[Show abstract][Hide abstract] ABSTRACT: The aim was to review the efficacy of the enamel matrix derivative (EMD) in direct pulp capping (DPC) procedures. Databases were explored using the following keywords: 'dental', 'dentine', 'enamel matrix derivative', 'pulp capping' and 'treatment'. The inclusion criteria were: (i) original studies; (ii) human and animal studies; (iii) reference list of potentially relevant original and review articles; (iv) intervention: effect of EMD on pulp-capping procedures; and (v) articles published only in English. Eight studies (four human and four animal) were included. Among the human studies, two studies reported that EMD is a more efficient DPC procedure compared with calcium hydroxide (Ca(OH)2 ). One study reported Ca(OH)2 to be more efficient for DPC than EMD. One study reported no difference in the efficacies between EMD and Ca(OH)2 for DPC. All animal studies reported EMD to be more effective in reparative dentine formation in comparison with Ca(OH)2 . EMD can provide favourable results in DPC procedures.
Australian Endodontic Journal 12/2013; 39(3):171-5. DOI:10.1111/j.1747-4477.2012.00357.x · 0.59 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The present investigation assessed the effect of acid etching on marginal adaptation of white- and gray-colored mineral trioxide aggregate (MTA) to apical dentin using microcomputed tomography (micro-CT) and scanning electron microscopy (SEM). Sixty-four extracted single-rooted human maxillary teeth were used. Following root-end resection and apical preparation, the teeth were equally divided into four groups according to the following root end filling materials: (i) white-colored MTA (WMTA), (ii) etched WMTA (EWMTA), (iii) gray-colored MTA (GMTA) and (iv) etched GMTA (EGMTA). After 48 h, the interface between root-end filling materials and the dentinal walls was assessed using micro-CT and SEM. Data were statistically analyzed using the Kruskal-Wallis and Dunn tests. Micro-CT analysis revealed gap volumes between the apical cavity dentin walls and EGMTA, GMTA, EWMTA and WMTA of (0.007 1±0.004) mm(3), (0.053±0.002) mm(3), (0.003 6±0.001) mm(3) and (0.005 9±0.002) mm(3) respectively. SEM analysis revealed gap sizes for EGMTA, WMTA, EWMTA and GMTA to be (492.3±13.8) µm, (594.5±17.12) µm, (543.1±15.33) µm and (910.7±26.2) µm respectively. A significant difference in gap size between root end preparations filled with GMTA and EGMTA was found (P<0.05). No significance difference in gap size between WMTA and EWMTA were found in either SEM or micro-CT analysis. In conclusion, pre-etching of apical dentin can provide a better seal for GMTA but not for WMTA.
International Journal of Oral Science 01/2013; 4(4):202-7. DOI:10.1038/ijos.2012.77 · 2.53 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective: The aim of the present study was to examine the efficacy of a resin-modified glass ionomer (Geristore® syringeable) to repair accidental furcal perforations occurring during root canal treatment in dogs.
Materials and methods: Two beagle dogs (mean age and weight: 15 months and 13.8 kg respectively) with furcal perforations (2 mm x 3 mm) in the mandibular second premolars (P2) were included. Under general anesthesia, supragingival scaling was performed, performation sites were irrigated with 0.9% sodium hypochlorite and haemorrhage was controlled. Geristore® syringeable was delivered to the perforation site using intra-oral tips. The material was left over the perforation defect for ten seconds and then light-cured according to the manufacturers’ instructions. After 4 months, a periodontal examination was performed following which the animals were sacrificed. Jaw segments were prepared and histologically assessed for the presence or absence of hard tissue apposition in the furcal sites where Geristore® was placed.
Results: Upon clinical examination, teeth with furcal perforations repaired with Geristore® presented with bleeding on probing, pus discharge and bone resorption. Histological results displayed severe gingival inflammation with chronic inflammatory infiltrate around the defect and absence of cementum repair.
Conclusion: Within the limits of the present histological experiment, it is concluded that Geristore® is not advantageous for repairing furcal perforations occurring accidentally during endodontic treatment.
[Show abstract][Hide abstract] ABSTRACT: The aim was to review the efficacy of the enamel matrix derivative (EMD) in direct pulp capping (DPC) procedures. Databases were explored using the following keywords: “dental”, “dentin”, “enamel matrix derivative”, “pulp capping” and “treatment”. The inclusion criteria were: 1) Original studies; 2) Human and animal studies; 3) Reference list of original and review articles; 4) Intervention: effect of EMD on pulp capping procedures; and 5) Articles published only in English. Eight studies (four human and four animal) were included. Among the human studies, two studies reported that EMD is more efficient DPC procedures compared to calcium hydroxide (Ca(OH)2). One study reported Ca(OH)2 to be more efficient for DPC than EMD. One study reported no difference in the efficacies between EMD and Ca(OH)2 for DPC. All animal studies reported EMD to be more effective in reparative dentin formation in comparison to Ca(OH)2. EMD can provide favorable results in DPC procedures.
Australian Endodontic Journal 01/2012; · 0.59 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study evaluated the formation of reparative hard tissues in baboon pulps after Emdogain (EMD) application in conjunction with 3 pulp-capping materials.
Thirty-two premolars in four 3-year-old baboons were randomly assigned to 1 of 3 pulp-capping materials. A split-mouth design and intra-animal side randomization were applied to 3 experimental groups (calcium hydroxide, ProRoot White mineral trioxide aggregate, white Portland cement) and the control group (no pulp-capping material). In the hybrid EMD approach, a small drop of EMD was placed over the exposure site after arrest of hemorrhage. The designated pulp-capping material was placed over the EMD, followed by placement of resin-modified glass ionomer cement over the set/unset pulp-capping material. The animals were killed after 4 months. Histomorphometric analysis and micro-computed tomography were performed on the retrieved specimens.
All groups capped with EMD and 1 of the 3 capping materials exhibited similar reparative tissue thickness (P > .05). Dentin tunnel defects were absent in the mineral trioxide aggregate and Portland cement groups after the use of EMD. However, only a tubular was identified from all specimens.
Mineral trioxide aggregate produces a better quality reparative hard tissue response with the adjunctive use of Emdogain, when compared with the use of calcium hydroxide.
Journal of endodontics 05/2011; 37(5):667-72. DOI:10.1016/j.joen.2011.02.003 · 3.38 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study evaluated the responses of baboon dental pulps after the application of 3 pulp capping materials.
Thirty premolar teeth in four 3-year old baboons were randomly assigned to 1 of 3 pulp capping materials. A split-mouth design was used, and intra-animal side randomization was applied to the 3 experimental groups (calcium hydroxide, ProRoot white mineral trioxide aggregate, white Portland cement) and the control group (no pulp capping material). Animals were divided into 4 groups (n = 8 teeth/pulp capping material). The animals were killed after 4 months. Histomorphometric analysis and micro-computed tomography were performed on the retrieved specimens.
Pulps capped with ProRoot white mineral trioxide aggregate and white Portland cement exhibited thicker reparative hard tissue deposition over the exposed pulps when compared with those that were capped with calcium hydroxide (P < .007), but they were not significantly different from one another (P > .05). No tubular reparative dentin could be identified from any of the specimens. Dentin tunnel defects were evident in all groups. There was no reparative hard tissue formation in the negative control group.
Reparative hard tissue formation in pulps capped with Portland cement-based materials differs only in quantity (thickness) but not in quality from those that were formed after direct pulp capping with calcium hydroxide. It appears that other growth factors and up-regulation of transcription factors are required apart from those sequestered via the application of alkaline pulp capping materials for dental pulp stem cells to commit to the odontoblast lineage.
Journal of endodontics 04/2011; 37(4):507-12. DOI:10.1016/j.joen.2010.11.001 · 3.38 Impact Factor