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Biomedical subjects

D E Witherspoon

Publications and source records attributed to D E Witherspoon.

15 recordsLinked to original sources

Coronal leakage following three obturation techniques.

AIM: To compare coronal bacterial and India ink leakage in three different obturation techniques with the smear layer having been removed. METHODOLOGY: Seventy extracted single-rooted teeth were instrumented to an apical preparation size 7 Profile Series 29 (Tulsa Dental Products, Tulsa, OK, USA). The smear layer was removed and 20 teeth were randomly obturated with lateral compaction, 20 teeth with vertical compaction, and 20 teeth with Thermafil (Tulsa Dental Products, Tulsa OK, USA). Ten teeth were used for positive (five teeth) and negative (five teeth) controls. Teeth were stored for 90 days in 100% humidity, then subjected coronally to Proteus vulgaris for 21 days to assess bacterial leakage. Following bacterial challenge, India ink was placed coronally for a further 21 days, then scored according to depth of dye leakage. RESULTS: Vertical compaction leaked significantly less than lateral compaction during bacterial challenge. However, when dye was used there were no significant differences. CONCLUSIONS: Bacterial leakage and dye leakage demonstrated considerable variability. The use of a dye following bacterial testing may highlight the failure of experimental devices and vertical root fractures, thus avoiding false positive results found with bacterial testing alone.

Carbon↗

The effect of FIV infection on CD4+ and CD8+ counts in periradicular lesions.

AIM: The purpose of this study was to elucidate whether a decrease/increase in T-cell populations is present in the development of periradicular disease in the immunocompromised feline model. METHODOLOGY: Eight cats were immunosuppressed with steroids prior to infection with feline immunodeficiency virus (FIV). Another eight cats, age and sex matched littermates, were monitored and tested at equivalent periods of time and served as uninoculated, seronegative controls. Periradicular lesions were induced using local bacterial inoculations into the pulp of the canine teeth and assessed after one- and four-week periods, corresponding to the acute and chronic stages of the periradicular disease. Block sections were obtained and specimens were prepared for H & E and immunohistochemical staining for CD4+ and CD8+ receptors. Cells were quantified using a computer imaging system and data analysed using generalized estimating equation (GEE) regression models. RESULTS: Significantly lower CD4+ counts and CD4+/ CD8+ ratios were observed at all time periods in the periradicular region of the FIV group (P = 0.0006). No significant difference in CD8+ counts was observed between the two groups. In both groups there was a significant difference in the CD4+ counts between one week and baseline, and 1 week and 4 weeks. There was no significant difference between baseline and 4 weeks for either group. CONCLUSION: FIV infection reflected decreased CD4+ counts at the periradicular level, however, inflammation and progression of the lesion, appeared to be comparable to the non-immunocompromised controls.

Animals↗

Histologic assessment of healing after the use of a bioresorbable membrane in the management of buccal bone loss concomitant with periradicular surgery.

Histological and morphometric assessment of periradicular wound healing was made after the use of a bioresorbable membrane over a buccal dehiscence. The third and fourth premolar teeth of nine dogs were resected and buccal defects created. Teeth were assigned randomly to the membrane or control group. One tooth in each quadrant received a membrane, covering both roots. The other tooth received no further treatment and served as a control. The animals were killed and specimens were assessed at two time periods: 9 wk and 27 wk. The 27-wk membrane group exhibited significantly more (p = 0.004) connective tissue height than the control group or either of the 9-wk groups. The amount of regenerated alveolar bone was significantly greater for the 27-wk membrane group than for the control (p = 0.001) and 9-wk groups. Mean junctional epithelium measurements were significantly greater (p = 0.012) for the control. The use of a bioresorbable membrane enhances bone regeneration when a buccal defect exists at the time of periradicular surgery.

Absorbable Implants↗

Feline immunodeficiency virus model to study human immunodeficiency virus/acquired immune deficiency syndrome conditions.

This study was designed to induce rapid progression of the feline immunodeficiency virus (FIV) infection in cats. Predictably inducing the FIV disease state in the cat would yield an excellent tool to study endodontic disease processes under immunosuppressed conditions. Eight cats were immunosuppressed with steroids before infection with FIV. Another eight cats, age- and sex-matched littermates, served as uninoculated seronegative controls. Complete blood counts were taken for 10 mo in the FIV group, and 10 wk in the control group, including lymphocyte subsets. ELISAs were used to detect FIV infection. Statistical analysis was performed with generalized estimating equation models. All cats were positive at one point in time. The FIV group had significantly lower peripheral blood CD4+ counts compared with the control group. Therefore the FIV model presented gives the desired outcome and simulates what occurs in human immunodeficiency virus infection.

Acquired Immunodeficiency Syndrome↗

Interleukin-1beta production in periradicular lesions in a human immunodeficiency virus/acquired immune deficiency syndrome model compared with a noninfected host.

This study elucidates the role of interleukin-1 (IL-1) in developing periradicular lesions in immunocompetent and immunocompromised (human immunodeficiency virus/acquired immune deficiency syndrome) hosts. Eight cats were immunosuppressed with steroids before infection with feline immunodeficiency virus (FIV). Eight uninoculated cats served as controls. Periradicular lesions were induced around the canine teeth. At 1 and 4 wk periradicular exudate was sampled via the root canals. IL-1beta levels were measured with ELISA. Data were analyzed using the Mann-Whitney U test and the Wilcoxon signed rank test. Statistically significant differences existed in cytokine levels between the FIV and non-FIV groups (p < 0.001). Cytokines were below detectable levels in the FIV group. A significant decrease in IL-1beta levels at 4 wk compared with 1 wk occurred in the non-FIV group (p < 0.05). In conclusion decreased IL-1beta production was obtained in the FIV group. In the non-FIV group decreases in IL-1beta levels were encountered at the chronic stage of the periradicular lesion compared with the acute stage.

Acute Disease↗

Calcific metamorphosis: a challenge in endodontic diagnosis and treatment.

Calcific metamorphosis (CM) is seen commonly in the dental pulp after traumatic tooth injuries and is recognized clinically as early as 3 months after injury. Calcific metamorphosis is characterized by deposition of hard tissue within the root canal space and yellow discoloration of the clinical crown. Opinion differs among practitioners as to whether to treat these cases upon early detection of CM or to observe them until symptoms or radiographic signs of pulpal necrosis are detected. In this review, the clinical, radiographic, and histopathologic appearance of CM is described; a review of the literature is presented to address these issues in an attempt to establish a sound rationale for treatment. Approximately 3.8% to 24% of traumatized teeth develop varying degrees of CM. Studies indicate that of these, approximately 1% to 16% will develop pulpal necrosis. Most of the literature does not support endodontic intervention unless periradicular pathosis is detected or the involved tooth becomes symptomatic. It may be advisable to manage cases demonstrating CM through observation and periodic examination.

Dental Pulp Calcification↗

One-visit apexification: technique for inducing root-end barrier formation in apical closures.

Numerous procedures and materials have been utilized to induce root-end barrier formation. Mineral trioxide aggregate (MTA) was introduced to dentistry as a root-end filling material. It has been advocated for filling root canals, repairing perforations, pulp capping, and root-end induction. Mineral trioxide aggregate reacts with tissue fluids to form a hard tissue apical barrier. As a result, MTA shows promise as a valuable material for use in one-visit apexification treatment, primarily for treating immature teeth with necrotic pulps.

Aluminum Compounds↗

Analysis of the healing response to gutta-percha and Diaket when used as root-end filling materials in periradicular surgery.

AIM: To analyse the healing response to gutta-percha and Diaket when used as root-end filling materials in periradicular surgery. METHODOLOGY: Periradicular surgery was completed using the mandibular second, third and fourth premolar teeth from nine male mongrel dogs. The six roots on one side of the mouth were randomly allocated to one of the following groups: group A: a resected root end and a burnished gutta-percha root filling; group B: cavities were prepared to a depth of 4.0 mm, using ultrasonic root-end preparation and filled with Diaket. The response was evaluated histologically at 55 (nine specimens) and 150 (three specimens) days post operatively. RESULTS: The data for the 55-day period was analysed statistically using Wilcoxon's Signed Ranks test. No statistical analysis was carried out on the 150-day group due to the small number of specimens. The level of significance was set at P < 0.05. No statistical significance was observed in the healing response between Diaket and gutta-percha in the following categories at 55 days: inflammatory response, angiogenesis, root-end resorption, and cementum deposition. Statistically significant differences were observed in the healing categories: bone apposition (P < 0.05) and periodontal ligament formation (P < 0.05). CONCLUSIONS: At both time intervals, Diaket had a better healing response that was characterized by hard tissue formation adjacent to the root-end filling material bordered by occasional multinucleated giant cells. The nature of both the hard tissue formation and the adjacent cells, however, remains undetermined. Diaket displayed the best healing of either material used in this study.

Animals↗

TGF-beta 1 alone and in combination with calcium hydroxide is synergistic to TGF-beta 1 production by osteoblasts in vitro.

AIM: To examine the effects of calcium hydroxide (Ca(OH)2), transforming growth factor-beta (TGF-beta 1), and Ca(OH)2/TGF-beta 1 coadministration on TGF-beta 1 and interleukin-6 (IL-6) synthesis by early (subculture 1) and late (subculture 5) osteoblast cultures. METHODOLOGY: Early and late cultures were established using bone cells harvested from 21-day-old fetal rat calvaria. Cell cultures of both early and late osteoblasts were divided into four groups: group 1, control; group 2, cells challenged with Ca(OH)2; group 3, cells challenged with TGF-beta 1; and group 4, cells challenged with Ca(OH)2 and TGF-beta 1 in combination. TGF-beta 1 and IL-6 levels for all groups were determined using ELISA methodology. RESULTS: ANOVA and Tukey HS analyses revealed that osteoblasts of groups 3 and 4 significantly increased (P < 0.001) TGF-beta 1 synthesis in both early and late cultures of osteoblasts. IL-6 was not detected in any of the groups considered in this study. CONCLUSIONS: Exogenous TGF-beta 1 has an autocrine effect on cell cultures of osteoblasts. Administration of TGF-beta 1 alone or in combination with Ca(OH)2 increases the synthesis of TGF-beta 1 in osteoblast cultures. Ca(OH)2 and TGF-beta 1 are compatible when placed in a culture of osteoblasts. Ca(OH)2 provides a favourable environment for the anabolic effects of TGF-beta 1.

Analysis of Variance↗

Effects of calcium hydroxide and transforming [correction of tumor] growth factor-beta on collagen synthesis in subcultures I and V of osteoblasts.

Collagen protein synthesis by osteoblasts is influenced by transforming growth factor-beta (TGF-beta 1) and is essential to bone formation. The effectiveness of TGF-beta 1 depends on efficient delivery of the growth factor to target cells, adequate binding to cell surface receptors, and an optimum environment for promotion of collagen synthesis. The effects of calcium hydroxide (Ca(OH)2), TGF-beta 1, and Ca(OH)2/TGF-beta 1 co-administration on total protein, collagen protein, and noncollagen protein synthesis by early (subculture I) and late (subculture V) osteoblast cultures were tested. TGF-beta 1 significantly increased all protein synthesis in subculture I osteoblasts (p = 0.001; p < 0.001; p = 0.019). Ca(OH)2/TGF-beta 1 co-administration significantly increased total protein and collagen protein levels in subculture I osteoblasts as well (p = 0.048; p = 0.012). TGF-beta 1 increased total protein and collagen protein synthesis significantly in subculture V cells (p = 0.025; p = 0.01). These data indicate that co-administration of Ca(OH)2 and TGF-beta 1 enhances collagen synthesis by osteoblasts and may have implications for the clinical setting.

Analysis of Variance↗

Thermal sensitivity of endodontically treated teeth.

CASE REPORTS: The problem of thermal sensitivity following non-surgical root-canal treatment is explored and case reports are presented. Possible causes for post-treatment discomfort from endodontic and restorative aetiologies are discussed, as are the mechanisms to explain the patients' painful experiences. Treatment of this problem may vary from the simple replacement of a defective restoration to a more extensive non-surgical retreatment of the case, despite radiographic evidence of an acceptable root filling and normal periradicular tissues.

Cold Temperature↗

Tooth resorption.

Tooth resorption is a common sequela following injuries to or irritation of the periodontal ligament and/or tooth pulp. The course of tooth resorption involves an elaborate interaction among inflammatory cells, resorbing cells, and hard tissue structures. The key cells involved in resorption are of the classic type, which include osteoblasts and odontoclasts. Types of tooth resorption include internal resorption and external resorption. There are two types of internal resorption: root canal (internal) replacement resorption and internal inflammatory resorption. External resorption can be classified into four categories by its clinical and histologic manifestations: external surface resorption, external inflammatory root resorption, replacement resorption, and ankylosis. External inflammatory root resorption can be further categorized into cervical resorption with or without a vital pulp (invasive cervical root resorption) and external apical root resorption. Other variations of resorption include combined internal and external resorption and transient apical breakdown.

Humans↗

Haemostasis in periradicular surgery.

The successful performance of endodontic surgical procedures is predicated on many factors. However, the ability of achieve sustained tissue haemostasis in the surgical site is crucial to the performance of these procedures. This achievement improves vision in the surgical site, minimizes surgical time, enhances the surgical procedures (root-end resection, preparation and filling), and reduces surgical blood loss, postsurgical haemorrhage and postsurgical swelling. A multitude of materials have used in dentistry and medicine to achieve both generalized and localized haemostasis, many without full assessment of their biological implications. The purpose of this paper is to provide a thorough and critical review of these materials from the perspective of surgical endodontics, highlighting their development, application and potential role in achieving proper haemostasis.

Antifibrinolytic Agents↗

Restoring teeth that are endodontically treated through existing crowns. Part I: Survey of pulpal status on access.

OBJECTIVE: The purpose of this study was to identify the pulpal findings encountered by practitioners when accessing complete-coverage crowns that require nonsurgical root canal treatment and the relevance of coronal leakage to the success of the RTC. METHOD AND MATERIALS: The survey package consisted of a cover letter stating the instructions, rationale, and purpose for the questionnaire, a questionnaire with 8 short-answer questions, and a stamped, self-addressed envelope. A randomized sample of active dentists (300 general practitioners, 300 prosthodontists, and 300 endodontists) was selected. Collected data were analyzed with the chi-square test. RESULTS: A 60% response rate was obtained. Statistically significant differences were found among the practitioner groups, depending on the question. General practitioners and endodontists obtain access through crowns and maintain these crowns as final restoration significantly more often than do prosthodontists. Practitioners responded that teeth with complete crowns require nonsurgical root canal treatment after 5 to 10 years. CONCLUSION: Respondents believe that leakage must be addressed when endodontic access cavities in artificial crowns are restored after nonsurgical root canal treatment. General practitioners perform nonsurgical root canal treatment more frequently than do prosthodontists. Practitioners indicated that when teeth with complete crowns require nonsurgical root canal treatment, treatment is most often performed 5 to 10 years after placement of the crown.

Attitude of Health Personnel↗

Restoring teeth that are endodontically treated through existing crowns. Part II: Survey of restorative materials commonly used.

OBJECTIVE: A survey was undertaken to categorize the materials used for the restoration of endodontic access openings through complete-coverage crowns after completion of nonsurgical root canal treatment. METHOD AND MATERIALS: The survey package consisted of a cover letter stating instructions, rationale, and purpose for the questionnaire, a questionnaire of 8 short-answer questions, and a stamped, self-addressed envelope. A randomized sample of active dentists (300 general practitioners, 300 prosthodontists, and 300 endodontists), was selected. Collected data were analyzed with the chi-square analysis. RESULTS: Most general practitioners (93%), endodontists (61%), and prosthodontists (75%) reported that they frequently or always permanently restore teeth after nonsurgical root canal treatment. Empress was the all-ceramic system used most commonly by prosthodontists (42%) and general practitioners (38%). A statistically significant difference in restorative material preference was found (P < 0.0001), depending on the type of crown used. CONCLUSION: Amalgam alone and in combination with bonding agents are materials of choice for restoration of access openings through all-metal complete crowns, while resin composite is the choice for all types of complete crowns involving porcelain. Endodontists preferred "other" materials.

Aluminum Silicates↗