Pulpal injury: pathology, diagnosis and periodontal reactions

Surgical Anatomy and Microvascular Surgical Technique Relevant to Experimental Renal Transplant in Rat Employing Aortic and Inferior Venacaval Conduits

OBJECTIVES

Rat models of renal transplant are used to investigate immunologic processes and responses to therapeutic agents before their translation into routine clinical practice. In this study, we have described details of rat surgical anatomy and our experiences with the microvascular surgical technique relevant to renal transplant by employing donor inferior vena cava and aortic conduits.

MATERIALS AND METHODS

For this study, 175 rats (151 Lewis and 24 Fisher) were used to establish the Fisher-Lewis rat model of chronic allograft injury at our institution. Anatomic and technical details were recorded during the period of training and establishment of the model.

RESULTS

A final group of 12 transplanted rats were studied for an average duration of 51 weeks for the Lewis-to-Lewis isografts (5 rats) and 42 weeks for the Fisher-to-Lewis allografts (7 rats). Functional measurements and histology confirmed the diagnosis of chronic allograft injury.

CONCLUSIONS

Mastering the anatomic details and microvascular surgical techniques can lead to the successful establishment of an experimental renal transplant model.

Aspects of Solvent Chemistry for Calcium Hydroxide Medicaments

Calcium hydroxide pastes have been used in endodontics since 1947. Most current calcium hydroxide endodontic pastes use water as the vehicle, which limits the dissolution of calcium hydroxide that can be achieved and, thereby, the maximum pH that can be achieved within the root canal system. Using polyethylene glycol as a solvent, rather than water, can achieve an increase in hydroxyl ions release compared to water or saline. By adopting non-aqueous solvents such as the polyethylene glycols (PEG), greater dissolution and faster hydroxyl ion release can be achieved, leading to enhanced antimicrobial actions, and other improvements in performance and biocompatibility.

Dens Invaginatus of the Mandibular First Molars in a Dog

A 6-year-old dog was presented for draining tracts associated with both mandibular first molar teeth. Radiographs of the affected teeth showed periapical bone lysis. Surgical tooth extractions were performed and the tooth segments were submitted for histopathologic examination. Microscopic evaluation of the teeth showed in folding of the enamel and dentin consistent with a diagnosis of dens invaginatus. Examination performed 13-months following the extraction procedures indicated uncomplicated healing at the extraction sites and no other visible evidence of endodontic disease.

Effect of indomethacin-loaded nanocapsules incorporation in a dentin adhesive resin

OBJECTIVES

The aim of this study was to produce indomethacin-loaded nanocapsules (IndOH-NCs) and evaluate the influence of their incorporation into an adhesive resin.

MATERIALS AND METHODS

Indomethacin was encapsulated by the deposition of preformed polymer. IndOH-NCs were characterized by laser diffractometry, Fourier transformed infrared spectrometry, transmission electron microscopy (TEM), scanning electron microscopy, high-performance liquid chromatography (HPLC), and MTT assay. Nanocapsules (NCs) were incorporated into an adhesive in concentrations of 1, 2, 5, and 10 %. The addition was visualized by TEM and drug release was evaluated by HPLC until 120 h of immersion in simulated body fluid (SBF). Drug diffusion through dentin was tested using a Franz diffusion cell apparatus and quantified by HPLC. The degree of conversion (DC), softening in ethanol, and microtensile bond strength (μTBS) were evaluated to determine whether the nanocapsules influenced the adhesive. Data were analyzed using one-way ANOVA and Tukey's post hoc test for DC, softening in ethanol, μTBS, and cytotoxicity, and paired t test for comparison between the initial and final Knoop microhardness.

RESULTS

IndOH-NCs, with a spherical shape and a mean diameter of 165 nm, were incorporated into an adhesive. Indomethacin content was 7 mg drug/g powder. IndOH-NCs maintained high cell viability. At 120 h, an amount of 13.83 % of indomethacin was released, and after 7 days, 7.07 % of this drug was diffused through dentin for an adhesive containing 10 % of nanocapsules. No alteration in the DC, softening in ethanol, and μTBS resulted from NC addition.

CONCLUSIONS

IndOH-NCs may be incorporated into adhesive systems, without compromising properties, to add an anti-inflammatory drug controlled release for restorative procedures in deep cavities.

CLINICAL SIGNIFICANCE

Here is the first step toward the goal of providing agents to act at an inflammatory process of pulp tissue through dental adhesives via encapsulation of drug.

Dental pulp testing: a review

Dental pulp testing is a useful and essential diagnostic aid in endodontics. Pulp sensibility tests include thermal and electric tests, which extrapolate pulp health from sensory response. Whilst pulp sensibility tests are the most commonly used in clinical practice, they are not without limitations and shortcomings. Pulp vitality tests attempt to examine the presence of pulp blood flow, as this is viewed as a better measure of true health than sensibility. Laser Doppler flowmetry and pulse oximetry are examples of vitality tests. Whilst the prospect is promising, there are still many practical issues that need to be addressed before vitality tests can replace sensibility tests as the standard clinical pulp diagnostic test. With all pulp tests, the results need to be carefully interpreted and closely scrutinised as false results can lead to misdiagnosis which can then lead to incorrect, inappropriate, or unnecessary treatment.

Diagnosis and treatment planning are essential prior to commencing endodontic treatment: discuss this statement as it relates to clinical endodontic management

Diagnosis and treatment planning are essential to the practice of endodontics. Diagnosis aims to determine whether pathological involvement of the dental pulp has or is occurring. Treatment planning meanwhile, involves appropriately selecting cases, determining how difficult the treatment may be to perform on a specific individual and sequencing treatment procedures to achieve a healthy and functional dentition. In endodontic management, this may involve establishing whether the tooth is restorable and periodontally sound, the patient is able to tolerate the treatments and the clinician has the skills to perform the required treatment procedures. Careful consideration of these issues must be given prior to commencing treatment.