulp. Results: Mean score of Group Ia is 0.4±0.83 and Ib was 0.55±0.88 respectively while the mean score of Group IIa was 0.75±1.118 and in IIb was 0.75±1.019 respectively. Microleakage was found to be highest in Group IIa and minimum in Group Ia. Conclusion: Use of a flowable composite SDR above and below the CEJ in Class II composite resin restorations showed good results.

Periapical granuloma is a histological term that refers to the formation of a mass of granulomatous tissue around the apex of a tooth resulting from inflammation and necrosis of the pulp tissue. It consists of an infiltrate of inflammatory cells such as macrophages, plasmocytes and lymphocytes, as well as fibroblasts, collagen fibers and capillaries. Periapical surgery is an alternative for preserving the tooth in the oral cavity in cases where periapical inflammation is persistent even after treatment of root canals. The objective of this study was to report a clinical case in which the surgical technique was used to remove granulomatous lesions from a patient, female, with a history of recurrent periapical abscess without painful symptomatology in the region of the anterior 11,12 and 13 teeth. The histopathological exam demonstrated the presence of a granulomatous tissue with intense inflammatory infiltrate mixed, permeated with lymphocytes and high number of plasmocytes, confirming the diagnosis of periapical granuloma. The treatment was considered successful since the patient remained asymptomatic and there was incorporation of the inorganic bovine bone graft and initiation of bone neoformation in the periapical region.

Background: Due to the complications of root canal treatment, conservative modalities to preserve pulp vitality are favorable. Direct pulp capping (DPC) refers to the coverage of the pulp tissue exposed by a biocompatible agent that can improve the prognosis of the tooth by 44% to 95%. Some recent studies have reported more predictable results (a success rate of about 90%) for DPC with laser and regenerative materials such as mineral trioxide aggregate (MTA). This study aimed to clinically compare DPC with ProRoot MTA alone and in combination with Er:YAG (erbium-doped yttrium aluminium garnet) laser irradiation (2940 nm). Methods: This clinical trial was conducted on 26 patients with a mean age of 29 years (in the range of 17 to 46 years) who required DPC following pulp exposure during deep caries removal. The teeth were divided into two groups. In the control group, the teeth underwent DPC with ProRoot MTA while in the test group, the teeth were first irradiated with a 2940 nm Er:YAG laser and then underwent DPC with ProRoot MTA. The patients were recalled at one, 3 and 6 months for the follow-up (clinical and radiographic examinations). The data were analyzed using Fisher exact test. Results: The success rate was 75% in the laser group and 93% in the control group. The groups were not significantly different (P>0.05). Conclusion: No significant difference was found in terms of the success rate of DPC with ProRoot MTA alone and in combination with Er:YAG laser irradiation.

Enamel matrix derivative (EMD) is a periodontal tissue regeneration material that induced hard tissue formation. This study was performed to examine the reaction of dental pulp tissue directly capped with a synthetic peptide prepared based on EMD research, and to investigate its potential as a pulp capping material. The experiments were performed in the maxillary left and right first molars of five 6-week-old male Sprague–Dawley rats. The exposed pulp was capped with synthetic peptide in the peptide group, but left uncapped in the control group. Two weeks later, the maxillary bone was isolated and photographed by microfocus computed tomography (CT). The opaque area and volume of the coronal pulp cavity were measured on CT images, and the area-to-volume ratio was calculated. After decalcification, tissue samples were prepared, stained with hematoxylin and eosin (H&E), and examined histopathologically. CT images for both groups showed an opaque area in the coronal pulp cavity, and the fraction of images showing opacity was significantly higher in the peptide group (P < 0.01). A large amount of hard tissue was formed in the coronal pulp cavity in the peptide group, around which aggregation of cells with eosinophilic substances in polytopes was observed. Only slight hard tissue formation was observed in the control group. As it showed eosinophilicity on H&E staining, the synthetic peptide was suggested to be involved in hard tissue formation. Synthetic peptides can potentially be used as pulp capping materials.

Three-dimensional (3D) bioprinting of cells is an emerging area of research but has not been explored yet in the context of periodontal tissue engineering. Objetive: This study reports on the optimization of the 3D bioprinting scaffolds and tissues used that could be applied clinically to seniors for the regenerative purpose to meet individual patient treatment needs. Material and Methods: We methodically explored the printability of various tissues (dentin pulp stem/progenitor cells, periodontal ligament stem/progenitor cells, alveolar bone stem/progenitor cells, advanced platelet-rich fibrin and injected platelet-rich fibrin) and scaffolds using 3D printers pertaining only to periodontal defects. The influence of different printing parameters with the help of scaffold to promote periodontal regeneration and to replace the lost structure has been evaluated. Results: This systematic evaluation enabled the selection of the most suited printing conditions for achieving high printing resolution, dimensional stability, and cell viability for 3D bioprinting of periodontal ligament cells. Conclusion: The optimized bioprinting system is the first step towards the reproducible manufacturing of cell laden, space maintaining scaffolds for the treatment of periodontal lesions.

Two hundred and twenty five, day-old Arbour Acre broiler birds were use to investigate the effect of graded dietary levels of Parkia biglobosa pulp meal (PBPM) on the performance, haematological and carcass parameters of the birds from 0-8 weeks of age. Five isocaloric and isonitrogenous diets were formulated to contain PBPM at 0,10,20, 30 and 40 percent respectively making a total of 5 treatments. Each treatment was replicated three times with 15 birds per replicate in a completely randomized design experiment. Feed and water were supplied ad libitum. Records taken included weekly weight changes and weekly feed intake. There was no record of mortality throughout the duration of the experiment. Results obtained showed a decrease in the bird’s performance as the dietary levels of the pulp increased. The final weight (g/b) and weight gain (g/b/day) decreased from 2122 and 33.91 for the control to 1309 and 20.97 for the 40% inclusion level of PBPM meal respectively However birds placed on 10% dietary level had a performance that were not significantly (P>0.05) different from those placed on the control diet which were on standard broiler starter and finisher rations. Also it was observed that values obtained for the haematological parameters fall within the range often reported for healthy birds indicating that the pulp did not impart any deleterious effect on the health of the birds. It can be concluded that broiler chickens can be fed up to 10% dietary level of PBPM without adverse effect on the performance of the birds. Keywords : Parkia pulp, Dietary levels ,Broiler chickens, Performance

To date, there is a theory that increased resistance to caries is observed in the teeth, which for any reason underwent destructive changes in the pulp. That is why there is a need to study the impact of pulp vitality on the development of the carious process. The aim of the research was to study the microscopic structure of epoxy sections of intact and carious third molars. We studied 4 intact and 6 carious third molars. For this purpose, specimens were made taking into account the free penetration of the fixative solution into the pulp. To this end, immediately after the tooth was removed, we cut off its roots almost near the crown, preserving the integrity of the latter. The method relied on the impregnation of specimens with epoxy resin, according to the method of epoxy plastination of tooth specimens, developed at the Department of Human Anatomy of Ukrainian Medical Stomatological Academy. The epoxy blocks were cut with a disk into two halves until the hard tissues of the tooth crown were exposed together with the pulp. We found that the hard tissues (dentin and enamel coating) of intact third molars did not have any structural defects. However, their pulp chamber contained mainly an amorphous substance, devoid of any typical pulp tissue structures. That is, the pulp was in a state of complete devolution. Quite the opposite presentation was observed in specimens of carious teeth. We found that their pulp chamber contained quite noticeable tissue structures typical of the dental pulp. It is interesting that in the subodontoblastic layer, in front of the carious alteration of the enamel, there was compaction of the pulp, which may be due to infiltration of perivascular connective tissue by immunocompetent cells. It was found that on the border with carious destruction of enamel, there was a compacted spot of altered dentin, whose matrix was intensely pigmented in brown colour, due to the accumulation of melanin on the dentino-enamel junction. Its excessive formation is associated with the destruction of protein-carbohydrate complexes of organic matter in the deep layers of dentin. We found that the pulp compaction and the focus of carious alteration of the enamel are projectively connected by a radial cord of altered dentin, known in the literature as “dead tracts”. Hence, there is reason to believe that the identified changes indicate a latent form of caries, with a pulpogenic mechanism of development. Thus, it can be argued that the teeth, which for any reason underwent degenerative changes in the pulp, are not prone to carious lesions, whereas in carious teeth, the pulp is active and involved in the pathogenesis of the carious process.

Background The outcome of vital pulp treatment after carious pulp exposure is multifactorial and related to the procedure, biomaterial and pre-operative pulpal diagnosis. Objectives To conduct a systematic review and meta-analysis determining the outcome of direct pulp capping (DPC) in mature permanent teeth with a cariously exposed pulp and a clinical diagnosis of reversible pulpitis, and ascertain whether the capping material influences the outcome. Methods Sources: MEDLINE Ovid-SP, Cochrane Central Register of Controlled Trials (CENTRAL), International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, Embase and Web of Science until April 2020. Inclusion: Prospective, retrospective cohort studies and randomized trials investigating DPC outcome or comparing different capping materials after carious pulp exposure. Exclusion: Primary teeth, mechanical, traumatic or not specified pulp exposure, teeth with irreversible pulpitis or no pulpal diagnosis. Risk of bias assessed using Cochrane and modified Downs and Black quality assessment checklist. Meta-analysis on combined clinical/radiographic outcome was performed using a random effect model. Success was defined as absence of signs and symptoms of irreversible pulpitis, apical periodontitis or loss of pulp vitality. Results Quality assessment highlighted four non-randomized studies to be of fair and five of poor quality. Four randomized trials had a high risk of bias. The pooled success rate differed based on material and follow-up. Calcium hydroxide success rate was 74% at 6-months, 65% at 1-year, 59% at 2-3 years and 56% at 4-5 years. Mineral trioxide aggregate (MTA) success was 91%, 86%, 84% and 81% at the same time points. Biodentine success was 96% at 6-months, 86% at 1 year and 86% at 2-3 years. The meta-analysis revealed MTA had better success than calcium hydroxide at 1-year (OR 2.66, 95% CI; 1.46- 4.84, P = 0.001) and 2- to 3-year follow-up (OR 2.21, 95% CI; 1.42-3.44, P = 0.0004). There was no difference between MTA and Biodentine. Discussion These results were based on poor methodological quality studies. The effect size for of MTA vs Ca(OH)2, although modest, was consistent with narrow CI. Conclusions Low-quality evidence suggests a high success rate for direct pulp capping in teeth with cariously exposed pulps with better long-term outcomes for MTA and Biodentine compared with calcium hydroxide.

Caries or cavities is a breakdown of teeth due to acids made by bacteria. Individual tooth surfaces have different susceptibilities to caries which vary over time. Progress of caries towards the pulp leads to damage to the pulp. Caries 2 caries involve proximal surfaces of posterior teeth. The aim of the present study was to identify the association of age and gender distribution in patients having class II caries resulting in root canal treatment in lower premolars and molars. The data was collected from the DIAS - dental information archiving software. All case sheets were reviewed and findings are recorded. The data were tabulated using excel and analysed with the help of SPSS software. In this study, class II caries were common in the age group 60 to 70 years (73.9%). Males (63.8%) were more affected than females (36%). Lower molars (51%) showed a slightly higher incidence of class II caries when compared to premolars (49.4%). Within the limitations of the study, male patients showed a higher incidence of class II caries resulting in root canal treatment compared with female patients. 60 to 70 years was the commonly affected age group.

Relevance. Occlusal splints, made for the patients with temporomandibular disorders (TMD), influence proprioceptive sensitivity, sensory characteristics of pain, parameters of microcirculation of the pulp and periodontium of the healthy teeth. Condition of the pulp and periodontium of the healthy teeth should be assessed in patients with TMD associated with connective tissue dysplasia (CTD).Materials and methods. The study examined 36 TMD patients aged 26.3 ± 1.3 лет (М ± m) with CTD (n = 20, main group) and without CTD (n = 16, control group); with natural teeth, without complaints of TMD, masticatory muscles and periodontal condition. Laser doppler flowmetry (LDF) helped to analyze blood flow parameters in the periodontium and pulp of the healthy teeth. Received results were statistically analyzed.Results. Wavelet analysis revealed different microcirculatory flowmotion: high-amplitude irregular type was in patients of the main group, low-amplitude regular type was in controls. In the main group, perfusion is supported by high values of flux and vasomotion, ergotropic sympathetic effects (controlled by catecholamines) prevail, myogenic tone is reduced, elevated microvascular tone reflects possible changes in rheologic blood properties, microcirculatory signs of pain syndrome and relatively elevated ischemic index in pulp microcirculation of healthy teeth.Conclusion. Sensory and regulatory mechanisms, reflected by the condition of periodontium and pulp blood flow, can be regarded as early signs of inflammation and chronic pain in the diagnosis of TMD in patients without complaints.

Diabetes mellitus (DM) é uma doença crônica não transmissível caracterizada como o aumento da glicose, devido às disfunções do metabolismo dos carboidratos, lipídios e proteínas. Aliado com o avanço da ciência os frutos e seus subprodutos tem sido considerados promotores da saúde. Neste estudo foi avaliado o efeito anti-hiperglicêmico do extrato hidroetanólico da casca e polpa dos frutos de Litchi chinensis (lichia) em ratos diabéticos. Foram utilizados ratos wistar (250 a 300 g) com DM induzido por aloxana 130 mg/kg. Os animais foram tratados com 300 mg/kg de extratos de Litchi chinensis, durante 75 dias, por gavagem. Foram avaliados a glicemia e os biomarcadores, como os triglicérides, colesterol, função renal e hepática. Tecidos como fígado, rins, coração e pâncreas foram retirados para análise histológica. Os ratos diabéticos tratados com a casca de Litchi chinensis apresentaram uma redução significativa na glicemia em jejum, quando comparados aos ratos não tratados. Além dessa ação benéfica, os ratos tratados tanto com a casca quanto com a polpa, obtiveram redução dos níveis de lipídeos, reduzindo as taxas de triglicerídeos e colesterol. Portanto, Litchi chinensis mostrou seu benefício nos efeitos hipoglicemiantes e hipolipemiantes, tendo potencial terapêutico na prevenção e no tratamento das complicações do diabetes mellitus.

Aim: To determine the pulpal sensory thresholds in human teeth using different conducting media and to check presence of gender based differences. Materials and Methods: The study was performed on 40 maxillary central incisors in 40 healthy participants, 20 males and 20 age-matched females. The three conducting media tested were gel based product – Lox 2% Jelly and toothpastes- Sensodyne Repair and Protect & Meswak. The media were used in random order and each medium was tested twice on the tooth with 1 minute interval. The tooth probe of the tester was coated with a thin layer of the test medium and a stimulus was applied on the tooth until felt by the participant. At the faintest sensation felt by the patient, the sensory threshold value and the pain scores were recorded. The mean of the two threshold values for each conducting medium and the VAS scores were used for ANOVA followed by post hoc analysis. Results: Sensory threshold values elicited by Lox 2% Jelly was significantly lower than the other conducting media (P Conclusion: Pulpal sensory thresholds to electric stimuli generated by EPT differ according to the conducting media used and gender. Keywords: Electrical conductance, Electric pulp test, Electrical stimuli, Pulp sensibility test, Sensory threshold.

An immature tooth with necrotic pulp and periapical pathology imposes a great difficulty to the endodontists. The case becomes more difficult when the clinician comes across a rare presentation of tooth morphology. Endodontic treatment options for such teeth consist of conventional apexification procedures. This article demonstrates the recent concept of mineral trioxide aggregate (MTA) apical plug technique, for the management of a single rooted immature second molar with a single continuous canal. Keywords: Apexification, apical plug, mineral trioxide aggregate, necrotic teeth with immature apices. Abbreviations: CH-Calcium Hydroxide, MTA-mineral trioxide aggregate.

The problems encountered while treating immature, necrotic teeth has led to a shift in the treatment protocol. The biologically-based principles and regenerative endodontic protocols replacing the traditional methods. Preliminary research suggests that Revascularization has emerged as such an alternative. The stem and progenitor cells from the pulp and? or periodontium lead to root development. The aim of this paper is to accomplish a literature review concerning this novel concept. Keywords: Maturogenesis, Regeneration, Immature Teeth, Revascularization, Revitalization.

Introduction: Endodontic treatment has long been considered the only conservative therapeutic option for teeth with irreversible acute pulpitis. Histological studies have shown that the inflammation is confined to a limited surface of the pulp, near the decaying lesion, and it is not uncommon to find normal histology in the coronary pulp away from decayed surfaces as well as in roots. In dentistry, it is universally accepted that the vital pulp tissue should be preserved if possible. Aim: The objective of this study is to review the literature on the clinical and radiographic assessment criteria for coronary pulpotomy therapeutics on mature permanent teeth with irreversible acute pulpitis. Materials and Methods: To find relevant articles on this therapy, an electronic search strategy on PubMed, Cochran Library and Science Direct databases using the combination pulpotomy and pulpitis and permanent tooth, for indexed studies from January 2008 to April 2018. Results: Results of this study indicated favorable success rates for this therapy. A 2018 study reported 98.4% of clinical and radiographic successes at six months. At one year, it reported 100% clinical success and 98.4% radiographic success with the use of Biodentine. Furthermore, it reported 100% clinical success and 97.5% of radiographic success rate with the use of mineral trioxide aggregate (MTA) in the first year, and 92.7% of radiograph success after three years. In 2014, a publication reported 98.19% clinical success rate with cement-enriched mixture (CEM) over a 27 month period. However, the X-ray success rates were 86.7%. Conclusion:This treatment can be a realistic alternative for mature permanent human molars with irreversible pulpitis symptoms. But other large-scale multicentered clinical trials are strongly encouraged to substantiate this hypothesis. Keywords: Irreversible pulpitis, Full pulpotomy, Mature permanent teeth, Permanent teeth, Pulpitis, Pulpotomy.

Aim: Beta-thalassemia (β-thalassemia) major is one of the most common inherited genetic blood disorders and is characterized by many systemic manifestations and skeletal problems. Children with β-thalassemia have a high caries index and must receive proper dental treatment to achieve better oral health. The aim of study is to compare two types of vital pulp therapies in children with β-thalassemia major. Methods: Sixty-five children with β-thalassemia major having carious primary molars were selected from Ain Shams University and the Hereditary Blood Disorders Clinic at the National Research Centre to be treated at Pediatric Dentistry, Department, Faculty of Dentisrtry, Ain Shams University . Patients received one of both types of vital pulp therapies: mineral trioxide aggregate (MTA) pulpotomy and indirect pulp capping. The children were divided into two groups as follow: Group I (n=30) received MTA pulpotomy and Group II (n=35) received indirect pulp capping using high viscosity glass ionomer cement. Clinical and radiographic follow-ups were done at the baseline, six months, and after one year. Patient preferences for types of vital pulp therapies were evaluated at the end of treatment. Comparison of the groups with qualitative data was done using Chi-square test. Comparison of the groups with quantitative data and a parametric distribution was done using an independent t-test at significance level 0.05. Results: The findings revealed success rates of 90% in Group I and 100% in Group II. There was 10% clinical and radiographic failure in Group I and 0% in Group II but the difference between the two groups when compared to each other was statistically not significant (p= 0.055). Conclusions: Both types of vital pulp therapies showed high success rates in children with β-thalassemia major and thus can be used safely in these patients. However, minimally invasive types of dental treatment may be preferred in children with β-thalassemia major as indirect pulp capping for being less invasive and requires less effort, fatigue and time.

In this case, it was aimed to restore a traumatized permanent incisor with open apex using a modified polyethylene fiber post after amputation as well as to present a four-year long term follow-up. A healthy 10-year-old boy was referred with a complaint of pain caused by tooth number 11. The patient fell and broke his upper incisor ten days ago and no treatment was done before. Total amputation was carried out after clinical and radiological examination. The exposed root pulp was covered with BiodentineTM (Septodent, Saint-Maur-Fosses Codex, France). Glass-ionomer cement (Fuji IX extra, GC Corp., Tokyo, Japan) was placed on the BiodentineTM, and after a 3-month follow-up, polyethylene fiber post (Ribbond, Seattle, WA, USA) was placed in the crown since healing was observed in the relevant tooth. The restoration was completed with composite resin (Clearfil Majesty Esthetic Kuraray, Osaka, Japan). Four years later, radiographic examination revealed completed root formation and complete root obliteration. Clinical examination revealed favorable esthetic and functional outcome. Traditional treatments can be modified in order to obtain long term clinical success. Polyethylene fiber post can be used as an alternative method to root canal therapy in complicated crown fractures in teeth with immature root formation due to the advantages such as the possibility of modification according to the crown, aesthetics, easy application, and supporting the vitality of the tooth.

Treatment of crown-root fracture can be complicated, time-consuming and expensive. This paper presents a treatment approach that minimises intra-operatory intervention and preserves the biologic tissue. A 15-year-old boy reported for treatment of an oblique crown fracture in the left permanent maxillary central incisor (#21, Federation Dentaire Internationale) with mature root apices. The treatment presented an endodontic, periodontal and restorative challenge as the crown fracture exposed the pulp and extended subgingivally. The patient also had accompanying generalised enamel hypoplasia due to dental fluorosis (grade 3 Deans Fluorosis index), making the aesthetic rehabilitation difficult. The case was managed by preserving the vital pulp by MTA pulpotomy, followed by the adhesive bonding of autogenous crown fragment. A three-year follow-up revealed healthy vital pulp tissue and retained bonded fragment with acceptable aesthetics and periodontal health.

Aim: Citrullus lanatus is a fruit widely consumed for its pulp though incompletely, as its other parts (seed and rind) are discarded and may possibly offer bioactive compounds involved in ameliorating certain disease conditions. Hence, this study aimed at comparatively investigating the nutritional composition and antioxidant properties of the seed, pulp and rind of C. lanatus so as to inform the inclusion of these different parts into the fare of the people. Methodology: Standard analytical methods of Association of Official Analytical Chemists were used to determine proximate, phytochemical, vitamin, mineral and antioxidant aspects of the fruit parts. The results were analyzed using Student’s t-test at .05. Results: The proximate analysis showed a high moisture value in the pulp (93.34 +/- .82) followed by the rind (77.11 +/- 3.44) and the seed (10.00 +/- .48). High crude protein and fiber contents were both noted in the seed followed by the rind and pulp. Mineral determinations revealed potassium to be abundant in the rind (452.31mg/kg) than the seed (305.7mg/kg) and the pulp (100.5mg/kg), followed by calcium occurring more in the rind (292.61mg/kg) than in the pulp (257.21mg/kg) and seed (227.45mg/kg) and then manganese being the least concentrated among the minerals. The investigated phytochemical principles revealed the highest concentration of cardiac glycosides in the seed (14.82 +/- .66) than the rind (1.95 +/- 0.80) and pulp (1.10 +/- 0.17), followed by saponins occurring most in the rind (12.05 +/- 3.91) than the seed (10.17 +/- 0.63) and pulp (.13 +/- .01). The seed had the highest DPPH scavenging activity followed by the rind and pulp respectively. The seed also showed a higher reducing power and lipid peroxidation capacities than the other fruit parts suggesting a potent property for antioxidant activity in the fruit parts of C. lanatus. Conclusion: The findings imply that both seed and rind of C. lanatus can be good sources of nutritional, phytochemical and antioxidant components in addition to the pulp which is commonly consumed and these may be implicated in management of certain diseases with further evidential research.

Background/aims Traumatic dental injuries (TDI) occur frequently and may result in pulp sequelae. This includes pulp necrosis with infection, pulp canal obliteration and root resorption. The aim of this study was to assess the prevalence and risk factors of pulp sequelae after TDI among Norwegian adolescents. Material and methods A retrospective longitudinal study, including historical clinical data, was conducted with 16-year-old pupils in western Norway. All first-grade pupils, born in 1997 (n = 5184), attending public high schools, were invited to participate and to respond to an electronically administered closed-ended questionnaire (response rate 39.6%, n = 2055). Consent was given to access the dental records in the Public Dental Health Service in Hordaland, where information regarding TDI (diagnosis and treatment) and radiographs were interpreted. Only TDIs to anterior teeth were recorded (canine to canine in the maxilla and mandible). Outcome variables of TDI were registered and analysed using logistic regression, Kaplan-Meier survival estimates and log-rank test. Results The prevalence of TDI in the sample population was 16.4% (338 pupils), with a total of 637 teeth involved. The number of included teeth for analysis was 571 (90.5%). The prevalence of pulp necrosis with infection was 7.5%. Moderate and severe TDI was associated with a higher frequency of pulp necrosis with infection. Pulp canal obliteration and root resorption were found in 2.8% and 2.3% of teeth with TDI, respectively. Dental hard tissue injuries were more prone to the development of pulp necrosis than luxation injuries and combination injuries. The relationship between root development stage and development of pulp necrosis with infection was not statistically significant. Conclusions Occurrence of different pulp sequelae among teeth affected with TDI was low. Moderate and severe TDI were more at risk of developing pulpal complications and hard tissue injuries were at higher risk of developing pulp necrosis with infection.

Objective: The purpose of this study was to determine if gas tension and acidity levels could serve as biomarkers of pulp inflammatory status in primary dentition. Study design: The present study evaluated acidity level and blood partial pressures of O2 and CO2 collected from vital pulp chambers of 84 primary molars with deep carious lesions encroaching the pulp. Teeth were treated with pulpotomy or pulpectomy based on clinical judgement. Pulpectomy was performed when symptoms of spontaneous pain, difficulty in obtaining hemostasis and/or dark purple blood were present. Using a glass capillary, pulp chamber bleeding was collected and within ten minutes a neonate Astrup test was performed to determine blood gas module pH, pCO2, and pO2. Results: Eighty-four children with one affected tooth participated in the study (37 girls and 47 boys). Age ranged between 3.5 to 9-years (average: 5.3 years). Seventy-one (84%) were treated with the aid of inhalation analgesia, conscious sedation or general anesthesia. Pulpotomy was performed on 58 teeth (69%). Teeth undergoing pulpectomy revealed significant higher level of CO2 partial pressure (P= 0.002). Acidity level values (pH) were also lower but none significantly in teeth with pulpectomy (P= 0.137). Conclusions: Higher pCO2 levels was found in pulps needing pulpectomy.

The study of regenerative dentistry receives a fast growing interest. The potential ability of the dentin-pulp complex to regenerate is both promising and perplexing. To answer the challenging nature of the dental environment, scientists have developed various combinations of biomaterial scaffolds, stem cells, and incorporation of several growth factors. One of the crucial elements of this tissue engineering plan is the selection and fabrication of scaffolds. However, further findings suggest that cell behavior hugely depends on mechanical signaling. Nanotopography modifies scaffolds to alter cell migration and differentiation. However, to the best of the author's knowledge, there are very few studies addressing the correlation between nanotopography and dentin-pulp complex regeneration. Therefore, this article presents a comprehensive review of these studies and suggests a direction for future developments, particularly in the incorporation of nanotopography design for dentin-pulp complex regeneration., Highlights • Nanotopographical size and forms affects different dental pulp stem cell's response. • Dental pulp stem cell responses both molecular and mechanical cues from the environment. • The nanotophography of scaffold generates mechanotransduction on dental pulp stem cell. • Mechanotransduction is related to gene expression, arrangement, and morphological changes of dental pulp stem cell. • Smaller size nanotopography tends to enhance cell attachment; the larger one increases differentiation and proliferation.

Introduction Patients seeking endodontic treatment commonly present with reduced mechanical pain thresholds (ie, mechanical allodynia [MA]) in the offending teeth. In patients with moderate to severe pain, MA may manifest in the teeth contralateral to the offending teeth because of the onset of central sensitization (CS). We hypothesize that there are quantitative differences in MA and CS in patients with different pulp and periradicular diagnoses. Methods Patients (n = 70) receiving endodontic treatment in the graduate endodontic clinic at the University of Texas Health Science Center at San Antonio and healthy volunteers (n = 10) were included in this cross-sectional study. The mechanical pain threshold from molar teeth was measured by a digital bite force transducer on the offending tooth (ipsilateral) and the contralateral tooth. Ipsi- and contralateral MA among different endodontic diagnoses were analyzed using the Kruskal-Wallis with Dunn post hoc test and the Student t test for differences between sexes. Multivariate regression models analyzed predictors for MA and CS. Results Periradicular diagnoses of asymptomatic apical periodontitis, symptomatic apical periodontitis, and chronic apical abscess cases were significantly associated with MA. CS, seen as contralateral MA, was only detected in pulpal diagnosis of symptomatic irreversible pulpitis, previously initiated treatment, symptomatic apical periodontitis, and chronic apical abscess. Females experienced significantly lower pain thresholds than males on both sides. MA and CS were significantly correlated in both sexes. The preoperative pain level and duration were significant predictors for MA and CS only in female patients. Lastly, age was a significant predictor for MA in females. Conclusions The magnitude of MA and CS varied with different endodontic diagnoses, with CS being correlated with increases in MA. Only in female patients were age, preoperative pain duration, and intensity significant predictors for the development of MA and CS.

This report describes the second attempt at pulp revascularisation, using an association between 2% chlorhexidine (CHX) and calcium hydroxide (CH) as intracanal dressing, in an immature traumatised anterior tooth with pulp necrosis. A 21-year-old woman complained of pain and dental crown darkening of a permanent maxillary right central incisor. Her medical records presented a history of dental trauma, and at age 15, the first attempt at revascularisation was performed, using triple antibiotic paste (TAP) as the intracanal dressing. Recent radiographs then showed a periapical lesion associated with an immature root, which demonstrated the failure of the first attempt. The second pulp revascularisation was performed, using an association between CHX and CH as intracanal medication. The case was followed up for 24 months. Observations showed evidence of root development, dentinal wall thickening and periapical healing. In this case, the association between CHX and CH showed favourable results as an intracanal medication.

Introduction: Plants are known to contain numerous phytochemicals with potential antimicrobial activity. Aim: Nutritional, phytochemical and antimicrobial activities of the leaves and the fruit pulp extracts of Tetrapluera tetraptera was carried out. Methodology: Collection and identification of isolates and plants parts, and preparation of extracts and nutrient (proximate, vitamins and minerals and anti-nutrients) evaluations were all done using standard protocols previously reported. Evaluations of phytochemicals were carried out using crude screening, quantification and gas chromatography coupled to mass spectrophotometer for a robust analysis. Antimicrobial activities were evaluated using the standard disc method and chloramphenicol as control. Results: The results revealed varying amounts of proximate nutrients (ash, fibre, moisture, carbohydrate, protein and fat) in both samples. Vitamin analysis showed the presence of vitamin A, total and soluble vitamin C, niacin, riboflavin and thiamin in both samples. Furthermore, both samples had minerals such as Na, K, CA, P, Mg, Zn, Fe, and Cu, and K, Na, Ca, Mg, P, Fe, Zn and Cu in order of decreasing abundance in the fruit pulp and leaves, respectively. Both samples showed the presence of permissible levels of anti-nutrients compared to edible vegetables. Using all three methods, several phytochemicals such as terpenes, alkaloids, flavonoids, polyphenol, organic and fatty acids, amongst other in various amounts were obtained in the samples. Antimicrobial activities against identified clinical isolates used in this study which were Escherichia coli, Staphylococcus aureus and Proteus spp with both extracts ranged from 12.78±0.03 to 17.34±0.34 mm. Conclusion: Given the rising cases of antimicrobial resistance and absence of newer antibiotics, the antimicrobial activity of our study plant is worth further evaluations.

Background Laparoscopic repair is a well-accepted treatment modality for perforated peptic ulcer (PPU). However, intraoperative conversion to laparotomy is still not uncommon. We aimed to identify preoperative factors strongly associated with conversion. Methods A retrospective review of records of all PPU patients treated between January 2011 and July 2019 was performed. Patients were divided into three groups: laparoscopic repair (LR), conversion to laparotomy (CL), and primary laparotomy (PL). Patient demographics, operative findings, and outcomes were compared between the groups. Logistic regression analyses were performed, taking conversion as the outcome. Results Of 822 patients, there were 236, 45, and 541 in the LR, CL, and PL groups, respectively. The conversion rate was 16%. Compared with those in the LR group, patients in the CL group were older (p p p p = 0.003). PULP score was the only independent risk factor for conversion. The area under the curve (AUC) for the PULP score to predict conversion was 75.3%, with a best cut-off value of ≥ 4. The operative time was shorter for PL group patients than for CL group patients with PULP scores ≥ 4. For patients with PULP scores Conclusion The PULP score may have utility in predicting and minimizing conversion for laparoscopic PPU repair. Laparoscopic repair is the procedure of choice for PPU patients with PULP scores

AIM To investigate the relationship between radiographically and macroscopically well-defined carious lesions and the dentine-pulp complex with regard to: (i) level of bacterial penetration; (ii) inflammatory status including the presence of hyperplastic pulp stroma; and (iii) formation of hard and/or ectopic connective tissue. METHODOLOGY The material comprised 68 untreated cavitated permanent teeth divided into well-defined radiographic categories based on the lesion penetration depth: (i) deep lesions ( ≥3/4 of the dentine thickness with a radio-dense zone separating the lesion from the pulp) and (ii) extremely deep lesions (the carious lesion penetrated the entire thickness of the dentine, without a radio-dense zone). After extraction, the teeth were processed for histology. The material was scored with regard to coronal breakdown, macroscopic variables describing caries activity and histological variables describing the dentine-pulp complex (bacteria, inflammatory infiltrate, partial pulp necrosis, hyperplastic changes and hard tissue/ectopic presence of connective tissue). Interrater agreement was assessed using Cohen's kappa. Associations between variables were assessed using Pearson's chi-squared or Fisher's exact test. The effect size was reported by odds ratio (OR) and associated 95% confidence interval (CI). Level of significance was set to 5%. RESULTS There were significant associations between a closed environment (1-2 surfaces involved) and the presence of biofilm, retrograde demineralization and light-coloured demineralized dentine. Whereas radiographically defined deep lesions tended to have bacteria only in the primary dentine (P < 0.001, OR = 20.55, 95% CI [4.44, 107.89]), extremely deep carious lesions tended to have bacteria in contact with the pulpal tissue (P = 0.007, OR = 6.84, 95% CI [2.00, 62.83]), presence of an inflammatory infiltrate (Fisher's exact; P < 0.001) and partial pulp necrosis. Hyperplastic pulps were seen only in extremely deep lesions. CONCLUSIONS Unlike deep lesions, extremely deep carious lesions were often associated with severe pulp inflammation and infection. A radiographic threshold between deep and extremely deep lesions is suggested as indicator of the bacterial penetration level and the severity of the pulpal response prior to intervention.

Background This study investigates the influence of insulin on pulp tissue healing after pulp capping in diabetic dogs. Methods Diabetes mellitus was induced in four dogs, and their blood glucose levels were adjusted by insulin to normoglycemic level in two dogs (normoglycemic group) and to hyperglycemic level in two dogs (hyperglycemic group). Class V buccal cavities were performed in 15 teeth in each diabetic dog and two normal dogs (control group). The three groups (30 teeth each) were divided according to the capping materials into three subgroups (10 teeth each) including: subgroup A - mineral trioxide aggregate (MTA), subgroup B - bioaggregate (BA), and subgroup C - calcium hydroxide (Ca(OH)2 ). Each subgroup was divided into two subdivisions according to the evaluation period, subdivision 1: 1 month and subdivision 2: 2 months. Qualitative and quantitative evaluations of the inflammation and dentine bridge formation were assessed histologically. Results The hyperglycemic diabetic group exhibited significant higher inflammatory cell count and scores and lower dentine bridge thickness than those of the normoglycemic diabetic and control groups (P .05). Conclusion Insulin has favourable effects on the pulp tissue healing after pulp capping in diabetic dogs.

Preserving the vitality of pulp can never be overemphasized. Conventionally, pulp exposures were root canal treated but it results in loss of vitality of pulp. Vital pulp therapy maintains tooth vitality, functionality and to render tooth asymptomatic. Pulpotomy using Calcium silicate based cements could be a good alternative for RCT for management of symptomatic mature permanent teeth with carious pulp exposure, however large scale clinical trials are highly encouraged to confirm this hypothesis. Keywords: Vital Pulp Therapy, Pulpotomy, Biodentine.

Orthodontic tooth movement (OTM) can be possibly be performed on endodontically treated teeth with remarkable outcomes. There is however a scarcity of adequate knowledge and data regarding the crisp association between endodontics and orthodontic treatment. This association comprises of various effects involving the pulp and periodontium that occurs as a result of orthodontic treatment. It is hence always suggested to apply adequate and appropriate amount of occasional forces that would bring about satisfactory tooth movement. This would in turn restrict pulpal damage, and also aid in its healing. Thus, proper evaluation of such endodontically treated case with a thorough clinical and radiographical assessment before orthodontic treatment is primarily important prior to orthodontic treatment. Hence, this review portrays a brief image about the various adverse effects of OTM on endodontically treated tooth. Keywords: Orthodontic tooth movement, Root resorption, Periodontium.

This article presents a literature review, the results of the analysis of random samples of third molars removed for various clinical indications (11 samples). The teeth samples were analyzed visually, then their coronal parts were treated with epoxy plastination technique and prepared polished sections were studied microscopically. The analyzed data demonstrate the pathogenesis of fissure caries in our samples studied can be explained in terms of the direct virulent effect of pathogenic bacteria on the organic matter in the superficial dentin and basal enamel with the formation of auto antigens, which, as a result of sensitization of the local immune system, become the initial source of the carious process spreading to other teeth. This gives grounds to identify it with the pathogenesis of autoimmune pathology. It has been established that carious damage to hard tissues on the smooth surfaces of the dental crown begins with the pulp, when it is vital, and stops as a result of its tissue degeneration. It has been shown that a single latent damage to the hard dental tissues is the initial manifestation of the latent stage of the carious process, while multiple defects indicate its further progression. As for the generally accepted classification of caries, according to which superficial, medium and deep caries are distinguished, then, in our opinion, they should be considered as stages of the further process of carious destruction of hard dental tissues. We can suggest the study of the pathogenesis of carious lesions of third molars is necessary in order to prevent the occurrence of autoimmune diseases and increase the effectiveness of their treatment.

The response of the dentin-pulp complex in rat teeth was investigated after direct capping with biodentine with or without bone marrow-derived stem cells (BMDSCs). Following mechanical exposure, pulps were randomly capped with one of the followings materials: calcium hydroxide, biodentine or 1 × 105 BMDSCs mL-1 + biodentine. Histological examination was performed by light microscopy after 1, 3 and 5 weeks. Inflammatory reaction, necrotic tissue formation and calcific bridge formation were scored. Analysis showed that compared with the effects of calcium hydroxide or biodentine, BMDSCs + biodentine substantially reduced inflammatory reaction and necrotic tissue while promoting calcified tissue formation. Therefore, the combination of biodentine and BMDSCs could potentially stimulate pulp tissue regeneration after direct pulp capping.

The present study aimed to identify proteins obtained from pulp tissue and correlate with each clinical diagnosis (healthy pulp, inflamed pulp, and necrotic pulp). A total of forty-five molars were used. Three biological replicas were evaluated. Lysis and sonication were used for protein extraction. Protein quantification was assessed by using the Bradford technique, and shotgun proteome analysis was performed by nanoUPLC-MSE using a Synapt G2 mass spectrometer. Mass spectra data were processed using the Waters PLGS software, and protein identification was done using the human Uniprot database appended to the PLGS search engine. A total of 123 different proteins were identified in all evaluated pulp conditions. Among these, 66 proteins were observed for healthy pulp, 66 for inflamed pulp, and 91 for necrotic pulp. Most protein identification was related to immune response, multi-organism process, platelet activation, and stress in inflamed pulp samples compared to healthy pulp. Proteins related to cellular component organization or biogenesis, developmental process, growth, immune response, multi-organism process, response to stimulus, signaling, stress, and transport were identified in cases of apical periodontitis compared to inflamed pulp. The progression of the disease to inflamed pulp promoted a high abundance of proteins related to the immune system and stress. Comparing the necrotic pulp with inflamed pulp conditions, a high abundance of proteins was noticed related to metabolism, transport, and response between organisms. This finding may assist in future studies of new markers, understanding of tissue engineering, and development of future products.

The calcified root canals cause many problems during endodontic treatment due to difficulty in canal orifice location, negotiation, preparation as well as consideration of operating time. Most serious problem may arise during any phase of root canal treatment procedure even taking a lot of precaution. Partial or total obliteration of pulpal chamber or root canal space is the most common consequences of a tooth which is exposed to traumatic injury. The most common presentation of such a tooth is complete or partial loss of the pulp space radiographically and discoloration particularly yellow discoloration of the clinical crown. Around 7–27% of teeth having the feature of partial canal calcification shows features of pulp necrosis accompanied by radiographic signs of chronic periapical periodontitis. Very low numbers of teeth( 2-3%) may present with total obliteration of pulp chamber and the root canal system . Teeth with such features is challenging to provide a successful root canal treatment; . In this case report a 21 years old female patient attended with complaints of discoloration , mild spontaneous pain , and several episodes of gingival swelling with history of trauma four years back in her both maxillary central incisors. The case was evaluated clinico radiographically and the diagnosis was a case of calcification both maxillary central incisors. Root canal treatment to manage the calcified canals following conventional technique was planned . After treatment patient was free from subjective and objective signs and symptoms and she was advised for periodic follow-up Update Dent. Coll. j: 2020; 10 (2): 21-25

The efficiency of extracts with antioxidant properties of plum pulp, black tea and green tea leaves was evaluated, analyzing the induction periods (IP) and rate constants (k) at 110 °C, in the 1st, 30th, 57th an 91st day of storage. Antioxidant activity was observed in all extracts, either by the rat constant decreased or by the induction period increase. The higher induction period obtained was 9.15 h for the black tea leaves extract while the lower was 6.97 h for the green tea leaves extract. The control had an average induction period of 6.95 h for the first day. The models obtained are significant and showed determination coefficients greater than 0.90 with no significance lack of fit at the level of 5%. The optimization with maximization of the induction period and minimization of the rate constant showed that the black tea extract was the most suitable to avoid oxidation. On the first day of test, the optimization indicates the mixture containing 50% of black tea and 50% of plum pulp extract as the best mixture. The optimizations provided a variation of 8.92

Odontoblast processes are thin cytoplasmic projections that extend from the cell body at the periphery of the pulp toward the dentin‐enamel junction. The odontoblast processes function in the secretion, assembly and mineralization of dentin during development, participate in mechanosensation, and aid in dentin repair in mature teeth. Because they are small and densely arranged, their three‐dimensional organization is not well documented. To gain further insight into how odontoblast processes contribute to odontogenesis, we used serial section electron microscopy and three‐dimensional reconstructions to examine these processes in the predentin region of mouse molars and incisors. In molars, the odontoblast processes are tubular with a diameter of ~1.8 μm. The odontoblast processes near the incisor tip are similarly shaped, but those midway between the tip and apex are shaped like plates. The plates are radially aligned and longitudinally oriented with respect to the growth axis of the incisor. The thickness of the plates is approximately the same as the diameter of molar odontoblast processes. The plates have an irregular edge; the average ratio of width (midway in the predentin) to thickness is 2.3 on the labial side and 3.6 on the lingual side. The plate geometry seems likely to be related to the continuous growth of the incisor and may provide a clue as to the mechanisms by which the odontoblast processes are involved in tooth development.

External root resorption (ERR) is often a complication of traumatic injury to the teeth. Traditionally, external inflammatory root resorption is treated with calcium hydroxide. The outcome of ERR, especially replacement resorption, is unpredictable. The purpose of the present case report was to describe regenerative endodontic procedures (REPs) for 1 replanted avulsed tooth with severe external root resorption and root perforation (tooth #9) and 1 extruded tooth (tooth #8). A 9-year-old girl was referred for the treatment of teeth #8 and #9 4 months after the initial trauma. Clinical examination showed that tooth #9 had a sinus tract present near the periapical area, was tender to percussion and palpation, and did not respond to pulp sensibility tests. Tooth #8 responded to pulp sensibility tests. Periapical radiographic and cone-beam computed tomographic examination showed that tooth #9 had a periapical radiolucent lesion and severe ERRs with a root perforation. Tooth #9 was diagnosed with a necrotic pulp and symptomatic apical periodontitis. Regenerative endodontic procedures (REPs) were initiated. Tooth #8 became nonresponsive to pulp sensibility tests and developed a periapical lesion 12 months after REPs of tooth #9 and was also treated with REPs. The clinical symptoms and apical lesions resolved for both teeth after REPs. The severe ERRs were arrested, and root perforation was repaired for tooth #9. Teeth #8 and #9 underwent canal obliteration by hard tissue formation after REPs and were in function at 18 months and 30 months, respectively. REPs may be used to manage traumatized immature permanent teeth with a necrotic pulp and apical periodontitis associated with severe ERR and root perforation.

Diabetes induces inflammation in the brain and kidneys; it is also known to be linked with changes in the expression and functionality of Kir channels. Diets rich in antioxidants (e.g., phenolic compounds) tend to reduce diabetes-related oxidative damage in several organs and the expression of K+ channels. We evaluated the effect of a diet supplemented with mango cv. ‘Ataulfo’ pulp and peel on the expression of the genes of K+ channels in the brain (hippocampus) and kidney of diabetic rats. Groups of experimental (streptozotocin, STZ-induced diabetes) male Wistar rats were fed with a diet supplemented with mango cv. ‘Ataulfo’ to evaluate, through end-point and quantitative PCR, what K+ channel genes change their expression in the hippocampus and kidneys. We found that mango supplementation produced significant differences in the relative mRNA expression of Kir6.2 (KCNJ11) in both tissues. In the kidney, the expression increased significantly, while in the hippocampus, mango supplementation decreased or increased it depending on when supplementation began, before or after diabetes was induced, respectively. Thus, mango supplementation in this diabetes model exerted significant qualitative and quantitative changes to the expression of K+ channels’ genes in the hippocampus and kidneys of rats with streptozotocin-induced diabetes.

It is well described that the presence of microbial flora in the pulp space of the tooth, and the inability of the immune system to remove these pathogens, are the major sources of peri-apical and radicular inflam-mation.1 Eradication of these pathogens from the pulp and root canal space by means of cleaning, shaping, disinfecting and complete obturation is necessary to safeguard the health of the periodontal tissues from endodontic infection and subsequent breakdown.2,3 The basic objectives of cleaning and shaping of root canals include: (1) removal of all infected soft and hard tissues; (2) creating space for delivery of disinfectants and medicaments to the apical part of the canal; (3) facilitating three dimensional obturation and (4) preservation of radicular structures.4 Even modern endodontic file systems leave untouched areas on the root canal walls after preparation and show compaction of hard tissue debris.5 This debris consists of pulp tissue remnants, bacteria and dentine chips of which most is found in the apical part of the prepared root canal system.6 Aiming for a centred preparation that corresponds to the original canal anatomy accompanied by the lowest amount of canal transportation, especially in middle and apical parts of curved canals, will result in the most favourable post instrumented canal shape. The four optimal canal shaping objectives are: (1) to have a tapered funnel from orifice to apex, (2) maintenance of original anatomical canal pathway, (3) apical foramen position should remain constant and (4) leaving the apical opening as small as possible.2,7

Pulpectomy is a procedure done for non-vital teeth which involves the extirpation of pulp from primary teeth and filling it with an inert substance. pulpectomy requires biomechanical preparation, but this biomechanical preparation alone is insufficient. Irrigants are used during this procedure for the purpose of lubrication, disinfection and washing away action. These irrigants penetrate the smaller accessory and lateral canals, thereby cleaning and disinfecting them. It is essential to eradicate the microorganisms and their by products from the root canal and pulp chamber. The aim of this study is to evaluate the most common irrigants used during pulp therapy in primary teeth by south indian dentists. Data was collected and tabulated. The collected data was further analyzed, recorded in Microsoft excel software and was subjected to statistical analysis using IBM SPSS statistics analyzer. The total sample size of the current study was 2400 cases. The most common age group of the patients who reported to the clinics were 0 to 5 years of age (69.1 %) (p < 0.05 - significant). The more common gender for using saline as an irrigant were male (57.7 %) (p < 0.05 - significant). We found that saline was the most commonly used irrigant (58.7 %), while sodium hypochlorite was the least commonly used (0.1 %). The most common visit for using saline as an irrigant were single visit (p < 0.05 - significant) followed by multi-visit. Within the limitations of the current study, saline was the most commonly used and sodium hypochlorite was the least commonly used for pulpectomy procedure in primary teeth. Saline was also commonly preferred for single visit in patients in the age group of 0 to 5 years.

Aim To investigate the effect of miR-223 on NLRP3, subsequently regulating the production of the NLRP3/CASP1 inflammasome pathway-mediated proinflammatory cytokines IL-1β and IL-18 in human dental pulp fibroblasts (HDPFs). \ud Methodology Human dental pulp tissue (HDPT) and HDPFs were obtained from impacted third molars. The miR-223 mimics and inhibitor or NLRP3 plasmid were used to upregulate or downregulate miR-223 or NLRP3 in HDPFs, respectively. Computational prediction via TargetScan 5.1 and a luciferase reporter assay were conducted to confirm target association. The mRNA and protein expression of NLRP3, caspase-1, IL-1β and IL-18 were determined by qRT-PCR and western blotting, respectively. The release of IL-1β and IL-18 was analyzed by ELISA. The significance of the differences between the experimental and the control groups was determined by using one-way analysis of variance, P

Objectives To investigate tooth ultrastructure and mutation of two patients in a family affected with osteogenesis imperfecta (OI) type IV and dentinogenesis imperfecta (DGI). Methods Mutations were detected by whole exome and Sanger sequencing. The permanent second molar obtained from the proband (DGI1) and the primary first molar from his affected son (DGI2) were studied for their color, roughness, mineral density, hardness, elastic modulus, mineral content, and ultrastructure, compared to the controls. Results Two novel missense COL1A2 variants, c.752C > T (p.Ser251Phe) and c.758G > T (p.Gly253Val), were identified in both patients. The c.758G > T was predicted to be the causative mutation. Pulp cavities of DGI1 (permanent teeth) were obliterated while those of DGI2 (primary teeth) were wide. The patients' teeth had darker and redder colors; reduced dentin hardness; decreased, disorganized, and scattered dentinal tubules and collagen fibers; and irregular dentinoenamel junction (DEJ), compared to controls. Lacunae-like structures were present in DGI2. Conclusions We reported the novel causative mutation, c.758G > T (p.Gly253Val), in COL1A2 for OI type IV and DGI. The DGI dentin demonstrated inferior mechanical property and ultrastructure, suggesting severe disturbances of dentin formation. These could contribute to fragility and prone to infection of DGI teeth. This study expands phenotypic and genotypic spectra of COL1A2 mutations.

Tooth infraction is usually of three types 1) confined to enamel (craze lines) and usually do not require treatment 2) related to cuspal fracture that typically do not involve pulp 3) more centrally located that do involve the pulp. Vertical root fracture (VRF) are longitudinal fracture that originate in root of teeth in contrast to tooth infraction that originate in the crown. VRF occurs usually in endodontically treated teeth. This case report represent tooth infraction originating in the tooth crown on the distal marginal ridge and propagating into the pulp chamber and DEJ(dentino enamel junction). Root canal treatment was performed and in a 7 month follow up period, there was a remarkable improvement in the supporting periodontal structures with bone deposition/remodelling in the crestal and furcation area/region and patient was quite satisfied with the treatment outcome. Keywords: Cracked teeth, Non vital teeth, Tooth infraction.

Background: The aim of this study was to evaluate tooth coronal index, bicervical diameter in mesiodistal direction & modified kvaal’s method of age estimation for age and gender determination. Materials and Methods: The digital panoramic radiographs of 200 subjects of aged 20-60 years were selected for the study. Tooth Coronal Index(TCI), height of the crown i.e Coronal Height(CH) and the height of the coronal pulp cavity i.e Coronal pulp cavity height (CPCH) of mandibular first molars was measured in millimeter(mm). Then TCI was calculated and calculated age was compared with chronological age. For pulp/tooth ratio, the measurements of Pulp Chamber Height (PCH) and Crown Root Trunk Height (CRTH) were performed on the mandibular first molar the pulp chamber crown root trunk height ratios (PCTHR) of selected tooth were calculated. Also the bicervical diameter in mesiodistal direction was measured. The measurements were performed on these JEPG images by using Digimizer 5.3 Software. The acquired data were subjected to Pearson correlation test, unpaired t test and Analysis of variance (ANOVA) analysis. Results: Results suggested that statistically significant differences were observed between chronological and calculated age with TCI for right mandibular molar, CPCH and Mesiodistal dimension where as CH shows negative correlation with chronological age. Keywords: Age estimation, Bicervical diameter, Panoramic radiograph, Pulp cavity height, Pulp/tooth ratio, Tooth coronal index.

AIM: To evaluate the efficacy of a prototype root canal dressing containing surface pre-reacted glass-ionomer (S-PRG) fillers on repairing induced periapical lesions in a rat model. Calcium hydroxide [Ca(OH)2 ] was applied as a comparison in the healing process. METHODOLOGY: The pulp chambers of the maxillary first molars in 64 male Wistar rats aged 16 weeks were opened to induce periapical lesions. After 28 days, the mesial canal of each tooth was prepared, irrigated with 2.5% sodium hypochlorite (NaOCl) only (control group: irrigation) or followed by the respective dressing [Ca(OH)2 group, irrigation + Ca(OH)2 ; S-PRG group, irrigation + S-PRG], and restored with composite resin for 3 or 7 days (10/group). Four rats with healthy molars were used as blank controls. Descriptive analysis of the periapical radiographs, haematoxylin and eosin staining, and immunohistochemical observation were performed 3 and 7 days after treatment. The periapical gray value, CD68 macrophages, and osteoclasts (cathepsin-K) were quantified and statistically analyzed with Tukey's honest significant difference test. A significant difference was achieved when p values were

The present study was aimed at investigating some biochemical properties and mineral contents in pulp, skin, and seeds of Carica papaya cv. solo 8 as a function of ripening stage. C. papaya cv. solo 8 fruits were obtained from a village plantation in Azaguié area’s (5° 38′ 00″ N and 4° 05′ 00″ W) in Côte d’Ivoire. Papaya fruits were harvested at four ripening stages especially unripe, 1/8 advanced, ¼ advanced and advanced. Skin, pulp and seeds were separated, and they were oven dried and ground to obtain the crude flour. Proximate composition and mineral contents were investigated using standard methods. Results showed significant differences in moisture dry matter, protein, carbohydrate, ash, crude fibre, and total sugar contents as a function of the ripening stage, and from a fruit part to another. Pulps exhibited the highest contents of moisture (93.67 %), carbohydrate (96.62 g / 100 g DW), total and reducing sugars (4.28 and 1.10 %, respectively) which increase during ripening. The better ash (0.86 %) and protein (21.52 %) contents were obtained in skin at the advanced stage. The highest crude fibre content was found in seeds at unripe stage (1.86 %) and the pulps recorded the lowest values (between 0.19 and 0.28 %). As concerned mineral elements, there were increase in potassium, phosphorus, calcium, and magnesium contents in skin during ripening, while these mineral contents decrease in seeds and pulp. Skin recorded highest content in potassium (2344.80 to 6865.50 mg /100 DW), phosphorus (691.51 to 1958.34 mg /100 DW), calcium (306.32 to 632.27 mg /100 DW), and magnesium (173.86 to 569.82 mg /100 DW) especially at ¼ advanced and advanced stages. Iron and zinc contents (respectively, 15.57 and 14.01 mg/ 100 g DW) were also greater in skin at advanced stages. All the parts of C. papaya cv. solo 8 fruit at different ripening stages, especially the skin would provide significant portion of the Recommended Daily Allowances of several nutrients.

Consumption of diets rich in fruits and vegetables bring substantial health benefits. Spondias cytherea is a plant belonging to the family of Anacardiaceae, the fruits are highly consumed in Cameroon and commonly known as “kassimango”. In this work, the antioxidant and cytotoxic activities of the aqueous extract of Spondias cytherea pulp was investigated. The antioxidant capacity was evaluated by DPPH (2,2-diphenyl-1-picryl-hydrazyl) ferric reducing antioxidant power (FRAP) and metal chelating power assays. The Total phenolic and flavonoid contents were determined by Folin-ciocalteu test and aluminum chloride colorimetric test respectively. Selenium, and Zinc contents were evaluated. The effect of S. cytherea fruit aqueous extract on cell cycle of B16-F10 skin cancer cells was investigated using propidium iodide staining. The results revealed that the extract was efficient in reducing Fe3+ into Fe2+ and its ion chelating power increased with the extract concentration. The IC50 value for DPPH radical was found to be 96.28 µg/ mL. Total phenolic and flavonoid contents of Spondias cytherea fruits were 649.45 ± 0.71 mg GAE/100 g and 86.69 ± 0.02 mg CE/100 g of dry matter respectively. As far as the tested minerals are concerned, S. cytherea fruit presented 4.48 mg/100 g of zinc and 0.86 µg/100 g of selenium. It was observed that S. cytherea fruit aqueous extract inhibit the proliferation of B16-F10 cancer cells by inducing the cell cycle arrest at Sub G0 phase (apoptotic phase), G0/G1 (proliferation phase) and G2/M phase (mitosis phase). These results indicated that Spondias cytherea fruit have antioxidant and can be used in the management of cancer pending on further researches.

The Bayesian approach is being a fundamental tool in forensic and legal field where inferences and decisions are made. In this study, a full Bayesian calibration model was developed to make probabilistic inferences about age estimation in a reference sample of 891 periapical X-rays of upper and lower canines. These teeth belonged to both deceased and living adult subjects, aged between 20 and 86 years, coming from five different countries (Turkey, Italy, Portugal, Japan and Mexico). For this purpose, the narrowing of pulp chamber due to the apposition of secondary dentine was analysed by means of the pulp/tooth area ratio. To determine the agreement of the method, intra- and inter-observer differences for measuring process were calculated by means of the intraclass correlation coefficient (ICC) analysis. Observer error tests showed excellent agreement between observers and between repeated assessments. According to the results of the ANCOVA, neither nationality nor sex was associated to the secondary dentine apposition while it is associated with individual’s age. The results of the present study indicated that the concept of probability is intrinsically linked to the assessment of age in a forensic context, and the Bayesian approach could be considered a robust tool to overtake the bias generated by traditional regression models, thus helping the decision-making process in a legal framework.

Aim To evaluate sources of student confidence and stress during the management of deep carious lesions and the exposed pulp during undergraduate clinics. Further aims were to identify barriers and facilitators, which could result in educational or practical improvements in the delivery of teaching and provision of treatment in this area. Methodology A exploratory qualitative study design was used, based on recorded focus group interviews, guided by 12 predetermined questions. The discussions were transcribed verbatim and analysed by inductive qualitative content analysis. Common categories were identified to aid understanding. Forty undergraduate dental students from 4th and 5th years in Dublin Dental University Hospital participated in the study. Results Student stress and confidence were multifactorial and broadly linked to specific domains: clinical procedure, academic education, clinical training, evaluation/grading, organization and equipment, vital pulp biomaterial and the patient. Most students expressed a preference for one-stage selective carious removal to soft dentine rather than potential pulp exposure in deep carious lesions, noting that although it helped to decrease their immediate stress, it also caused longer-term concern by leaving caries close to the pulp. Nevertheless, their confidence was affected by limited clinical experience of carrying out selective removal procedures in deep caries. A recurrent finding was students citing high levels of stress after pulp exposure. Feelings including anger, fear, embarrassment and denial were associated with pulp exposure during deep caries management. Generally, the students felt able to manage pulp capping procedures, but were less certain about partial pulpotomy, suggesting that although they are aware of its advantages, they were unsure about the appropriate volume of pulp tissue to remove. To reduce stress, students suggested that laboratory teaching should employ new 3-D printed solutions and clinics should establish clear consensus amongst supervising teachers about the best way to manage the exposed pulp. Conclusions Students lacked confidence as they neared the pulp and prefer selective caries removal techniques, which reduce the likelihood of pulp exposure. Students identified stressors and suggested improvements in several domains that would improve confidence. These ameliorations could lead to enhancements in student ability to perform these conservative techniques, and improve the provision of treatment in this area.