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Gonçalves MWA, Souza MRF, Becheleni MT, Galvão EL, Al-Moraissi EA, Falci SGM. Does cyanoacrylate have the best postoperative outcomes after third molar extractions when compared to conventional sutures? A systematic review and meta-analysis. Heliyon 2024; 10:e23058. [PMID: 38163159 PMCID: PMC10755274 DOI: 10.1016/j.heliyon.2023.e23058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 10/30/2023] [Accepted: 11/24/2023] [Indexed: 01/03/2024] Open
Abstract
Purpose Tissue synthesis is extremely important for the attenuation of postoperative discomforts, as it keeps the tissues coapted, accelerates the healing process, and reduces the bleeding period of the surgical wound. Thus, this study aimed to systematically review the results of clinical trials that compared the use of cyanoacrylate with conventional sutures after third molars extraction. Materials and methods Searches were conducted on MEDLINE (via PubMed), Cochrane Central Registry of Controlled Trials (CENTRAL), Virtual Health Library (VHL), and Web of Science. Articles published up to February 20, 2022, were included. No restrictions were imposed on data or language of publication. Results A total of 8 studies (5 randomized controlled trials and 3 non-randomized comparative clinical studies) were included in this review and five studies were included in the meta-analysis, comprising 440 patients. The use of cyanoacrylate promoted better results in pain reduction in the first postoperative day when compared to the use of conventional suture (SMD: -1.01; 95%CI -1.90 to -0.12). Cyanoacrylate group promoted significant but borderline edema reduction compared to conventional sutures in the 7th postoperative day (SMD: -0.24, 95%CI -0.46 to -0.01, I2 = 0 %). For the trismus outcome, in all periods evaluated no differences were found between the groups. Conclusion Although promising results, there is no high-quality evidence to suggest the use of cyanoacrylate was better than conventional sutures.
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Affiliation(s)
| | - Marina Rocha Fonseca Souza
- Department of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Marco Túllio Becheleni
- Department of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Endi Lanza Galvão
- Department of Physical Therapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Essam Ahmed Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Thamar, Yemen
| | - Saulo Gabriel Moreira Falci
- Department of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
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Hammouda DA, Mansour AM, Saeed MA, Zaher AR, Grawish ME. Stem cell-derived exosomes for dentin-pulp complex regeneration: a mini-review. Restor Dent Endod 2023; 48:e20. [PMID: 37284341 PMCID: PMC10240090 DOI: 10.5395/rde.2023.48.e20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/12/2023] [Accepted: 03/22/2023] [Indexed: 06/08/2023] Open
Abstract
This mini-review was conducted to present an overview of the use of exosomes in regenerating the dentin-pulp complex (DPC). The PubMed and Scopus databases were searched for relevant articles published between January 1, 2013 and January 1, 2023. The findings of basic in vitro studies indicated that exosomes enhance the proliferation and migration of mesenchymal cells, as human dental pulp stem cells, via mitogen-activated protein kinases and Wingless-Int signaling pathways. In addition, they possess proangiogenic potential and contribute to neovascularization and capillary tube formation by promoting endothelial cell proliferation and migration of human umbilical vein endothelial cells. Likewise, they regulate the migration and differentiation of Schwann cells, facilitate the conversion of M1 pro-inflammatory macrophages to M2 anti-inflammatory phenotypes, and mediate immune suppression as they promote regulatory T cell conversion. Basic in vivo studies have indicated that exosomes triggered the regeneration of dentin-pulp-like tissue, and exosomes isolated under odontogenic circumstances are particularly strong inducers of tissue regeneration and stem cell differentiation. Exosomes are a promising regenerative tool for DPC in cases of small pulp exposure or for whole-pulp tissue regeneration.
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Affiliation(s)
- Dina A. Hammouda
- Department of Oral Biology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Alaa M Mansour
- Department of Oral Biology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Mahmoud A. Saeed
- Department of Oral Biology, Faculty of Dentistry, Menoufia University, Shibin el Kom, Egypt
| | - Ahmed R. Zaher
- Department of Oral Biology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Mohammed E. Grawish
- Department of Oral Biology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
- Department of Oral Biology, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Dakahlia, Egypt
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A comparative histological study of the effect of TheraCal LC and biodentine on direct pulp capping in rabbits: an experimental study. Clin Oral Investig 2023; 27:1013-1022. [PMID: 35947203 PMCID: PMC9985587 DOI: 10.1007/s00784-022-04658-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/30/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This study histologically compared the effect of TheraCal LC and biodentine on direct pulp capping using a rabbit model. MATERIALS AND METHODS A direct pulp capping procedure was performed on 40 mandibular central incisors of 20 healthy, male New Zealand white rabbits. TheraCal LC and biodentine were applied to exposed pulp and 10 randomly selected rabbits were euthanized after the first and second week. Incisors were extracted and prepared for histological processing and examination to check the dentine bridge thickness, continuity, and extent of pulp inflammation. A blinded data analysis was performed, and groups were compared using a Wilcoxon signed-rank test while changes across time within each group were assessed using the Mann-Whitney U test. RESULTS When comparing the dentine bridge thickness, biodentine showed a significantly thicker dentine bridge in the first and second week (mean 28.16 µm, 33.66 µm), while TheraCal LC showed a dentine bridge in the second week only (mean 15.93 µm). Regarding dentine bridge continuity, biodentine showed a significantly better dentine bridge in the first week. Additionally, there was no difference in the second week. Furthermore, there was no statistically significant difference between each of the materials regarding the extent of inflammation. CONCLUSIONS Biodentine in vivo showed better results concerning thickness and continuity of the dentine bridge after direct pulp capping in rabbit incisors. Both biodentine and TheraCal LC had a similar inflammatory effect on the pulp. CLINICAL RELEVANCE Biodentine is more successful as a direct pulp capping material compared to TheraCal LC.
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Veríssimo AH, Ribeiro AKC, Martins ARLDA, Gurgel BCDV, Lins RDAU. Comparative analysis of the hemostatic, analgesic and healing effects of cyanoacrylate on free gingival graft surgical wounds in donor and recipient areas: a systematic review. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2021; 32:98. [PMID: 34406492 PMCID: PMC8373739 DOI: 10.1007/s10856-021-06573-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 06/14/2021] [Indexed: 06/13/2023]
Abstract
UNLABELLED To analyze the hemostatic, Dsurgical wounds in donor and recipient areas of free gingival grafts (FGG). Five databases (PubMed, Scopus, Science Direct, Cochrane and Web of Science) were searched up to March 2021 (PROSPERO CRD42019134497). The focus of the study (cyanoacrylate) was combined with the condition (periodontal surgery OR free gingival graft OR free soft tissue graft OR autografts), and outcome (healing OR epithelialization OR pain OR analgesia OR bleeding OR hemostasis OR hemostatic). Studies reporting cyanoacrylate isolated or associated with another substance in FGG stabilization and closure were investigated and assessed for the quality and risk of bias through the Cochrane Manual. Six studies with 323 participants were included. Evaluation of the quality and risk of bias highlighted a low risk for four articles, intermediate for one and unclear for another. The use of cyanoacrylate associated or not with the hemostatic sponge or the platelet-rich fibrin was more effective in healing (three studies), analgesia (four studies), and hemostasis in one study (p < 0.05). However, groups with the association in cyanoacrylate showed superior healing, and analgesic action to the isolated cyanoacrylate group. In addition, two studies demonstrated that cyanoacrylate use reduces surgery duration, one study showed that it reduces postoperative sensibility, and another present hemostatic effect (p < 0.05). There is scarce literature for the use of cyanoacrylate in FGG wounds indicates that it can promote a minor inflammatory response, reduce operation time, does not interfere with healing, relieves postoperative discomfort, and suggests the possibility immediate hemostasis. Its use presents an alternative to suturing in FGG surgeries. But, the limited number of cases and the relative heterogeneity of the included studies suggest caution in generalizing the indication. CLINICAL RELEVANCE Cyanoacrylate seems to present analgesic effects and less pain when applied to wound closure and covering donor and recipient areas reducing the need for postoperative analgesic medication; and has a healing effect in the closure of the donor area on the palate. In addition, it can reduce bleeding time after surgery, and prevents late bleeding during the first postsurgical week. Scientific justification: To evaluate the hemostatic, analgesic and healing actions of cyanoacrylate compared to the suture thread and other agents when used to close surgical wounds from periodontal free gingival graft surgical wounds in both the donor and recipient areas of the graft. MAIN FINDINGS The use of cyanoacrylate individually or in association with wound dressing agents presents analgesic effects because the patient reports less pain experienced when cyanoacrylate is applied to the wound closure and covering, thereby reducing the need for postoperative analgesic medication. In addition, a healing effect is observed in the closure of the donor area on the palate; as well as it seems to present hemostatic effects, reducing the bleeding time after surgery, and preventing late bleeding during the first postsurgical week. PRACTICAL IMPLICATIONS Dentists may cautiously apply cyanoacrylate after periodontal surgeries for free gingival graft in both the donor and recipient areas of the graft. However, they must consider the limitations of the surgery, tension-free positioning, the patient's dyscrasia and postoperative care, constituting a set of predictors for adequate clinical decision-making. Widespread use of such material for all patients and surgical configurations may not be recommended.
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Affiliation(s)
- Aretha Heitor Veríssimo
- Department of Dentistry, Federal University of Rio Grande do Norte (UFRN), Av. Salgado Filho, 1787, Lagoa Nova, Natal, 59056-000, Brazil.
| | - Anne Kaline Claudino Ribeiro
- Department of Dentistry, Federal University of Rio Grande do Norte (UFRN), Av. Salgado Filho, 1787, Lagoa Nova, Natal, 59056-000, Brazil
| | - Ana Rafaela Luz de Aquino Martins
- Department of Dentistry, Federal University of Rio Grande do Norte (UFRN), Av. Salgado Filho, 1787, Lagoa Nova, Natal, 59056-000, Brazil
| | - Bruno Cesar de Vasconcelos Gurgel
- Department of Dentistry, Federal University of Rio Grande do Norte (UFRN), Av. Salgado Filho, 1787, Lagoa Nova, Natal, 59056-000, Brazil
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Abdelaz P, ElZoghbi A, Shokry M, Ahmed AZ, Rasha H. Reparative Dentin Formation Using Stem Cell Therapy versus Calcium Hydroxide in Direct Pulp Capping: An Animal Study. Braz Dent J 2019; 30:542-549. [PMID: 31800747 DOI: 10.1590/0103-6440201902711] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 04/17/2019] [Indexed: 01/09/2023] Open
Abstract
Direct pulp capping process is a therapeutic method aimed at maintenance of pulp vitality and health by using a biocompatible material placed directly over the exposed pulp. The aim of this study was to evaluate and compare the effect of direct pulp capping procedures by dental pulp stem cells (DPSCs) or calcium hydroxide on dentin tissue formation. Three mongrel dogs were used as experimental model. Two access cavities were prepared in the right and left mandibular fourth premolars in all dogs to expose and extirpate the pulp tissues which were processed in the lab to obtain a single-cell suspensions. The isolated cells were cultures in odontogenic medium for subsequent differentiation. The maxillary teeth (3 incisors and one canine) of the corresponding dog number were subjected to class V cavities to expose their pulps which were assigned into 2 groups of 12 teeth each ( group I - pulp capping with calcium hydroxide) and (group II - pulp capping with dental stem cells DPSCs). The operated teeth were collected after 3 months and processed for histological and electron microscopic examinations. Specimens were subjected to elemental analysis of calcium and phosphorus. EDX elemental analysis revealed significant differences in the calcium and phosphorous wt, % in the reparative dentin of calcium hydroxide treated group which confirmed histologically. Direct pulp capping by DPSCs has shown promising generative potential for regaining normal dentin.
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Affiliation(s)
- Possy Abdelaz
- Department of Conservative Dentistry, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Amira ElZoghbi
- Department of Conservative Dentistry, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Mohamed Shokry
- Department of Surgery, Anesthesiology ?αμπ; Radiology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Abo-Zeid Ahmed
- Basic Dental Sciences, Dental Research Division, National Research Center, Giza, Egypt
| | - Hassan Rasha
- Department of Conservative Dentistry, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Promotion of Dental Pulp Wound Healing in New Zealand White Rabbits’ Teeth by Thai Propolis Product. J Vet Dent 2018; 36:17-24. [DOI: 10.1177/0898756418818891] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This study examined and compared wound healing between Thai propolis product and calcium hydroxide paste as pulp-capping agents after partial pulpotomy in New Zealand white rabbits. Forty incisor teeth from 10 rabbits were treated. Thirty-six teeth received class V cavity preparations with partial pulpotomy and application of either propolis or calcium hydroxide paste. Similar cavity preparations were performed in 2 teeth without any capping material as a positive control, whereas 2 teeth without the cavity preparation served as a negative control. Histological evaluation showed that both groups had dentin bridge formation. Dentinal tubules in the dentin bridge were more orderly arranged in the Thai propolis group than in the calcium hydroxide group. Wound healing and the median number of hyperemic blood vessels were not statistically significant different between the 2 groups. Thai propolis product may be used as a pulp-capping agent.
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Cavity Adaptation of Water-Based Restoratives Placed as Liners under a Resin Composite. Int J Dent 2017; 2017:5957107. [PMID: 28465685 PMCID: PMC5390628 DOI: 10.1155/2017/5957107] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 03/15/2017] [Indexed: 12/27/2022] Open
Abstract
Purpose. To investigate the cavity adaptation of mineral trioxide (ProRoot MTA/MT), tricalcium silicate (Biodentine/BD), and glass ionomer (Equia Fil/EF) cements used as liners and the interfacial integrity between those liners and a composite resin placed as the main restorative material. Materials and Methods. Standardized class I cavities (n: 8 per group) were prepared in upper premolars. Cavities were lined with a 1 mm thick layer of each of the tested materials and restored with Optibond FL adhesive and Herculite Precis composite resin. Cavity adaptation of the restorations was investigated by computerized X-ray microtomography. The regions of interest (ROI) were set at the cavity-liner (CL) interface and the liner-resin (LR) interface. The percentage void volume fraction (%VVF) in the ROI was calculated. The specimens were then sectioned and the interfaces were evaluated by reflection optical microscopy, to measure the % length (%LD) of the interfacial gaps. Selected samples were further evaluated by scanning electron microscopy. Statistical analysis was performed by two-way ANOVA and Student-Newman-Keuls multiple comparison test (a = 0.05). Results. MT showed significantly higher %VVF and %LD values in CL interfaces than BD and EF (p < 0.05). No significant differences were found among the materials for the same values at the LR interfaces. Conclusions. When used as a composite liner, ProRoot MTA showed inferior cavity adaptation at dentin/liner interface when compared to Biodentine and Equia Fil.
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AlShwaimi E, Majeed A, Ali AA. Pulpal Responses to Direct Capping with Betamethasone/Gentamicin Cream and Mineral Trioxide Aggregate: Histologic and Micro–Computed Tomography Assessments. J Endod 2016; 42:30-5. [DOI: 10.1016/j.joen.2015.09.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 09/24/2015] [Accepted: 09/25/2015] [Indexed: 10/22/2022]
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Bhat SS, Hegde SK, Adhikari F, Bhat VS. Direct pulp capping in an immature incisor using a new bioactive material. Contemp Clin Dent 2014; 5:393-6. [PMID: 25191081 PMCID: PMC4147821 DOI: 10.4103/0976-237x.137967] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Preservation of the pulp in a traumatized immature fractured incisor tooth is of prime importance in order to achieve apexogenesis, a natural apical closure. The main factor influencing this is pulpal protection by a bioactive material proving optimum marginal seal in preventing any microleakage. This case report presents an 8-year-old female diagnosed with Ellis Class 3 fracture of immature tooth 11 involving the mesial pulp horn. Under rubber dam isolation, a partial pulpotomy was performed and the pulp was sealed using a new bioactive material BIODENTINE to stimulate apexogenesis, dentine replacement and pulp protection. The fractured segment was reattached for optimum esthetics, which was a concern for the patient. The patient was followed-up for 1, 3, 6 and 12 months, which revealed continued apical closure and maintenance of pulp vitality. The patient remained asymptomatic. This case report provides evidence for the potential use of Biodentine as an effective pulp capping material in the future.
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Affiliation(s)
- Sham S Bhat
- Department of Paedodontics and Preventive Dentistry, Yenepoya Dental College, Mangalore, Karnataka, India
| | - Sundeep K Hegde
- Department of Paedodontics and Preventive Dentistry, Yenepoya Dental College, Mangalore, Karnataka, India
| | - Fardin Adhikari
- Department of Paedodontics and Preventive Dentistry, Yenepoya Dental College, Mangalore, Karnataka, India
| | - Vidya S Bhat
- Department of Prosthodontics, Yenepoya Dental College, Mangalore, Karnataka, India
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