RESUMEN
PURPOSE: Molar incisor malformation (MIM) is a dental anomaly rendering first permanent molar pulps inflamed/necrotic at a young age. It often affects permanent incisors, primary second molars and less frequently other teeth. The purpose of this study was to investigate the anatomy and histology of MIM in seeking insight into its pathogenesis. METHODS: Five MIM first permanent molars were examined with micro-computed tomography (micro-CT) for 3D morphology, with scanning electron microscopy for microanatomy, with energy-dispersive X-ray spectrometer (EDS) for chemical composition and for histology with optical microscopy. Composition differences were statistically determined using one-way ANOVA. RESULTS: Micro-CT confirmed dentin abnormalities in the middle and cervical third of the crown in the form of the radiodense 'cervical mineralized diaphragm' (CMD). This was peripherally intertwined with enamel fjords and projections severely disrupting the integrity of pulp chamber and its continuity with root canals. EDS showed increased Ca in CMD compared to dentin. The histological examination revealed anomalous osteodentin-like hard tissue with denticles in the CMD. CONCLUSION: An interconnection of anomalous cervical enamel with crown CMD dentin preceded to the severe pulp chamber and root dysplasias in MIM molar teeth.
Asunto(s)
Hipoplasia del Esmalte Dental , Anomalías Dentarias , Hipoplasia del Esmalte Dental/diagnóstico por imagen , Hipoplasia del Esmalte Dental/patología , Cavidad Pulpar/patología , Humanos , Incisivo/diagnóstico por imagen , Diente Molar/diagnóstico por imagen , Raíz del Diente , Microtomografía por Rayos XRESUMEN
AIM: To present a scientometric analysis of the entire body of scientific publications in the field of vital pulp therapy (VPT) and analyse the research trends and popular topics. METHODOLOGY: A comprehensive literature search was conducted in the Web of Science and Scopus databases on 21 August 2020 to identify all articles related to VPT. The publications were reviewed and basic research parameters were collected, including publication year, patterns of authorship, geographical distribution of scientific productions, journals, h-index, study design and keyword analysis. Web of Science, Scopus and Google Scholar databases were used for the citation analysis of the ten top cited articles. The data were analysed using VOSviewer and visualized by tables and diagrams. RESULTS: In total, 1197 VPT-associated items were identified from 64 countries in 176 journals. The majority of papers were published in the Journal of Endodontics. The United States of America was the leading country for number of publications, citations, h-index and collaborations. The distribution of articles based on study design was as follows: basic science (35%), clinical (27%), observational studies (26%) and review publications (12%). The most frequently occurring keywords were pulpotomy, mineral trioxide aggregate, calcium hydroxide and direct pulp capping. CONCLUSIONS: This scientometric analysis outlines the evolutionary trends and the productivity of researchers and countries in the field of vital pulp therapy. Research output is dominated by basic science articles involving innovative materials published in high impact factor dental journals.
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Bibliometría , Endodoncia , Bases de Datos Factuales , Pulpotomía , Proyectos de Investigación , Estados UnidosRESUMEN
AIM: To investigate pulp responses after pulpotomy and EDTA conditioning of pulp chamber dentinal walls with or without the placement of a collagenous scaffold in the experimental model of miniature swine teeth. METHODOLOGY: Forty-two fully developed permanent premolars and molars of healthy miniature swines were used. After preparation of pulp exposures through Class I cavities, the tissue of the pulp chamber was completely removed. The haemorrhage was controlled, and the root pulp was protected using a polyurethane film. The circumpulpal pulp chamber dentine was treated for 3 min with normal saline (group 1), or 17% EDTA solution (groups 2 and 3). The film was removed, and the pulp chamber cavities were left empty (groups 1 and 2), or filled with swine collagenous sponge (group 3). The access cavities were restored with a Teflon disc and glass ionomer. Teeth were evaluated histo-morphologically after 10 weeks. Data were compared using the nonparametric Fisher's exact test. RESULTS: Teeth after treatment of dentine with saline (group 1) were associated with no or only traces of hard tissue formation along the root canal walls. Atubular tertiary dentine deposition in the form of matrix deposition along root canal walls, or dentine bridge formation at the orifice of root canals or complete pulp canal obliteration, was found after treatment of dentine with EDTA in both experiments (groups 2 and 3). Significantly different types of mineralization in the root canals of groups 2 and 3 were seen (P = 0.001). Tissue changes in the pulp cavity, characterized by soft tissue growth and osteodentine or atubular tertiary dentine formation, were only seen after EDTA conditioning of dentine, in 6.2% of the teeth without scaffold and 64.7% of the teeth with scaffold application. Newly deposited mineralized matrix in the pulp chamber was always in continuation with hard tissue deposited in the root canals. CONCLUSIONS: The EDTA conditioning of pulp cavity dentinal walls after pulpotomy induced dentinogenic events in the root pulp. Application of collagenous scaffold in the pulp chamber enhanced soft tissue growth and mineralized tissue formation along the treated circumpulpal dentine.
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Dentina Secundaria , Dentinogénesis , Animales , Dentina , Ácido Edético , Porcinos , Porcinos EnanosRESUMEN
AIM: To use the fluid transport model to evaluate the ex vivo short- and long-term microleakage along root canals filled with Gutta-flow or AH-Plus using the cold lateral compaction technique. METHODOLOGY: A total of 38 single-rooted human teeth were used for the assessment of microleakage. The crowns of the teeth were sectioned below their cemento-enamel junctions to adjust the length of the roots to approximately 15 mm. The root canals were instrumented using the step-back technique and filled using cold lateral condensation. The sealer employed was either Gutta-flow (Group A) or AH-Plus (Group B). Microleakage along the root canals was evaluated using a fluid transport model after periods of 1 week and 3 months. RESULTS: The microleakage values (microL h(-1)) for group A were 0.36 +/- 0.33 at 1 week and 0.41 +/- 0.36 at 3 months. Group B showed mean microleakage values 0.2 +/- 0.31 at 1 week and 0.28 +/- 0.38 at 3 months. Statistical analysis indicated no significant differences (P > 0.05) between the two groups after either 1 week or 3 months. CONCLUSIONS: There was no significant difference between AH-plus and Gutta-flow in terms of sealing ability.
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Recubrimiento Dental Adhesivo , Filtración Dental/clasificación , Dimetilpolisiloxanos/química , Resinas Epoxi/química , Gutapercha/química , Materiales de Obturación del Conducto Radicular/química , Cavidad Pulpar/patología , Combinación de Medicamentos , Ácido Edético/química , Humanos , Humedad , Ensayo de Materiales , Presión , Irrigantes del Conducto Radicular/química , Preparación del Conducto Radicular/instrumentación , Preparación del Conducto Radicular/métodos , Hipoclorito de Sodio/química , Propiedades de Superficie , Temperatura , Factores de Tiempo , Agua/químicaRESUMEN
AIM: To evaluate ex vivo whether a simulated pulpal microcirculation inside a pulp chamber influenced intrapulpal temperature rise following application of heat on tooth surfaces. METHODOLOGY: An ex vivo model that allowed the circulation of 37 degrees C warm water inside the pulp chamber of an extracted human tooth was designed. The experimental model resembled pulpal microcirculation. After application of specific thermal stimuli for 30 s to the external surface of 15 maxillary central incisors, lateral incisors and canines, temperature changes were measured in the pulp chamber. The Greenhouse-Geisser and Bonferroni tests were used for analysis of the data. The level of significance was set at 0.05. RESULTS: Significant differences were found in all three groups of teeth between temperature measurements with or without intrapulpal water flow. Additionally, temperature changes resulting from the application of different stimuli to the group of lateral incisors were significantly greater compared with the other groups of teeth (P < 0.05). CONCLUSIONS: The importance of the cooling effect of simulated pulp microcirculation in the thermal behaviour of the dentine was established. Thickness of tooth tissue influenced significantly pulp temperature rise ex vivo.