Regeneration of Secondary Dentin Using Recombinant Human Platelet-Derived Growth Factor and MTA for Pulp Capping: A Randomized Controlled Human Clinical Trial

Assessment of dentin mineral density of human teeth using micro-computed tomography in two kilovoltage levels

A significant advancement in micro-computed tomography (μCT) translational application in endodontics has occurred. The purpose of the study was to assess the applications of a new method to measure dentin mineral density (DMD) and to compare between 2 levels of energy sources. Two sets of standardized porous solid hydroxyapatite (HA) phantoms, with mineral densities of 0.25 g/cm3 and 0.75 g/cm3, respectively were embedded in aluminum foil. The μCT homogeneity and noise in the HA phantoms were analyzed using 50 kV and 100 kV energy sources. DMD of 66 extracted human teeth was measured at the cemento-enamel junction (CEJ), mid-root, and apical levels. Assessment included linearity between the energy source and the DMD measurement. The quality of the images obtained from the 2 energy sources was compared and analyzed statistically. HA phantom rods and validation methods showed that 100 kV provided a more accurate measurement of the DMD in all groups tested. The 100 kV 3D reconstructed µCT images displayed a more defined details of the dentin structure. A statistically significant difference was found between 100 and 50 kV (p < 0.05) in all measured areas except for the mid-root. Using micro-computed tomography is a practical and non-destructive method to measure dentin density. 100 kV energy source provides clearer and more consistent images.

Regenerative Endodontic Procedures in Immature Permanent Teeth With Dental Trauma: Current Approaches and Challenges

After dental trauma to immature permanent teeth (IPT), there can be pulpitis, necrotic, and periapical periodontitis, which will halt further root development. Traditional endodontic root canal treatments and apexification cannot revitalize the necrotic pulp to revitalize the tooth to promote further root development. As a consequence, IPT with thin dentinal walls can be prone to fracture and if a fracture occurs, the patient will likely suffer the loss of the tooth. In an attempt to save IPT, there has been a growing interest among dentists to use regenerative endodontic procedures (REPs) to revitalize a replace dental pulp to continue root development and strengthen the dentinal walls to help prevent a subsequent loss of the tooth. However, the effectiveness of REPs and the precise methods to successfully accomplish REPs are controversial. Therefore, the objective of this review is to compare the different approaches to REPs in case reports by highlighting their advantages and limitations.