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Sinha Y, Bhattacharjee D, Pradhan P, Tilokani A, Banka A. Platelet-Rich Fibrin: A Self-Derived Biomaterial for Surgical Treatment of a Periapical Lesion. Cureus 2024; 16:e64796. [PMID: 39156242 PMCID: PMC11329884 DOI: 10.7759/cureus.64796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2024] [Indexed: 08/20/2024] Open
Abstract
This case report explores the application of platelet-rich fibrin (PRF) as an autologous biomaterial in the surgical management of a periapical cyst in an 18-year-old female patient. The patient presented with pain, discoloration, and swelling in the maxillary left central incisor region, indicative of an asymptomatic periapical lesion associated with a history of trauma. Despite initial endodontic treatment with calcium hydroxide, the lesion persisted, necessitating surgical intervention. PRF, prepared from the patient's blood, was utilized during periapical surgery to promote healing and tissue regeneration. The surgical procedure included enucleation of the cyst, apicoectomy, and retrograde filling with Biodentine. Clinical and radiographic assessments at follow-up visits (three, six, and nine months post-surgery) revealed successful healing with no signs of inflammation or discomfort. The use of PRF demonstrated favorable outcomes in enhancing wound healing and maintaining a favorable environment for tissue remodeling. This case underscores the potential of PRF as an effective biomaterial in periapical surgery, advocating for its integration into dental therapeutic strategies for its regenerative properties and cost-effectiveness.
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Affiliation(s)
- Yash Sinha
- Department of Conservative Dentistry and Endodontics, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, IND
| | - Debangana Bhattacharjee
- Department of Conservative Dentistry and Endodontics, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, IND
| | - Prasanti Pradhan
- Department of Conservative Dentistry and Endodontics, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, IND
| | - Akansha Tilokani
- Department of Conservative Dentistry and Endodontics, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, IND
| | - Aanchal Banka
- Department of Conservative Dentistry and Endodontics, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, IND
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Dong X, Su Q, Li W, Yang J, Song D, Yang J, Xu X. The outcome of combined use of iRoot BP Plus and iRoot SP for root-end filling in endodontic microsurgery: a randomized controlled trial. Clin Oral Investig 2024; 28:188. [PMID: 38430316 DOI: 10.1007/s00784-024-05569-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 02/20/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVES Root-end filling is important for the clinical outcome of endodontic microsurgery. Our previous study showed that combined application of iRoot BP Plus Root Repair Material (BP-RRM) and iRoot SP Injectable Root Canal Sealer (SP-RCS) in root-end filling exhibited better apical sealing as compared to the application of BP-RRM alone. The aim of this randomized controlled clinical trial was to evaluate the effect of the combined use of BP-RRM and SP-RCS on the prognosis of teeth with refractory periapical diseases after endodontic microsurgery. MATERIALS AND METHODS 240 teeth with refractory periapical diseases scheduled for endodontic microsurgery were randomly divided into BP-RRM/SP-RCS group (n = 120) and BP-RRM group (n = 120). The patients were followed up at 3 months, 6 months, and 12 months after endodontic microsurgery. Pre- and post-operative clinical and radiographic examinations were performed to evaluate the treatment outcome. The 1-year success rate of endodontic microsurgery in BP-RRM/SP-RCS and BP-RRM groups was compared by Chi-square test. Factors that might impact the prognosis were further analyzed using Chi-square test or Fisher's exact test. RESULTS A total of 221 teeth completed the 12-month follow-up. The 1-year success rates of the BP-RRM/SP-RCS and BP-RRM groups were 94.5% (104/110) and 92.8% (103/111), respectively. The combined use of BP-RRM and SP-RCS achieved a clinical outcome comparable to BP-RRM alone (P = 0.784). Tooth type (P = 0.002), through-and-through/apico-marginal lesion (P = 0.049), periodontal status (P < 0.0001), and Kim's lesion classification (P < 0.0001) were critical factors associated with the 1-year success of endodontic microsurgery. CONCLUSIONS The combined use of BP-RRM and SP-RCS is a practicable method for root-end filling in endodontic microsurgery with a satisfactory 1-year clinical outcome. CLINICAL RELEVANCE The combined application of BP-RRM and SP-RCS in EMS is an effective root-end filling method with a satisfactory 1-year clinical outcome. TRIAL REGISTRATION This study was registered in the Chinese Clinical Trial Registry (ChiCTR2100052174).
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Affiliation(s)
- Xu Dong
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Stomatology, The First People's Hospital of Liangshan Yi Autonomous Prefecture, Xichang, China
| | - Qin Su
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wen Li
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jinbo Yang
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Dongzhe Song
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jing Yang
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Xu
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Khoswanto C, Dewi IK. MTA as modulator of periapical tissue healing in rat molar: A histological study. J Oral Biol Craniofac Res 2024; 14:201-204. [PMID: 38445049 PMCID: PMC10912688 DOI: 10.1016/j.jobcr.2024.02.006] [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: 01/16/2024] [Revised: 02/10/2024] [Accepted: 02/23/2024] [Indexed: 03/07/2024] Open
Abstract
Background Periapical surgery has been suggested as a treatment option for teeth with periapical lesions when those lesions continue despite receiving root canal therapy. Since sealing the apical region is the operation's primary goal, the choice of the root-end filling material affects how the surgery turns out. The retrofilling materials Zinc Oxide Eugenol (ZOE) and Mineral trioxide aggregate (MTA) are both known to have antibacterial characteristics. The purpose of this study is to determine how MTA affects as a Modulator of Periapical Tissue Healing through histological examination in Rat Molar. Methods A dental fissure bur measuring 0.7 mm is used to remove the buccal root apex from the buccal alveolar bone's surface, creating the cavity. One of the following is placed within each cavity: Group 1: MTA, Group 2: ZOE. For each material series, six samples were used. We classified the healing outcomes for each MTA and ZOE retrograde filling material into three groups based on histological analysis: the amount of newly generated bone, the number of fibroblasts, and the infiltration of neutrophils into the surgical site. Results On the 6th day of examination, fibroblasts were seen in the area around the wound. A significant inflammatory response, including neutrophil infiltration, was seen around the ZOE after retrograde filling. On the 16th day, the new alveolar bone structure showed a slight increase. After filling the MTA on the 6th day of examination, the immediate inflammatory response was insignificant. Neutrophils were observed to enter the region surrounding the retrofilled MTA, and a small number of osteoclasts were observed to be resorbing bone. Around the wound site, fibroblasts can also be detected. On the 16th day, unlike ZOE, a lot of new bone grows close to this material. Conclusion MTA has the ability to modulate periapical healing in rat molar.
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Affiliation(s)
- Christian Khoswanto
- Department of Oral Biology Faculty of Dentistry, Airlangga University, Surabaya, Indonesia
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López-García S, Rodríguez-Lozano FJ, Sanz JL, Forner L, Pecci-Lloret MP, Lozano A, Murcia L, Sánchez-Bautista S, Oñate-Sánchez RE. Biological properties of Ceraputty as a retrograde filling material: an in vitro study on hPDLSCs. Clin Oral Investig 2023; 27:4233-4243. [PMID: 37126146 PMCID: PMC10415505 DOI: 10.1007/s00784-023-05040-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 04/24/2023] [Indexed: 05/02/2023]
Abstract
OBJECTIVES To assess the cytocompatibility and bioactive potential of the new calcium silicate-based cement Ceraputty on human periodontal ligament stem cells (hPDLSCs) compared to Biodentine and Endosequence BC root repair material (ERRM). MATERIALS AND METHODS hPDLSCs were isolated from extracted third molars from healthy donors. Standardized sample discs and 1:1, 1:2, and 1:4 eluates of the tested materials were prepared. The following assays were performed: surface element distribution via SEM-EDX, cell attachment and morphology via SEM, cell viability via a MTT assay, osteo/cemento/odontogenic marker expression via RT-qPCR, and cell calcified nodule formation via Alizarin Red S staining. hPDLSCs cultured in unconditioned or osteogenic media were used as negative and positive control groups, respectively. Statistical analysis was performed using one-way ANOVA or two-way ANOVA and Tukey's post hoc test. Statistical significance was established at p < 0.05. RESULTS The highest Ca2+ peak was detected from Biodentine samples, followed by ERRM and Ceraputty. hPDLSC viability was significantly reduced in Ceraputty samples (p < 0.001), while 1:2 and 1:4 Biodentine and ERRM samples similar results to that of the negative control (p > 0.05). Biodentine and ERRM exhibited an upregulation of at least one cemento/odonto/osteogenic marker compared to the negative and positive control groups. Cells cultured with Biodentine produced a significantly higher calcified nodule formation than ERRM and Ceraputty (p < 0.001), which were also higher than the control groups (p < 0.001). CONCLUSION Ceraputty evidenced a reduced cytocompatibility towards hPDLSCs on its lowest dilutions compared to the other tested cements and the control group. Biodentine and ERRM promoted a significantly higher mineralization and osteo/cementogenic marker expression on hPDLSCs compared with Ceraputty. Further studies are necessary to verify the biological properties of this new material and its adequacy as a retrograde filling material. CLINICAL RELEVANCE This is the first study to elucidate the adequate biological properties of Ceraputty for its use as a retrograde filling material.
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Affiliation(s)
- Sergio López-García
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010, Valencia, Spain
| | - Francisco J Rodríguez-Lozano
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, 30008, Murcia, Spain
| | - José Luis Sanz
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010, Valencia, Spain.
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, C/ Gascó Oliag 1, 46010, Valencia, Spain.
| | - Leopoldo Forner
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010, Valencia, Spain
| | - María Pilar Pecci-Lloret
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, 30008, Murcia, Spain
| | - Adrián Lozano
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010, Valencia, Spain
| | - Laura Murcia
- Department of Health Sciences, Catholic University San Antonio of Murcia, 30107, Murcia, Spain
| | - Sonia Sánchez-Bautista
- Department of Health Sciences, Catholic University San Antonio of Murcia, 30107, Murcia, Spain
| | - Ricardo E Oñate-Sánchez
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, 30008, Murcia, Spain
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Dimitrova I, Kouzmanova Y. Impact of photodynamic therapy on the marginal adaptation of Biodentine used as root-end filling material. Biomed Mater Eng 2023; 34:277-287. [PMID: 36502301 DOI: 10.3233/bme-221469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The marginal adaptation of root-end filling materials and the effective antibacterial control in a surgical site are crucial for the successful outcome of endodontic surgery. OBJECTIVE This study aimed to evaluate the effect of retrograde application of photodynamic therapy on the marginal adaptation of Biodentine used as a root-end filling material. METHODS Twenty single-rooted anterior teeth were selected, instrumented and obturated with gutta-percha and AH Plus. The apical 3 mm of the roots were resected and root-end cavities were prepared with an ultrasonic retro-tip. The teeth were randomly divided into two groups (n = 10). In the first group, photodynamic therapy (PDT) was applied in the retrograde cavity prior to the root-end filling. In the second group retro cavity was filled without PDT. All specimens were obturated with Biodentine and afterwards sectioned longitudinally. The gap width at the material-dentin interface was measured using a scanning electron microscope. The results were statistically analyzed. RESULTS The produced gap width by Biodentine/PDT was 3.85 μm versus 2.68 μm in the Biodentine control group with significant differences in-between. CONCLUSION Under the conditions of this study, PDT has a negative effect on the marginal adaptation of Biodentine used as root-end filling material.
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Affiliation(s)
- Ivanka Dimitrova
- Department of Conservative Dentistry, Faculty of Dental Medicine, Sofia Medical University, Sofia, Bulgaria
| | - Yaneta Kouzmanova
- Department of Conservative Dentistry, Faculty of Dental Medicine, Sofia Medical University, Sofia, Bulgaria
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Chao YC, Chen PH, Su WS, Yeh HW, Su CC, Wu YC, Chiang HS, Jhou HJ, Shieh YS. Effectiveness of different root-end filling materials in modern surgical endodontic treatment: A systematic review and network meta-analysis. J Dent Sci 2022; 17:1731-1743. [DOI: 10.1016/j.jds.2022.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 05/20/2022] [Indexed: 10/18/2022] Open
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