Wound healing of dehiscence defects following different root conditioning modalities: An experimental study in dogs

Objective: The purpose of this study was to investigate the periodontal healing pattern of dehiscence-type defects following different chemical root conditioning modalities. Materials and methods: Buccal osseous dehiscence defects were created on six teeth of seven dogs. After dental plaque accumulation, defects were treated with sterile saline solution (control group) or one chemical conditioning modality: citric acid (CA group), ethylenediaminetetraacetic acid (EDTA group), tetracycline (TTC group), citric acid + tetracycline (CA + TTC group), or tetracycline + citric acid (TTC + CA group). After 3 months of healing, clinical parameters were evaluated, and the animals were killed. Histological sections were processed, and a computer-assisted histometric analysis was used to evaluate the formation of new cementum, new bone, and epithelial apical migration. Results: All treatments yielded significant improvements in terms of probing depth decrease and clinical attachment level gain compared to baseline values; however, without significant differences among the groups (p > 0.05; one-way ANOVA). The highest amount of new cementum was noted in the EDTA group (3.72 ± 0.83 mm, 77.6 %), while the lowest amount of new bone was observed in the TTC group (0.7 ± 0.94 mm, 14.3 %). However, no statistically significant differences could be observed among the groups regarding epithelial apical migration, new cementum, and alveolar bone formation (p > 0.05). Conclusion: Chemical root surface conditioning did not promote any significant improvement in periodontal healing pattern of dehiscence-type defects in dogs. Clinical Relevance: Chemical root surface conditioning after surgical debridement did not promote positive or negative effects on periodontal healing pattern of dehiscence-type defects. © 2012 Springer-Verlag Berlin Heidelberg.

Effect of Indomethacin on Surface Treatment and Intracanal Dressing of Replanted Teeth in Dogs

Purpose: This study evaluated the healing process of teeth replanted after root treatment and intracanal dressing with indomethacin alone or indomethacin with calcium hydroxide (Ca[OH](2)).Materials and Methods: Through a case-control study, 24 teeth of 6 adult dogs were extracted, dried, and divided into 4 groups according to the root surface treatment protocols performed before replantation and the intracanal medication used after replantation. In group 1 (negative control), root surfaces were treated by immersion in a 0.9% saline solution and then replanted. In the other groups, the roots were immersed for 10 minutes in Ca(OH)(2) (group 2), indomethacin (group 3), or a solution of indomethacin and Ca(OH)(2) (group 4). After 2 weeks, group 1 teeth were subjected to single-visit root canal treatment and obturation with gutta-percha and sealer consisting of zinc oxide and eugenol. The teeth in the other groups were subjected to intracanal dressing with the same material used for immersion. After an additional period of 28 weeks, the animals were euthanized and the jaws containing the replanted teeth were processed for histologic analysis. Histometric values were statistically analyzed, with significance set at a P value less than or equal to .05.Results: Group 1 exhibited significantly more normal periodontium than group 4 (P = .02). Total resorption was greater in group 4 than in group 1 (P = .02). No statistically significant difference in the percentage of surface resorption or in total inactive resorption was observed between the groups.Conclusions: The findings of this study suggest that intracanal dressing and topical root treatment with Ca(OH)(2) with or without indomethacin is not recommended for teeth dried for 50 minutes, but the use of indomethacin alone as root surface treatment for delayed tooth replantation deserves further study using longer drying periods. In addition, the present results suggest that a single-visit root canal, performed up to 2 weeks after replantation, might be indicated for teeth dried for up to 50 minutes. (C) 2014 American Association of Oral and Maxillofacial Surgeons

Blood clot stabilization on root dentin conditioned by the combination of tetracycline and EDTA

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Morphology and adhesion on blood components in root surfaces treated by a piezoelectric ultrasonic: an in vitro study

The aim of this study was to evaluate the morphology and adhesion of blood components on root surfaces instrumented with piezoelectric ultrasonic Piezon Master Surgery. Methods 10 teeth were used in this study. The teeth had their proximal divided into four areas that received different treatments: Group 1: untreated control Group 2: scaling with manual instrument; Group 3: scaling with ultrasound; Group 4: Scaling with manual instruments and ultrasound. We obtained 20 samples, 10 of which were used to analyze the morphology and the other 10 were used for analysis of adhesion of blood components. The specimens were analyzed by scanning electron microscopy. Photomicrographs were analyzed by the scores of adhesion of blood components and the index of root morphology. The results were statistically by the Kruskall-Wallis and Mann-Whitney with a significance level of 95%. Results The morphological analysis showed that the Group 1 had a surface unchanged in relation to other groups (Group 1 X Group 2 = 0.0025; Group 1 X Group 3 = 0.0003; Group 1 X Group 4 = 0.0003) and Group 2 presented a smoother surface compared to Group 1 and groups instrumented with ultrasound (Group 2 X Group 3 = 0.0025; Group 2 X Group 4 = 0.0025) there were no statistical differences between the Groups 3 and 4. analysis of adhesion of blood components showed that the Groups 2, 3 and 4 had no statistically significant differences between themselves, but more biocompatible surfaces promoted the surface untreated control (Group 1 X Group 2 = 0.02; Group 1 X Group 3 = 0.04; Group 1 X Group 4 = 0.005). Conclusion The instrumentation with piezoelectric ultrasonic promoted an irregular root surface, but did not negatively affect the adhesion of blood components.

Erosive potencial of energy drinks on the dentine surface

Coordenação de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)

The effect of the angle of instrumentation of the piezoelectric ultrasonic scaler on root surfaces

To evaluate the influence of variations in the working angle of the piezoelectric ultrasonic scaler (PUS) on root surfaces. Material and methods Fifty-five uniradicular bovine teeth were used, of which 25 teeth were used for the analysis of the roughness and root wear, while the remaining 30 teeth were used for the analysis of morphology (MRS) and the attachment of blood components (ABC). The teeth were randomly divided into five groups according to the type of treatment (G1-G5: piezoelectric ultrasonic scaler; G6: manual curette) and to the PUS working angle applied (G1: 0°; G2: 30°; G3: 45°; G4: 60°; G5: 90°). For statistical analysis, the data describing the MRS and ABC were analysed by the Kruskal–Wallis and Dunn's tests, and the data describing the roughness and tooth wear were analysed by anova and Tukey's tests at the significance level of 5%. Results Manual curette (MC) promoted a smoother root surface than the application of the PUS. The PUS used at the angles of 30° and 45° resulted in a high level of ABC that was comparable to that obtained by MC. Additionally, the group in which the PUS was applied at an angle of 45° exhibited less tooth wear than the other groups. Conclusions Changes in the working angle of the PUS influenced the characteristics of root surfaces after instrumentation.

The smear layer created by scaling and root planing is physiologically eliminated in a biphasic process

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Root morphology and phosphorus uptake by potato cultivars grown under deficient and sufficient phosphorus supply

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Enamel matrix protein adsorption to root surfaces in the presence or absence of human blood

Background: The clinical use of an enamel matrix derivative (EMD) has been shown to promote formation of new cementum, periodontal ligament (PDL), and bone and to significantly enhance the clinical outcomes after regenerative periodontal surgery. It is currently unknown to what extent the bleeding during periodontal surgery may compete with EMD adsorption to root surfaces. The aim of this study is to evaluate the effect of blood interactions on EMD adsorption to root surfaces mimicking various clinical settings and to test their ability to influence human PDL cell attachment and proliferation. Methods: Teeth extracted for orthodontic reasons were subjected to ex vivo scaling and root planing and treated with 24% EDTA, EMD, and/or human blood in six clinically related settings to determine the ability of EMD to adsorb to root surfaces. Surfaces were analyzed for protein adsorption via scanning electron microscopy and immunohistochemical staining with an anti-EMD antibody. Primary human PDL cells were seeded on root surfaces and quantified for cell attachment and cell proliferation. Results: Plasma proteins from blood samples altered the ability of EMD to adsorb to root surfaces on human teeth. Samples coated with EMD lacking blood demonstrated a consistent even layer of EMD adsorption to the root surface. In vitro experiments with PDL cells demonstrated improved cell attachment and proliferation in all samples coated with EMD (irrespective of EDTA) when compared to samples containing human blood. Conclusion: Based on these findings, it is advised to minimize blood interactions during periodontal surgeries to allow better adsorption of EMD to root surfaces.

Root Growth and Oxygen Relations at Low Water Potentials. Impact of Oxygen Availability in Polyethylene Glycol Solutions1

Polyethylene glycol (PEG), which is often used to impose low water potentials (ψw) in solution culture, decreases O2 movement by increasing solution viscosity. We investigated whether this property causes O2 deficiency that affects the elongation or metabolism of maize (Zea mays L.) primary roots. Seedlings grown in vigorously aerated PEG solutions at ambient solution O2 partial pressure (pO2) had decreased steady-state root elongation rates, increased root-tip alanine concentrations, and decreased root-tip proline concentrations relative to seedlings grown in PEG solutions of above-ambient pO2 (alanine and proline accumulation are responses to hypoxia and low ψw, respectively). Measurements of root pO2 were made using an O2 microsensor to ensure that increased solution pO2 did not increase root pO2 above physiological levels. In oxygenated PEG solutions that gave maximal root elongation rates, root pO2 was similar to or less than (depending on depth in the tissue) pO2 of roots growing in vermiculite at the same ψw. Even without PEG, high solution pO2 was necessary to raise root pO2 to the levels found in vermiculite-grown roots. Vermiculite was used for comparison because it has large air spaces that allow free movement of O2 to the root surface. The results show that supplemental oxygenation is required to avoid hypoxia in PEG solutions. Also, the data suggest that the O2 demand of the root elongation zone may be greater at low relative to high ψw, compounding the effect of PEG on O2 supply. Under O2-sufficient conditions root elongation was substantially less sensitive to the low ψw imposed by PEG than that imposed by dry vermiculite.

Preferential expression of an ammonium transporter and of two putative nitrate transporters in root hairs of tomato.

Root hairs as specialized epidermal cells represent part of the outermost interface between a plant and its soil environment. They make up to 70% of the root surface and, therefore, are likely to contribute significantly to nutrient uptake. To study uptake systems for mineral nitrogen, three genes homologous to Arabidopsis nitrate and ammonium transporters (AtNrt1 and AtAmt1) were isolated from a root hair-specific tomato cDNA library. Accumulation of LeNrt1-1, LeNrt1-2, and LeAmt1 transcripts was root-specific, with no detectable transcripts in stems or leaves. Expression was root cell type-specific and regulated by nitrogen availability. LeNrt1-2 mRNA accumulation was restricted to root hairs that had been exposed to nitrate. In contrast, LeNrt1-1 transcripts were detected in root hairs as well as other root tissues under all nitrogen treatments applied. Analogous to LeNrt1-1, the gene LeAmt1 was expressed under all nitrogen conditions tested, and root hair-specific mRNA accumulation was highest following exposure to ammonium. Expression of LeAMT1 in an ammonium uptake-deficient yeast strain restored growth on low ammonium medium, confirming its involvement in ammonium transport. Root hair specificity and characteristics of substrate regulation suggest an important role of the three genes in uptake of mineral nitrogen.

A study of primary teeth restored by intracoronal restorations in children participating in an undergraduate teaching programme at Cork University Dental School and Hospital, Ireland

Aim: To study the outcomes for restored primary molar teeth; to examine outcomes in relation to tooth type involved, intracoronal restoration complexity and to the material used. Materials and methods: Design: Retrospective study of primary molar teeth restored by intracoronal restorations. A series of restored primary molar teeth for children aged 6-12 years was studied. The principal outcome measure was failure of initial restoration (re-restoration or extraction). Three hundred patient records were studied to include three equal groups of primary molar teeth restored with amalgam, composite or glass ionomer, respectively. Restorative materials, the restoration type, simple (single surface) or complex (multi-surface) restoration, and tooth notation were recorded. Subsequent interventions were examined. Data were coded and entered into a Microsoft Excel database and analysis undertaken using SPSS v.18. Statistical differences were tested using the c2 test of statistical significance. Results: Of the 300 teeth studied, 61 restoration failures were recorded with 11 of those extracted. No significant differences were found between outcomes for upper first, upper second, lower first or lower second primary molars. Outcomes for simple primary teeth restored by intracoronal restorations were significantly better than those for complex intracoronal restorations (P = 0.042). Teeth originally restored with amalgam accounted for 19.7% of the 61 failures, composite for 29.5%, while teeth restored with glass ionomer represented 50.8% of all restoration failures. The differences were significant (P = 0.012). Conclusions: The majority (79.7%) of the 300 restored primary teeth studied were successful, and 3.7% teeth were extracted. Restorations involving more than one surface had almost twice the failure rate of single surface restorations. The difference was significant. Significant differences in failure rates for the three dental materials studied were recorded. Amalgam had the lowest failure rate while the failure rate with glass ionomer was the highest.

Risk indicators associated with root caries in independently living older adults

Objective: To determine the risk indicators associated with root caries experience in a cohort of independently living older adults in Ireland. Methods: The data reported in the present study were obtained from a prospective longitudinal study conducted in a cohort of independently living older adults (n = 334). Each subject underwent an oral examination, performed by a single calibrated examiner, to determine the root caries index and other clinical variables. Questionnaires were used to collect data on oral hygiene habits, diet, smoking and alcohol habits and education level. A regression analysis with the outcome variable of root caries experience (no/yes) was conducted. Results: A total of 334 older dentate adults with a mean age of 69.1 years were examined. 53.3% had at least one filled or decayed root surface. The median root caries index was 3.13 (IQR 0.00, 13.92). The results from the multivariate regression analysis indicated that individuals with poor plaque control (OR 9.59, 95% CI 3.84–24.00), xerostomia (OR 18.49, 95% CI 2.00–172.80), two or more teeth with coronal decay (OR 4.50, 95% CI 2.02–10.02) and 37 or more exposed root surfaces (OR 5.48, 95% CI 2.49–12.01) were more likely to have been affected by root caries. Conclusions: The prevalence of root caries was high in this cohort. This study suggests a correlation between root caries and the variables poor plaque control, xerostomia, coronal decay (≥2 teeth affected) and exposed root surfaces (≥37). The significance of these risk indicators and the resulting prediction model should be further evaluated in a prospective study of root caries incidence. Clinical significance Identification of risk indicators for root caries in independently living older adults would facilitate dental practitioners to identify those who would benefit most from interventions aimed at prevention.

The expression of plasminogen activator system in a rat model of periodontal wound healing

BACKGROUND: The plasminogen activator system has been proposed to play a role in proteolytic degradation of extracellular matrices in tissue remodeling, including wound healing. The aim of this study was to elucidate the presence of components of the plasminogen activator system during different stages of periodontal wound healing. METHODS: Periodontal wounds were created around the molars of adult rats and healing was followed for 28 days. Immunohistochemical analyses of the healing tissues and an analysis of the periodontal wound healing fluid by ELISA were carried out for the detection of tissue-type plasminogen activator (t-PA), urokinase-type plasminogen activator (u-PA), and 2 plasminogen activator inhibitors (PAI-1 and PAI-2). RESULTS: During the early stages (days 1 to 3) of periodontal wound healing, PAI-1 and PAI-2 were found to be closely associated with the deposition of a fibrin clot in the gingival sulcus. These components were strongly associated with the infiltrating inflammatory cells around the fibrin clot. During days 3 to 7, u-PA, PAI-1, and PAI-2 were associated with cells (particularly monocytes/macrophages, fibroblasts, and endothelial cells) in the newly formed granulation tissue. During days 7 to 14, a new attachment apparatus was formed during which PAI-1, PAI-2, and u-PA were localized in both periodontal ligament fibroblasts (PDL) and epithelial cells at sites where these cells were attaching to the root surface. In the periodontal wound healing fluid, the concentration for t-PA increased and peaked during the first week. PAI-2 had a similar expression to t-PA, but at a lower level over the entire wound-healing period. CONCLUSIONS: These findings indicate that the plasminogen activator system is involved in the entire process of periodontal wound healing, in particular with the formation of fibrin matrix on the root surface and its replacement by granulation tissue, as well as the subsequent formation of the attachment of soft tissue to the root surface during the later stages of wound repair.

Differential expression and distribution of syndecan-1 and -2 in periodontal wound healing of the rat

Cell-surface proteoglycans participate in several biological functions including interactions with adhesion molecules, growth factors and a variety of other effector molecules. Accordingly, these molecules play a central role in various aspects of cell–cell and cell–matrix interactions. To investigate the expression and distribution of the cell surface proteoglycans, syndecan-1 and -2, during periodontal wound healing, immunohistochemical analyses were carried out using monoclonal antibodies against syndecan-1, or -2 core proteins. Both syndecan-1 and -2 were expressed and distributed differentially at various stages of early inflammatory cell infiltration, granulation tissue formation, and tissue remodeling in periodontal wound healing. Expression of syndecan-1 was noted in inflammatory cells within and around the fibrin clots during the earliest stages of inflammatory cell infiltration. During granulation tissue formation it was noted in fibroblast-like cells and newly formed blood vessels. Syndecan-1 was not seen in newly formed bone or cementum matrix at any of the time periods studied. Syndecan-1 expression was generally less during the late stages of wound healing but was markedly expressed in cells that were close to the repairing junctional epithelium. In contrast, syndecan-2 expression and distribution was not evident at the early stages of inflammatory cell infiltration. During the formation of granulation tissue and subsequent tissue remodeling, syndecan-2 was expressed extracellularly in the newly formed fibrils which were oriented toward the root surface. Syndecan-2 was found to be significantly expressed on cells that were close to the root surface and within the matrix of repaired cementum covering root dentin as well as at the alveolar bone edge. These findings indicate that syndecan-1 and -2 may have distinctive functions during wound healing of the periodontium. The appearance of syndecan-1 may involve both cell–cell and cell–matrix interactions, while syndecan-2 showed a predilection to associate with cell–matrix interactions during hard tissue formation.