Regenerative endodontic procedure combined with apical surgery of a necrotic permanent incisor with extensive periapical lesion using plasma rich in growth factors (PRGF) : a case report with 6 years post-op evaluation using CBCT

The aim of this case report is to describe the step-by step and outcomes of a treatment approach which simultaneously combines a Regenerative Endodontic Procedure (REP) and apical surgery using PRGF as treatment of a post-traumatic necrotic permanent cen

The effect of glass ionomer and adhesive cements on substance P expression in human dental pulp

Objectives: The purpose of this study was to quantify the effect of glass ionomer and adhesive cements on SP expression in healthy human dental pulp. Study Design: Forty pulp samples were obtained from healthy premolars where extraction was indicated for orthodontic reasons. In thirty of these premolars a Class V cavity preparation was performed and teeth were equally divided in three groups: Experimental Group I: Glass Ionomer cement was placed in the cavity. Experimental Group II: Adhesive Cement was placed in the cavity. Positive control group: Class V cavities only. The remaining ten healthy premolars where extracted without treatment and served as a negative control group. All pulp samples were processed and SP was measured by radioimmunoassay. Results: Greater SP expression was found in the adhesive cement group, followed by the glass ionomer and the positive control groups. The lower SP values were for the negative control group. ANOVA showed statistically significant differences between groups (p<0.0001). Tukey HSD post hoc tests showed statistically significant differences in SP expression between negative control group and the 3 other groups (p<0.01). Differences between the cavity-only group and the two experimental groups were also statistically significant (p<0.05 and p<0.01 respectively). There is also a statistically significant difference between the two experimental groups (p<0.01). Conclusions: These findings suggest that adhesive cements provoke a greater SP expression when compared with glass ionomer

Comparative outcomes of platelet concentrates and blood clot scaffolds for regenerative endodontic procedures : a systematic review of randomized controlled clinical trials

The main objective of this systematic review is to evaluate the effectiveness of platelet concentrates -Platelet-rich plasma (PRP) or Fibrin-rich plasma (PRF)- compared with blood clot (BC) as scaffolds for maturogenesis, in patients with immature perman

Dentin growth after direct pulp capping with the different fractions of plasma rich in growth factors (PRGF) vs MTA: experimental study in animal model

Background: The study aimed to evaluate the area of dentin growth in rabbit incisors after pulp capping with plasma rich in growth factors (PRGF) compared with mineral trioxide aggregate (MTA) by fluorescence. Methods: 27 upper and lower incisors of rabbits were divided into 4 groups: poor PRGF (F1) (n = 9 teeth), rich PRGF (F2) (n = 8 teeth), ProRoot MTA (positive control, n = 5 teeth) and untreated (NC) (negative control, n=5). Fluorochrome markers were injected 24 hours before surgery and the day before euthanasia, 28 days after the vital pulp therapy (VPT). Two transverse cuts were performed to every tooth: the first cut (A), 1 mm incisal to the gingival margin, and the second cut (B), 5 mm apical to the first cut. The sections were assessed with histomorphometric evaluation by fluorescence microscopy, comparing the dentin area between fluorescence marks and the total mineralized area. Results: The higher percentage of dentin growth was observed in the F2 group (B=63.25%, A=36.52%), followed by F1 (B=57.63%, A=30,12%) and MTA (B=38.64%, A=15,74%) The group with lowest percentage of dentin growth was the NC group (B=29.22%, A=7.82%). Significant difference (p <0.05) was found between F2 group and MTA, also statistically significant difference has been observed comparing dentin growth areas of NC group with F1 and F2 groups. Conclusions: The application of PRGF rich and poor fraction as a pulp capping material stimulated dentin formation significantly more intensively than MTA and NC

Effectiveness, efficiency, and apical extrusion of 2 rotaries and 2 reciprocating systems in removing filling material during endodontic retreatment. A systematic review

This systematic review investigated the effectiveness, efficiency and apical extrusion of the debris of two rotary and two reciprocating single-file systems used for the removal of filling material from straight root canals. A literature search was per

The effect of orthodontic forces on calcitonin gene-related peptide (CGRP) expression in the human periodontal ligament and its relationship with the human dental pulp

The purpose of this study was to quantify the effect of moderate and severe orthodontic forces on Calcitonin gene-related peptide (CGRP) expression in the healthy human periodontal ligament (PDL) and its possible relationship with the human dental pulp

Expresión de sustancia P, péptido relacionado con el gen de la calcitonina y factor de crecimiento endotelial vascular en pulpa dental humana bajo diferentes estímulos clínicos

8 páginasBackground: The aim of this study was to measure the dental pulp infammatory response through neuropeptides (SP and CGRP) as a response to occlusal trauma, orthodontic movements and a combination of both, as well as the angiogenic defense mechanism through VEGF expression, which could be the initial step to mineralized tissue formation. Methods: Forty human dental pulp samples were collected from healthy frst premolars with extraction indicated due to orthodontic reasons from a sample of 20 patients. Patients were divided into four groups with 10 premolars each (1 mandibular and 1 maxillary premolar from each patient): healthy pulp control group, occlusal trauma group, moderate orthodontic forces group; and occlusal trauma plus moderate orthodontic forces group. Stimuli were applied for 24 h before tooth extraction in all experimental groups. All samples were processed, and SP, CGRP, and VEGF were measured by radioimmunoassay. The Kruskal–Wallis test was performed to assess signifcant diferences among groups and Mann–Whitney’s U post hoc pairwise comparisons were also performed. Results: The highest increase in SP, CGRP, and VEGF expressions was found in the occlusal trauma plus orthodontic forces group, followed by the moderate orthodontic forces, the occlusal trauma and the control groups, with statisti‑ cally signifcant diferences between all groups for each of the 3 peptides analyzed (Kruskal–Wallis p<0.001). All pos‑ sible pairwise post-hoc comparisons were also signifcant for each peptide analyzed (Mann–Whitney’s U p<0.001). Conclusion: SP, CGRP, and VEGF expressions signifcantly increase in human dental pulps when stimulated by occlusal trauma combined with moderate orthodontic forces, as compared with these two stimuli applied independentlyAntecedentes: El objetivo de este estudio fue medir la respuesta inflamatoria de la pulpa dental a través de neuropéptidos (SP y CGRP) como respuesta a trauma oclusal, movimientos de ortodoncia y una combinación de ambos, así como el mecanismo de defensa angiogénico a través de la expresión de VEGF, que podría ser el paso inicial hacia el tejido mineralizado formación. Métodos: Se recolectaron cuarenta muestras de pulpa dental humana de primeros premolares sanos con extracción indicada. por motivos de ortodoncia a partir de una muestra de 20 pacientes. Los pacientes fueron divididos en cuatro grupos con 10 premolares cada uno (1 premolar mandibular y 1 maxilar de cada paciente): grupo de control de pulpa sana, grupo de trauma oclusal, grupo de fuerzas de ortodoncia moderadas; y grupo de trauma oclusal más fuerzas de ortodoncia moderadas. Los estímulos fueron aplicado durante 24 h antes de la extracción del diente en todos los grupos experimentales. Todas las muestras fueron procesadas y SP, CGRP y VEGF se midió por radioinmunoensayo. Se realizó la prueba de Kruskal-Wallis para evaluar diferencias signifcativas entre grupos y también se realizaron comparaciones por pares post hoc U de Mann-Whitney. Resultados: El mayor incremento en las expresiones de SP, CGRP y VEGF se encontró en el trauma oclusal más ortodoncia. grupo de fuerzas de ortodoncia, seguido por las fuerzas de ortodoncia moderadas, el trauma oclusal y los grupos de control, con estadísticas diferencias significativas entre todos los grupos para cada uno de los 3 péptidos analizados (Kruskal-Wallis p<0,001). Todas las pos‑ Las posibles comparaciones post-hoc por pares también fueron significativas para cada péptido analizado (Mann-Whitney's Up p <0.001). Conclusión: las expresiones de SP, CGRP y VEGF aumentan significativamente en las pulpas dentales humanas cuando se estimulan por trauma oclusal combinado con fuerzas de ortodoncia moderadas, en comparación con estos dos estímulos aplicados independientement

Variation in the expression of insulin-like growth factor-1 in human pulp tissue according to the root-development stage

Insulin-like growth factor-1 (IGF-1) plays an important role in cell proliferation and differentiation. It actively participates during odontogenesis and mineralization of dental hard tissues. The purpose of this study is to use a radioimmunoassay (RIA) to determine whether there are differences in the expression of IGF-1 in human pulp from teeth having incomplete or complete root development. Twenty-six pulp samples were obtained from freshly extracted human third molars, half of them from teeth with incomplete root development. All of the samples were processed and labeled using an IGF-1 RIA kit. Results showed IGF-1 presence in all human pulp samples with a statistically significant higher expression in pulps having complete root development. The present findings are consistent with the hypothesis that IGF-1 contributes toward forming and mineralizing dental tissues in teeth with incomplete root development as well as in pulp-repairing process in teeth with complete root development

Expression of insulin-like growth factor-1 and proliferating cell nuclear antigen in human pulp cells of teeth with complete and incomplete root development

Aim To quantify the expression of insulin-like growth factor-1 (IGF-1) and proliferating cell nuclear antigen (PCNA) in human pulp cells of teeth with complete or incomplete root development, to support the specific role of IGF-1 in cell proliferation during tooth development and pulp reparative processes. Methodology Twenty six pulp samples were obtained from freshly extracted human third molars, equally divided in two groups according to root development stage (complete or incomplete root development). All samples were processed and immunostained to determine the expression of IGF-1 and PCNA in pulp cells. Sections were observed with a light microscope at 80· and morphometric analyses were performed to calculate the area of PCNA and IGF-1 immunostaining using digital image software. Mann– Whitney’s test was used to determine statistically significant differences between groups (P < 0.05) for each peptide and the co-expression of both. Results Expression of IGF-1 and PCNA was observed in all human pulp samples with a statistically significant higher expression in cells of pulps having complete root development (P = 0.0009). Conclusion Insulin-like growth factor-1 and PCNA are expressed in human pulp cells, with a significant greater expression in pulp cells of teeth having complete root development