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Biomedical subjects

C F Cox

Publications and source records attributed to C F Cox.

At least 19 recordsLinked to original sources

Reparative dentin: factors affecting its deposition.

Results of this study showed no correlation between the thickness or amount of reparative dentin deposited and the type of dental restorative material placed at either 5 or 8 weeks in controlled Class V cavity preparations in monkey teeth. Factors such as preparation trauma from the bur, operator hand instrumentation, and microleakage of bacterial toxins played a greater role in the stimulation of reparative dentin than did material irritation or toxicity. Some differences in the thickness of the reparative dentin deposited were noted when teeth were grouped according to the amount of remaining dentin.

Analysis of Variance

Microleakage related to restorative procedures.

A current Med-line search from 1966 to present cited over 344 juried publications employing the term microleakage. Dentistry recognizes microleakage as a multifaceted biological phenomenon. Brännström et al. (1967), Trowbridge (1982), Närhi (1983), and others have reported the sensory component of microleakage as a consequence of hydrodynamic fluid movement within the dentinal tubule complex. This movement of dentinal fluid has been demonstrated to displace nociceptive receptors which stimulate the nerves of the Group A fibers which run and terminate within the odontoblastic layer (see Matthews 1992). Penetration of oral fluids, bacteria and their toxic products within the preparation-material interface following material insertion accounts for the pathological component of microleakage (Browne and Tobias 1986). Continued microleakage of bacterial infiltrates eventually present as an inflammatory process which may initially signal the dentin complex to respond by deposition of a hypermineralized or sclerotic dentin. The pulp-dentin interface will repair with a specialized zone of reparative dentin. An overwhelming carious lesion often results in pulp infection and eventual necrosis. Vital dentin is an extension of the pulp, presenting the first line of defense to the consequences of microleakage. Recent publications have demonstrated that microleakage of dental materials in non-exposed and exposed pulps is a function of controlling bacterial infection. In an exposed mature dental pulp, the mesenchymal tissue permits the reorganization of pulp tissue and regeneration of a new dentin bridge in the presence of a biological seal. New odontoblastoid cells appear to regenerate from deeper pulpoblasts in the presence of various dental materials, apparently without an epithelial stimulating factor (Yamamura 1985). This inherent healing of the dental pulp and regeneration of a new dentin bridge is expressed in the presence of various dental materials, but only in the absence of bacterial infection. Data which evaluates the biological deposition of reparative and dentin bridges as either repair or regeneration are presented as a basis for considering the clinical selections of dental materials. Recent data demonstrate that dentin and pulp healing are ensured when a proper biological seal is provided to control and prevent microleakage.

Animals

Pulpal response to chemically cured and experimental light-cured glass ionomer cavity liners.

This investigation evaluated the effects of an experimental light-cured glass ionomer (LCGI) cavity liner and chemically cured Ketac-Bond glass ionomer restorative material on the pulpal tissues of monkeys. Class V cavities were prepared in 71 teeth of three adult Macaca mulatta monkeys at 7- and 35-day intervals. Ketac-Bond or LCGI cavity liners were placed in cavities with the smear layer intact (groups I and II) or with the smear layer removed (groups III and IV) and were restored with composite resin. Tissues were acquired, sectioned at 7 microns, stained for microscopic evaluation, or prepared for SEM evaluation. No statistically significant differences between materials existed at either time interval, regardless of smear layer presence. Histopathologic results demonstrated minimal pulpal reactions for groups I through IV. SEM analysis showed tenacious bonding of the LCGI material to prepared cavity walls, with absence of contraction gap formation. The results indicated excellent pulpal responses to both materials.

Acid Etching, Dental

Pulpal response to threaded pin and retentive slot techniques: a pilot investigation.

This investigation compared pulpal response to threaded pin techniques with response to retentive slot techniques. The teeth were restored with composite resin. Twenty-four teeth were assigned to three treatment groups in one Macaca mulatta monkey. Ten teeth (group 1) received 32 TMS 0.021-inch self-threading pins. Ten teeth (group II) received circumferential slot retention 1 mm deep, 0.5 mm inside the dentinoenamel junction. Four teeth (group III) served as controls. Groups I and II were restored with composite resin. Fourteen days later, the teeth were removed, demineralized, serially sectioned, and stained with hematoxylin and eosin. Chi-square analysis indicated more pulp inflammation when self-threading pins were used (p less than 0.5). Pins placed within 0.5 mm of the pulp elicited severe inflammatory responses, and those placed further than 1 mm had minimal effect. Little correlation existed between remaining dentin thickness and adverse pulp response when slot retention was used.

Animals

Healing of pulp exposures: an ultrastructural study.

The fine structure of tissue changes during the first 14 days following pulp exposure and capping with a hard setting Ca(OH)2 cement has been studied. The early changes included hemorrhage and moderate inflammation which were largely resolved during the first week. During the second week differentiation of cells occurred at the wound surface. These cells had the characteristic features of odontoblasts and formed a predentin-like collagen matrix. The capping material was closely adapted to cellular structures at the wound surface or to the predentin-like matrix at all observation periods. Dentin fragments displaced into the pulp tissue during cavity preparation, acted as sites for pulp stone formation.

Animals

Effects of lithotripter fields on development of chick embryos.

Chick embryos at 72 h incubation were subjected to three double shock waves from a Wolf Model 2137.50 Electrohydraulic Lithotripter. The pressure amplitude at the embryo was adjusted by variation of the distance from the source to the embryo. After a total of 120 h of incubation, they were assessed for developmental abnormalities. Early deaths, delayed deaths and malformations were all significantly increased at pressures of 10 MPa with suggestions of possible effects at lower pressure levels.

Animals

[Characterizing the smear layer].

The smear layer was first described as a debris layer which is left on all cavity walls following tooth preparation. It is composed of an outer contiguous layer of amorphous instrumentation matrix which covers all cavity walls, and a deeper zone of matrix plugs which obturate the cut tubules. Recent scanning electron microscopic (SEM) studies have characterized the smear layer as mineralized collagen fibers appearing as globules dispersed within an amorphous cutting matrix. Removal of smear plugs increases the outward hydraulic conductance (Lp) of dentinal fluid flow which may lead to dentinal hyperalgesia, bacterial infection and pulp pathosis if left untreated.

Collagen

[Microleakage: evaluation and treatment].

Microleakage is a biological phenomenon with several implications. The affective component patient hyperalgesia (pain/hypersensitivity) of dentin which is a function of episodic hydrodynan (fluid) movement. The effective component is the disease process which signals the dentin-pulp complex to respond by disposition of sclerotic and/or reparative dentin. Vital dentin is an extension the pulp, presenting the first line of response to the consequences of microleakage. Recent data has demonstrated a correlation between pulp response and material biocompatibility when microleakage is prevented. Dentin-pulp healing is ensured when a proper hermetic seal is provided to control prevent microleakage. A critical evaluation of various clinical procedures is discussed.

Dental Leakage

Inhibition of bacterial growth under composite restorations following GLUMA pretreatment.

The purpose of this investigation was to test in five adult monkeys the effects of a glutaraldehyde-containing dentin bonding agent, GLUMA, on bacterial colonization in Class V cavities restored with composite resin. Experimental groups consisted of immediate placement of GLUMA and composite resin as well as placement of GLUMA or Scotchbond (control) in acid-etched cavities that had been left open to the oral environment for 48 hours. Various procedures for pretreatment of the cavities were included. Tissue specimens were prepared for light microscopy for observation of bacterial presence and pulp tissue reactions after eight days and 90 days. Bacteria were not detected in any of the 54 cavities treated with GLUMA regardless of observation period or use of enamel-etching procedure prior to placement of composite resin. When cavities were restored with composite resin without prior GLUMA pretreatment or with Scotchbond, bacteria were present under the majority of restorations at both time intervals. Pulpal inflammation of varying extent and character was seen after eight days in teeth that had been previously infected. At 90 days, pulps showed repair and healing regardless of treatment protocol. Data indicate that GLUMA has a distinct in vivo antibacterial effect that seems to prevent bacterial growth in tooth/restoration interfaces.

Aldehydes

Intentional vital root transection: a 52-week histopathologic study in Macaca mulatta.

Past studies dealing with the vascular supply to surgically mobilized dentoalveolar segments have mentioned occasional encounters with vital root transection and have noted varying degrees of pulpal response to this insult. The purpose of this investigation was to observe the pulpal and periapical responses of monkey dental tissues to intentional vital root transection over a 1-year postoperative period. Four adult Macaca mulatta monkeys were used in this study. All roots were surgically transected within the apical third with a bur. Maxillary and mandibular quadrants for 1, 2, 3, 4, 6, 12, 24, and 52 weeks following surgery were obtained after the animals were killed by perfusion of the left ventricle. The tissue blocks were prepared by routine histologic methods. The results demonstrated a disruption of the normal pulpal architecture, with initial pulpal degeneration and subsequent early replacement by the periodontal ligament tissue. A cellular cemental lining of the root canal occurred in all specimens. The periodontal ligament-like tissue continued to deposit cementum, resulting in almost total obliteration of the root canal and pulp chamber and leaving an intact but much reduced blood supply to the pulp chamber containing periodontal tissues.

Animals

Pulp capping of dental pulp mechanically exposed to oral microflora: a 1-2 year observation of wound healing in the monkey.

Four adult Rhesus monkeys provided 120 teeth for buccal Class V cavities. Twenty-nine were non-exposed controls and 91 were exposed for 3 intervals. All 120 teeth were capped with a hard set Ca(OH)2 medicament, restored with amalgam, 57 evaluated after 1 year and 63 after 2 years. Of the 91 exposed pulps, 45 showed complete healing, 25 showed pulpal inflammation varying from acute to chronic, 12 showed severe pulpal breakdown and abscess formation and 9 were necrotic. No difference was observed in the healing response between the 3 exposure times. New hard tissue formed at, or subjacent to, the medicament in 77 of 91 exposed pulps with a tunnel defect frequently present, running from the medicament interface to the pulp. This study demonstrates that recurring pulp inflammation observed after 1 & 2 year direct pulp capping, is associated with bacterial contamination.

Animals

Vital apicoectomy of the teeth: a 1-4 week histopathological study in Macaca mulatta.

Several studies have reported devitalization of teeth following surgical procedures in the area of the root apices. The purpose of this investigation was to observe the 1-4-week wound healing pattern in monkey dental tissues following intentional vital apicoectomy (IVA). Two adult Macaca mulatta were used in this study. All of the teeth were surgically transected within the apical one-third with a bur. The soft tissues were then closed. At death, a maxillary and a mandibular quadrant for 1, 2, 3 and 4 weeks following surgery were obtained after vascular perfusion. Each quadrant was demineralized in EDTA, processed, serially sectioned at 7 microns and alternately stained with hematoxylin and eosin, Preece's modified trichome, and McKay's bacterial stains. Examination of sequential IVA cuts showed an initial disruption of the pulpal neurovascular supply resulting in pulpal necrosis. The pulpal tissues underwent a process of replacement with PDL-like connective tissues and deposition of cementum on all cut dentin surfaces of the tooth roots as well as in some of the pulp chambers. No abscesses, external resorption or ankylosis were found.

Alveolar Process