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Ability of a bovine bone graft, alone or enriched with PDGF-BB or rhBMP-2, to promote human periodontal ligament (PDL) cells proliferation. A preliminary study.

One of the most important goals of the periodontal therapy procedures is to stimulate the formation of new bone into osseous defects resulted from periodontal disease. A wide range of grafting materials is used to achieve this aim. Recently, the Human Tissue Bank of the National Center for Scientific Research 'Demokritos' in Athens (Greece) has prepared, in a preliminary study, a cancellous bovine-derived bone matrix (BBM). The purpose of the present work was to investigate the role of this bovine bone material in the periodontal regeneration, by studying the rate of human periodontal ligament (PDL) cells proliferation in the presence of this matrix alone, or after the addition of the growth factors, platelet-derived growth factor-BB (PDGF-BB) or recombinant human bone morphogenetic protein-2 (rhBMP-2).Bovine bone graft was prepared using the 'know how' acquired by the 30 years continuous preparation and delivery of lyophilized human bone grafts by the 'Demokritos' Bank.PDL cells cultures were derived from the mid root of two maxillary premolars. The teeth were caries-free and were extracted for orthodontic reasons from 1 adult female patient. Cells were grown in 24-well dishes in the presence of 20 mg BBM. On day 2 of quiescence, new medium was added with 10 ng/ml of PDGF-BB or 50 ng/ml of rhBMP-2. To determine the effects of the test agents on cell proliferation, DNA synthesis was estimated by measuring [(3)H] thymidine incorporation. After 48 h of incubation the cells were processed to subject to scintillation counting. Counts per minute (cpm/well) were determined for each sample.The results revealed that this BBM has the ability to maintain PDL cells proliferation and could be used as an alternative graft material. PDGF-BB when added improved the cell proliferative response resulting in a more active BBM, while the presence of rhBMP-2 did not support cell mitosis.

Journal Article↗

The detection and prevalence of reactive and physiologic sclerotic dentin, reparative dentin and dead tracts beneath various types of dental lesions according to tooth surface and age.

The pulpo-dentinal complex responds to external injuries with dentin sclerosis (DS), dead tracts (DT), or reparative dentin (RD). This investigation correlates the prevalence of these responses with age, sex, type and surface location of tooth lesions (caries, restorations, attrition, abrasion and erosion) utilizing ground sections, microradiographs and decalcified paraffin-embedded tooth sections treated with the Pollak trichrome stains (270 teeth from 113 patients). The main response to caries, restorations and erosion was DS, followed by RD and DT. DS, RD and DT occurred equally in any tooth, on any tooth surface and even beneath the same lesion. DS did not necessarily prevent RD. Root and furcation DS and RD in the floor of the pulp chamber and root canals were unrelated to particular lesions but did relate to increasing age. Root DS extended from apical to cervical area with increasing age. Beneath caries and restorations DS and RD were more prevalent in males, but DT was more prevalent in females. Pollak staining of decalcified paraffin sections for DS was approximately 80% as accurate as ground sections and microradiography. In pulp studies, where the result is contrary to previous experience, the Pollak stains reveal whether DS has decreased dentin permeability.

Adolescent↗

A follow-up study of screwpost-retained amalgam crowns.

A follow-up study of amalgam crowns retained with brass screwposts (Dentatus) has been performed. The teeth had been restored by undergraduates at the Department of Cariology, School of Dentistry, Stockholm, during the years 1970-1976. Radiographs of the teeth made at the time of insertion of posts were available in all cases. The material comprised 56 teeth with altogether 69 screwposts. Average observation time was 7.8 years. Anamnestic data were collected and clinical and radiographic investigations of the restored teeth and surrounding tissues were carried out. Of the 56 teeth, 8 teeth containing altogether 11 screwposts had been lost by extraction. Annotations from the treating dentists were available in all cases and showed that five of the extractions had been necessary because of extensive caries, one because of parodontitis and two because of root fractures. No corrosion of screwposts had been observed in the fractured teeth. The anamnestic investigation revealed sporadic tenderness and metallic taste in only a few cases. The most frequent clinical findings were discoloration and pitting of amalgam surfaces and discoloration of tooth substance and gingiva. The discolorations of the gingiva were related to restorations extending below the gingival margin. No clinical or radiographic signs of corrosion of screwposts were found in the investigated teeth.

Crowns↗

A comparison of combinations of clinical and radiographic examinations in evaluation of a dental clinic population.

Panoramic periapical anterior and posterior bitewing radiographic, mirror-explorer, and transillumination clinical examinations were performed on 300 patients. Various combinations of the radiographic and clinical examination techniques were compared in terms of their ability to diagnose caries, alveolar bone loss, calculus, periapical bone lesions, impacted teeth, root tips, and miscellaneous conditions. A mirror-explorer clinical examination with panoramic and posterior bitewing radiographs and either anterior bitewing radiographs or transillumination proved to be as efficient in the initial examination of patients as the mirror-explorer clinical examination with periapical and posterior bitewing radiographs.

Alveolar Process↗

Eighteen-month coronal caries incidence in North Carolina older adults.

In this longitudinal study of a random sample of North Carolinians over the age of 65 and living in their homes, 325 blacks and 280 whites were examined and interviewed 18 months after baseline examinations. Coronal caries incidence was greater among whites than blacks. The increment due to teeth becoming root fragments were similar for both races; however, there were more newly crowned teeth among whites. Newly crowned surfaces were not used as part of the caries increment in logistic regression models to investigate potential risk predictors. For blacks, caries development over the 18-month period was associated with a higher lactobacillus score and more coronal caries at baseline, more previously filled coronal surfaces, and lack of active membership in clubs or other groups. For whites, having no self-reported tooth sensitivity, having a lower socioeconomic index score, taking antihistamine medications at baseline, and having the perception of more problems after the age of 40 than before were all associated with the development of coronal caries.

Black or African American↗

Biological factors in dental caries enamel structure and the caries process in the dynamic process of demineralization and remineralization (part 2).

Dental caries is a complex disease process that afflicts a large proportion of the world's population, regardless of gender, age and ethnicity, although it does tend to affect more indivduals with a low socioeconomic status to a greater extent. The physicochemical properties of the mineral comprising the tooth surface and subsurface modulate the development, arrestment and remineralization of dental caries. Post-eruption maturation of enamel surfaces and exposed root surfaces is important in order for more susceptible mineral phases to be modified by incorporation of soluble fluoride from the plaque into dental hydroxyapatite. The chemical reactions that occur during acidic conditions when tooth mineral dissolves (critical pH) are determined by the supersaturation of calcium and phosphate within plaque and saliva, as well as if fluoride is present.

Apatites↗

Caries prevention--a continuing need.

The frequently iterated, optimistic view of the demise of caries is not supported by the epidemiologic data. What is in evidence is a changing pattern of caries in developed countries. Among the young there is a polarisation in prevalence with 20 per cent of the children experiencing 70 per cent of the decay. The ageing population is at increasing risk because of longer tooth retention and exposure of root surfaces. A realistic view would envision control rather than extinction of caries with enhancement of current methods of combating tooth decay and more effective employment of multiple anticaries strategies.

Adolescent↗

Remineralization of bovine incisor root lesions in vitro: the role of the collagenous matrix.

This study deals with the role of collagen in the remineralization of bovine incisor root lesions. The degradability of the collagenous matrix after in vitro remineralization was also investigated. The root surfaces were exposed to 0.1 M acetic acid, pH 4.0, to produce erosive lesions or to 0.1 M lactic acid, 0.2 mM methane hydroxy diphosphonate, pH 5.0, to produce subsurface lesions. After demineralization, the roots were subjected to remineralization, with or without prior treatment with a bacterial collagenase to remove accessible collagen. Remineralization was carried out in solutions with a Ca/Pi molar ratio of 1.67, and [Ca]. [Pi] concentration products of 0.6, 1.35 or 2.4 mM2, with all solutions having an ionic strength of 0.15 M, and a pH of 7.0. After remineralization, the roots that were not treated with collagenase were incubated with the enzyme. The results indicate that remineralization of erosive lesions is surface-controlled and that of subsurface lesions diffusion-controlled. For both lesion types it was shown that the removal of collagen before remineralization did not affect the rate of mineral deposition in the root lesions. Nevertheless, remineralization in those lesions where accessible collagen had not been removed resulted in a significant reduction in the amount of degradable collagen. The observations of this study suggest that remineralization did not occur by nucleation of mineral on the organic matrix but rather by growth of residual crystals in the partially demineralized root tissue.

Animals↗

Evaluation of the effects of F in acidified gelatin gel on root surface lesion development in vitro.

Oral exposed, natural root surfaces of extracted human teeth were subjected to artificial lesion formation in gels of dialyzed gelatin that contained 75 mM lactic and 25 mM acetic acid and 1, 3, 10, 32, 100, 320, 550, or 1,000 mg F/l at pH 4.3-4.4 and at 36 degrees C. Ca and PO4 demineralization per square millimeter exposed surface and lesion depth decreased with increased F concentrations, except for the levels above 320 mg/l. Quantitative microradiographic image analyses showed that the mean percent mineral content of the entire lesions relative to the adjacent sound tissue was constant at about 64% for the F levels less than 320 mg/l. F above 3 mg/l changed the mineral density profile of the lesions by eliminating subsurface lamination. This showed that sufficient F incorporated at the site of demineralization prevented lesion progression and that the best effect would be obtained for F levels between 100 and 320 mg/l. Higher levels of F may also prove to be beneficial by providing labile F from CaF2 formed in the root surface.

Acids↗

Long-term outcomes of primary molar ferric sulfate pulpotomy and root canal therapy.

PURPOSE: The purpose of this study was to compare long-term outcomes of ferric sulfate pulpotomy (FS) and primary tooth root canal therapy (RCT) in vital pulps of deciduous molars exposed to caries lesions. METHODS: A total of 291 molars were treated in 130 children. One hundred and eighty-two molars received FS and 109 received RCT by random selection. RESULTS: At 3-year re-assessment, 29 molars (15 FS, 14 RCT) were available for clinical and radiographic examination. Two independent pediatric dentists evaluated periapical radiographs of the treated molars. Molars were classified 1 of 4 outcomes: (1) N = normal treated molar; (2) H = nonpathologic radiographic change present; (3) P(o) = pathologic change present, follow-up in 6 months; (4) P(x) = pathologic change present extract immediately. Survival analysis was applied. A good level of agreement between raters was found for molars with outcome P(x) (K = 0.79). No difference in radiographic outcomes was demonstrated 3 years after treatment (chi2 = 1.4). Survival analysis demonstrated a 3-year survival probability of 0.62 for FS-treated molars and 0.92 for RCT molars. Survival of RCT molars was significantly greater than for FS molars (Wilcoxon: P = .01; log-rank: P = .02). CONCLUSIONS: RCT-treated molars demonstrated significantly greater survival than FS-treated molars 3 years after treatment.

Child, Preschool↗

Root hard-tissue demineralization rate measured by 125I absorptiometry: comparison with lesion-depth measurements.

The aim of the present study was to compare demineralization of root hard tissue, monitored by 125I absorptiometry, with lesion-depth measurements under polarized light microscopy. The intact roots of ten human molars, which had not been exposed to the oral environment, were divided into 39 cementum/dentin blocks and exposed to a buffer solution of pH 4.5 containing 2.2 mmol/L calcium and inorganic phosphate. After demineralization for 3.5, 7, 14, and 21 days, transmission measurements by 125I absorptiometry were performed, and one block from each tooth was taken out of the solution for lesion-depth measurement. The results showed a high degree of correlation (r = 0.952) between lesion depth and change in transmission, with a more rapid increase initially in both variables. A linear relationship with the square root of time was found. Conversion of transmission data to lesion-depth data was possible when this caries model system was used on cementum dentin blocks.

Absorptiometry, Photon↗

Effects of nanosecond pulsed Nd: YAG laser irradiation on dentin resistance to artificial caries-like lesions.

BACKGROUND AND OBJECTIVE: Previous investigations have demonstrated improved enamel caries resistance after laser irradiation. In this study, effects of nanosecond pulsed Nd:YAG laser irradiation on crown/root dentin susceptibility to caries-like lesions were investigated. STUDY DESIGN/MATERIALS AND METHODS: Extracted human molar teeth were irradiated using a Q-switched nanosecond pulsed Nd:YAG laser. All teeth except controls were irradiated at: fluence, 1 or 5 J/cm2; spot size, 3 mm; and then subjected to demineralization. Measurements of caries lesion depth using scattering light microscopy and SEM were performed. RESULTS: Lesion depth measurements did not differ significantly between controls and irradiated samples (P < 0.01), but SEM results showed some irradiation-induced alterations on crown and root dentin surfaces. Irradiated surfaces were partially melted, with sometimes narrowed or occluded tubules. CONCLUSION: No consistent caries-protective effect of Q-switched nanosecond pulsed Nd:YAG laser irradiation on crown and root dentin was determined, but laser-induced morphological changes were observed.

Dental Caries↗

The cariostatic effect of betel nut chewing.

The island of Aua 143 miles off the N.E. coast of Papua New Guinea has a population consisting of (41%) Roman Catholics who chew betel nut regularly and (59%) Seventh Day Adventists who do not. This provided an ideal opportunity to compare the effects of betel nut chewing on all aspects of dental health against an identical population who did not chew and therefore provided an excellent control. The results of this survey showed, for those of the population who had never lived away from the island, that for betel nut chewers the prevalence of dental caries was 23% whereas for non-chewers it was considerably and statistically significantly greater at 49%. The amount of dental caries as measured by DMFT was also considerably and statistically significantly greater for this group of non-chewers at 1.162 compared with 0.364 for chewers. The above findings confirmed the work of other investigators which at the time of this survey were not known to the author, and this led to a laboratory investigation of the possibility that the betel nut stain may mediate its effect by acting as a chemical or physical barrier against the acid attack of dental caries. Betel nut stained teeth from PNG, which had been extracted due to periodontal disease were prepared with "windows" of enamel from which the betel nut stain had been removed, and their roots were protected by layers of varnish. These teeth were maintained in an "Artificial Caries Medium" at pH's of 3.5, 4.0 and 4.5 for several months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Root canal treatment in mandibular canines with two roots: a report of two cases.

AIM: To highlight anatomical variation in the mandibular canine. SUMMARY: Two clinical case reports are presented to illustrate anatomical variation in the human mandibular canine. Endodontic treatment may sometimes fail because morphological features of the tooth adversely affect the treatment procedures. Many investigators have reported the anatomical variations associated with mandibular canines. Mandibular canines are recognized as usually having one root and one root canal in most cases, although approximately 15% may have two canals or sometimes two roots. This paper describes two clinical cases of mandibular canines with two roots and two canals. KEY LEARNING POINTS: Failure to control infection in the root canal system has an adverse impact on outcome. Clinicians should be aware of anatomical variations in the teeth they are managing, and should never assume that canal systems are simple. The majority of mandibular canines have one root and root canal, but 15% may have two canals, and a smaller number may have two distinct roots.

Cuspid↗