The Assessment Of Root Canal Sealers Ph In The Treatment Of Periapical Inflammation Processes – An In Vitro Study

Introduction: The endodontic treatment represents the best conservative option for irreversible endodontically affected teeth maintenance on the dental arch. Besides the rigorous mechanic-chemical treatment, in aseptic conditions, the regenerative or, on the contrary, inhibitive qualities of the root canal sealer on the periradicular tissue play an important role in the long-term success of the treatment. The aim of the study The object of this study consisted in analysing the pH values of frequently used root canal sealers in the endodontic treatment, to make a series of correlations with their therapeutically indications. Materials and Methods We tested the following root canal sealers: AH-26 (De Trey), ZOE, Pulpispad (Spad, Dijon), Sealapex (Kerr), Endomethasone (Septodont), Endospad (Spad, Dijon). The materials were prepared according to the producer indications. The pH recordings were made on different time points: immediately after the preparation, after 24 hours, after a week and after two weeks. Results Our data analysis revealed a variation of the pH values of the 6 root canal sealers and differences in their pH values on different time recordings. The highest values were presented by Sealapex; in the alkaline values order, this was followed by Endomethasone and Endospad. The lowest pH values, to acid zones, were recorded from AH-26, ZOE and Pulpispad. Conclusions The presence in the root canal of an alkaline pH sealer ensures an additional opportunity for the infection control and tissue regeneration of the periradicular tissue. Due to this property, the root canal sealers that have calcium hydroxide in their composition are used more and more frequently

STUDY REGARDING THE QUANTIFICATION OF RANKL LEVELS IN PATIENTS WITH CHRONIC PERIODONTITIS AND OSTEOPOROSIS

Introduction and aim: Osteoporosis, a systemic skeletal disease characterized by an inflammatory status, can enhance the inflammation on periodontal level, with severe alveolar bone loss. The study proposed an evaluation of local and systemic RANKL levels, pre- and post- periodontal therapy. Materials and method: The clinical study was conducted in patients with chronic periodontitis, divided in osteoporosis group and systemically healthy subjects. The clinical periodontal parameters were determined at baseline and after scaling and root planing. The RANKL levels were investigated pre-therapy in gingival crevicular fluid and post-therapy in serum. Results and discussion: The periodontal tissue loss and the crevicular fluid RANKL were significantly more severe in the osteoporosis group, as image of the local influence of an impaired skeletal system. Both groups had a positive response to the periodontal therapy, with low levels of clinical parameters and serum RANKL. Conclusions: Our results support the relationship between osteoporosis and periodontal inflammatory changes, which can be amended by the conventional therapy

PROSTHETIC TREATMENT AND ITS IMPACT ON ORAL HEALTH OF A GROUP OF INSTITUTIONALISED PATIENTS

In the context of demographic aging, the demographic pressure conditions brought by population segment over 65 years, it is obvious that the proportion health problems specific to this age increase, representing a challenge to the medical world.In older adults, OHRQoL is known to be associated with socioeconomic status with regular dental visits, subjective masticatory capacity and the number of remaining natural teeth. By analyzing and processing the data obtained through questionnaires we got that gender, education level, state of life, ability to obtain living expenses, status dentures, dental checks, treatments and dental visits in the past year were not significantly associated with altered stomatognathic system functions and total scores of GOHA

The Effects of Periodontal Laser Therapy on Pain in Adult Patients with Orthodontic Treatment: A Randomized Clinical Trial

(1) Background: Pain is the most common complaint of patients with fixed orthodontic treatment, especially when applying and activating the orthodontic device. The effectiveness of low-level laser therapy (LLLT) in reducing pain caused by the orthodontic treatment has been frequently studied over the last few years. In this study, we aim to evaluate the influence of laser therapy on pain caused by orthodontic forces acting on periodontal tissues during fixed orthodontic treatment. (2) Methods: A total of 36 patients who met the inclusion criteria were submitted to laser therapy after beginning a fixed orthodontic treatment. For each patient, one half-arch was treated with laser (HL), the opposite one being the control half-arch (HC). The evaluation of pain was conducted by asking the patients to rate their pain on a VAS scale from 0 to 10. (3) Results: Analyzing the VAS score values reported after applying the orthodontic device, we noticed that the pain increased in the first few hours, it was the highest 24 h after application, and it decreased towards the 7th day. The pain reported by most patients was significantly reduced in the HL compared to the HC, in all three moments that were evaluated (p < 0.0001). (4) Conclusions: Repeated LLLT in patients with orthodontic treatment leads to a significant decrease in pain levels, as the comparison between the laser half-arch and the control half-arch showed

Assessment of Salivary Levels of RANKL and OPG in Aggressive versus Chronic Periodontitis

RANKL (receptor activator of nuclear factor kappa-β ligand) and OPG (osteoprotegerin) are two proteins involved in bone remodelling. During the active phase of periodontal disease, an imbalance between the ratios of the two elements can be noticed. While the expression of RANKL is elevated compared with that of OPG, the RANKL is available to bond with RANK (receptor activator of nuclear factor kappa-β). This study was conducted on 41 patients: 19 with generalized aggressive periodontitis, 18 with severe chronic periodontitis, and 4 periodontal healthy subjects. For each patient included, we determined the salivary levels of RANKL and OPG with the help of two Human ELISA kits. The results show that the patients affected by periodontitis, either aggressive or chronic, have significant higher values of RANKL and RANKL/OPG ratio. This values correlate with the local inflammation status

STUDY REGARDING THE INFLUENCE OF PERIODONTAL MAINTENANCE THERAPY ON TOOTH SURVIVAL IN PATIENTS WITH REMOVABLE PARTIAL DENTURES

Aim: Removable partial dentures (RPDs) can influence the oral health and have the potential to cause further tooth loss, especially of abutment teeth. However, no evidence indicates the effective interval of regular periodontal maintenance after RPD provision. This study aimed to examine the impact of regular periodontal maintenance visits on survival of RPD abutment teeth. Materials and Methods: Patients were included if they had been provided with a clasp-retained RPD and had used it for 2 years or more. According to the frequency of periodontal maintenance, study samples were divided into three groups; every 3–6 months (3–6M) group, 1-year (1Y) group and no-maintenance (NM) group. Results: Five-year cumulative survival rates were 82.6% (3–6M), 74.4% (1Y) and 70.8% (NM) respectively. Survival of abutment teeth in the 3–6M group was significantly better than both 1Y and NM groups. Conclusion: The periodontal maintenance at least once in 6 months had the most favorable outcome. Frequent periodontal maintenance after RPD provision could be effective in preventing further tooth loss

Effects of Laser Application on Alveolar Bone Mesenchymal Stem Cells and Osteoblasts: An In Vitro Study

Mesenchymal stem cells isolated from the bone marrow have a great differentiation potential, being able to produce many cell lines, including osteoblasts. Osteoblasts have an important role in bone remodeling by actively participating in the maturation and mineralization of the extracellular matrix. The aim of this study was to determine the effect of laser application on the viability and proliferation of osteoblasts. Methods: Alveolar bone was harvested from 8 patients and placed into a culture medium to induce proliferation of mesenchymal stem cells. These were differentiated into osteoblasts in special conditions. The cells from each patient were split into two groups, one was treated using a 980 nm laser (1W output power, pulsed mode, 20 s, 50 mm distance) (laser “+”) and the other one did not receive laser stimulation (laser “-”). Results: Using the confocal microscope, we determined that the cells from the laser “+” group were more active when compared to the laser “-” group. The number of cells in the laser “+” group was significantly greater compared to the laser “-” group as the ImageJ-NIH software showed (p = 0.0072). Conclusions: Laser application increases the proliferation rate of osteoblasts and intensifies their cellular activity

Effects of Laser Therapy on Periodontal Status in Adult Patients Undergoing Orthodontic Treatment

Orthodontic treatment with fixed devices should only be indicated in case of a stable, non-active periodontal disease status. Throughout orthodontic treatment, a careful assessment of the periodontal status is advised. Due to its anti-inflammatory and antimicrobial effects, laser therapy is frequently used as an adjunct to classic periodontal therapy. The aim of this study was to evaluate the advantages and limitations of the use of laser therapy on periodontal status during orthodontic treatment. Throughout the 9 months during which this placebo-controlled, single-blind clinical trial was conducted, 32 patients were included in the study, divided into two groups: microscope “+” (patients who observed the bacteria within the dental plaque-sample examination on the screen of a dark-field microscope in real time) and microscope “−” (patients who did not see the oral pathogens using a dark-field microscope). For all patients, using the split-mouth study design, laser therapy was applied to one hemiarch (HL), whereas the other hemiarch received treatment without active light (HC). After one month, by analyzing the main indicators of periodontal health status, we found that the plaque index (PI) and bleeding on probing (BOP) values were significantly decreased after receiving treatment (for PI: HL-p = 0.0005, HC-p = 0.0297; for BOP: HL-p = 0.0121, HC-p = 0.0236), whereas the probing-depth (PD) values remained almost the same as before treatment (HL-p = 1.5143; HC-p = 1.4762). Conclusions: The use of the dark-field microscope proved to be beneficial in sensitizing patients to the presence of bacteria in the oral cavity and motivated them to strictly follow the rules of oral hygiene. Laser treatment can be a valuable aid in periodontal therapy, but only in adjunction with mechanical therapy

Assessment of Pulpal Status in Primary Teeth Following Direct Pulp Capping in an Experimental Canine Model

(1) Background: This study aimed to assess the pulpal response of primary teeth by pulse-oximetry (PO) in a canine model, following direct pulp capping (DPC). (2) Methods: Forty-eight primary teeth from eight canine subjects were divided into three treatment groups, based on the DPC material—calcium hydroxide (CH), MTA, BiodentineTM)—and three corresponding control groups. Data from PO pulp testing were correlated with laser Doppler flowmetry (LDF) testing, computer tomographic (CT) densitometry and histological analysis; the experiment lasted 14 days. (3) Results: SpO₂ recordings revealed statistically significant differences (p = 0.002, <0.05) between the treatment and control groups, and no significant differences (p = 0.257, >0.05) were observed between treatment groups. LDF recordings showed significant differences (p = 0.002, <0.05) between the treatment and control groups and identified significant differences between materials (p = 0.001, <0.05). CT densitometry indicated vital pulps in all teeth, with pulpal inflammation detected in 6/8 CH-capped teeth and 2/8 MTA-capped teeth. Histologic evaluation confirmed vital pulp in all specimens, with different degrees of inflammation. (4) Conclusions: Within its limitations, the present study confirms the diagnostic value of PO evaluation of pulpal status in primary teeth with histologic means after pulp-capping procedures in a canine model. However, various degrees of pulpal inflammation elicited by different pulp-capping materials seem not to correlate with the obtained PO values