Theracal lc: A boon to dentistry

TheraCal LC, the focus of this article, is a material that creates a new category of resin-modified calcium silicates (RMCS). It is a light-cured, resin-based, and highly radiopaque liner designed to release calcium to promote hard-tissue formation, and is indicated for use under direct restorative materials as a replacement to calcium hydroxide and other calcium silicate-based materials, glass ionomers, eugenol-based sedative materials, and pulp capping restoratives. TheraCal LC exhibits several properties to help maintain ideal hard-tissue health and to reduce the incidence of postoperative sensitivity. This article is aimed to review the composition, method of application, setting reaction, properties and uses of TheraCal LC. TheraCal LC is interesting and promising product, which have the potential of creating major contributions to maintaining pulp vitality.

Analysis and Assessment of Pulp Vitality of 102 Intrinsically Stained Teeth in Dogs

Our prospective study analyzed clinical, radiographic, and histological characteristics of 102 intrinsically stained teeth. Sixty-nine dogs ranging from one to fifteen years of age were included in this study. Little more than half of the intrinsically stained teeth had no evidence of coronal injury (53.9%, 55/102). We found that most intrinsically stained teeth were histologically nonvital (87.6%, 85/97) and approximately 2/3 of these (57.7%, 56/97) had no histological endodontic or periodontal inflammation at the time of evaluation. Radiographic evidence of endodontic disease was present in 57% (58/102) of the intrinsically stained teeth. Radiographic evidence of periodontal disease was present in 48% (49/102) of intrinsically stained teeth and 28% (29/102) had radiographic evidence of tooth resorption. 18.6% (19/102) of intrinsically stained teeth were radiographically normal. Evidence of pulp necrosis was common in these intrinsically stained teeth, while only occasional teeth (12.4%, 12/97) had histologically confirmed pulpitis. All teeth with radiographic evidence of periapical lucency had pulp necrosis. Based on our histological findings, the majority of intrinsically stained teeth 87.6% are truly nonvital.

Decision-Making and Management of Immature Permanent Teeth with Crown Fractures in Small Animals—A Review

Immature permanent teeth with crown fractures present a unique challenge in human and animal patients. Immature permanent teeth have not yet developed completely, often presenting with thin dentin walls, incomplete apical formation, and increased crown-to-root ratios. Loss of pulp function at this stage has devastating long-term implications for these teeth. Ideally, attempts should be made to preserve pulp vitality in immature permanent teeth to allow for continued dental development. The range of treatment options for vital teeth includes odontoplasty with bonding and sealing +/− restoration, indirect pulp capping, and direct pulp capping/vital pulp therapy. These treatments have long been established in human and veterinary medicine, and cases have been reported in dogs and cats. Apexification using calcium hydroxide is a well-established treatment for nonvital immature teeth. The advent of mineral trioxide aggregate and other bioceramic materials for use in vital pulp therapy and apexification has reduced treatment sessions and improved outcomes. Recent developments in the field of regenerative endodontic therapy further expand treatment options and provide the possibility for continued development of a formerly nonvital tooth. Selecting the appropriate treatment based on the severity of tooth fracture and status of pulp vitality can avoid a lifetime of poor structure and function for the affected tooth. This article provides multiple step-by-step protocols for the management of immature permanent teeth with crown fractures in small animals.

Cell-Based Transplantation versus Cell Homing Approaches for Pulp-Dentin Complex Regeneration

Regenerative dentistry has paved the way for a new era for the replacement of damaged dental tissues. Whether the causative factor is dental caries, trauma, or chemical insult, the loss of the pulp vitality constitutes one of the major health problems worldwide. Two regenerative therapies were introduced for a fully functional pulp-dentin complex regeneration, namely, cell-based (cell transplantation) and cell homing (through revascularization or homing by injection of stem cells in situ or intravenously) therapies, with each demonstrating advantages as well as drawback, especially in clinical application. The present review is aimed at elaborating on these two techniques in the treatment of irreversibly inflamed or necrotic pulp, which is aimed at regenerating a fully functional pulp-dentin complex.

Fibroma cementoossificante bilateral mandibular apresentando diferentes estágios de maturação: relato de caso clínico / Bilateral ossifying fibroma of the jaw with different maturation stages: a case report

The ossifying fibroma (OF) is characterized as a benign neoplasm originated from the mesenchymal periodontal membrane, being composed of different amounts of mineralized material and fibrocellular stroma, leading to a mixed aspect. More commonly found as solitary lesions, the OF can be multiple in rare cases, normally associated with hyperparathyroidism-jaw tumor syndrome (HPT-JT). The aim of this study is to report a case of bilateral OF in the mandible with different stages of maturation, not associated with HPT-JT. This case shows a 20-year-old female patient with asymptomatic intraoral hard swelling in both sides of the mandible, presenting a slight expansion in the buccal bone cortex, near to the molars, hard to palpation. CBCT showed a unilocular, well-circumscribed hypodense image, with calcified masses only on the right side. Incisional biopsies were performed and a diagnosis of bilateral OF was reached. Due to the different stages of maturation of the lesions, two different surgical approaches were performed, curettage in the left side and surgical resection in the right side with extraction of the lower second premolar and lower first molar. These areas were restored with bone grafts and the left first molar was unresponsive to the pulp vitality test and endodontic treatment was performed. The patient is undergoing periodic clinical and radiographic follow-up, and after 12 months no signs or evidence of recurrence were observed.

Evaluation of pulp vitality using a pulse oximeter in patients undergoing radiotherapy for rhabdomyosarcoma or rhinopharynxcarcinoma

The oral cavity is highly susceptible to pathological changes due to the deleterious effects of radiation (RI) on tissues exposed during radiotherapy (RT). The aim of this study was to evaluate the feasibility of using pulse oximeter (PO) as a diagnostic instrument for assessing the pulp oxygenation level (%SpO2) of immature teeth previously exposure to IR. Pulp oxygenation saturation was evaluated in fifteen children or adolescent patients (Group RT) that received previous IR, 6.01 years ago (SD 4.08 years), and fifteen patients without a history of neoplasms or previous chemotherapy or radiotherapy (CO group). As result, the mean %SpO2 measured in Group RT and Group CO was 86.06% (SD 1.61%) and 91.11% (SD 0.87%), respectively. Conclusions: The use of the pulse oximeter adapted for dentistry for pulpal vitality evaluation in patients who received radiotherapy is feasible showing lower level of SpO2 than that of the control group (p<0.05).

Efficacy of Laser Doppler Flowmetry, as a Diagnostic Tool in Assessing Pulp Vitality of Traumatised Teeth. A Split Mouth Clinical Study

Aim: This study aimed to evaluate the efficacy of laser Doppler flowmetry (LDF) in determining the changes in the pulpal blood flow (PBF) during post-traumatic period of the traumatised permanent teeth. Methods: 88 teeth of 44 patients (mean age 10.30 ± 2.38) were recruited according to the eligibility criteria and divided into two groups: test group (44 traumatised teeth) and control group (44 sound and healthy teeth). The measurement of PBF was performed, using a LDF monitor. Results: The analysis of the LDF outcomes in function of diagnosis indicated that the measurements of the traumatised teeth were significantly higher than those of non-traumatised teeth (p ˂ 0.05). Conclusions: LDF application provides dentists with fundamental benefits in terms of an early and precise investigation of PBF. In addition, LDF is a useful monitoring tool for revascularization of traumatised teeth and reliable objective diagnostic indicator of pulp vitality. Trial registration: ClinicalTrials.gov (Registration number: NCT04967456).

Microbiological analysis of root canal space prepared for prosthetic intracanal posts

The aim of the study was to microbiologically analyze the root canal space prepared for prosthetic intracanal posts. Thus, a 2% chlorhexidine solution was used after the intraradicular preparation of ten teeth with endodontic treatment performed for prosthetic purposes and pulp vitality history. Two collections were performed for microbiological analysis: one before the use of the studied solution, showing positive microbiological culture in all cases; and another, after application for 3 minutes of 2% chlorhexidine solution. The results showed the effectiveness of the solution in nine of ten cases, presenting negative results in microbial culture.

“EVALUATION OF THE INCIDENCE OF ENDODONTIC FLARE UPS AND THEIR ASSOCIATED FACTORS- A PROSPECTIVE –OBSERVATIONAL STUDY.”

The purpose of this prospective observational study was to evaluate the incidence of endodontic are-ups and the various factors associated with these are ups. The study was carried out in dept. of cons & endo among 250 patients including both male and females to nd out to various reasons for these occurrences of pain and swelling. The study included a questionnaire based survey where the dentists and patients who had undergone root canal therapy were asked to record about the amount of pain perceived by them. Results- In this study it was observed that the incidence of are ups among the study subjects was 18.8%. Various factors that were observed for the incidences of are ups reveals that age, previous history of pain. Pulp vitality, non signicant value, where as it was recorded that periapical radiolucency showed a signicant value. Conclusion- That a sudden and unknown response of the hosts towards endodontic therapy can be avoided at through proper knowledge and observance towards endodontic therapy

Integrated clinical treatment of external cervical resorption: Case report

External cervical resorption (ECR) has an inflammatory nature and the proximity to the gingival sulcus favors contamination and progression of the lesion. Change in crown color, inflammation of the marginal gingiva or even the presence of secretion in the gingival sulcus are the main clinical signs. Being an asymptomatic lesion, it can be neglected and its progression can jeopardize the tooth involved. This report describes the treatment of a patient who presented two teeth with ECR. On clinical examination, the crown of tooth 17 showed a pinkish translucency on the occlusal surface. On tooth 12, this spot was dark and located in the cervical third of the labial surface of the crown. Both the teeth were asymptomatic, and the radiographic examination showed an image comparable with root resorption in the cervical third of the crown. On tooth 17, the middle and cervical third of the crown was compromised and the pulp vitality test was negative. The treatment for the case was extraction. A tomographic examination of tooth 12 demonstrated pulpal involvement and biologic width violation. The vitality test was positive. After endodontic treatment, the tooth was extruded by 4 mm, the resorbed area was exposed and restored with composite resin. A 39-month clinical and radiographic control showed integrity of the root surface and the periodontium. It was found that early diagnosis influences the prognosis of treatment considering the speed of progression of resorption. It emphasizes the importance of clinical and radiographic control of the clinical conditions that predispose to ECR.