Australian Endodontic Journal最新文献

This study examined the histological response of human dental pulp to Mineral Trioxide Aggregate (MTA) as a pulp-capping agent, with or without Low Level Laser Therapy (LLLT). Thirty-two premolars from 16 patients were treated in a split-mouth design: one side received MTA alone, the other MTA with diode laser-assisted haemostasis and decontamination. After 6 weeks, the teeth were extracted for histological analysis. Results showed that the group with LLLT had a higher incidence of complete dentine bridges (87.5% vs. 68.8%) and thicker bridges (> 0.25 mm: 81.3% vs. 68.8%), though differences were not statistically significant. Inflammation was significantly lower in the LLLT group, with all samples showing moderate inflammation compared to 68.8% in controls, and some severe inflammation cases. Tissue organisation was similar between groups. The study suggests that adding LLLT to MTA reduces pulpal inflammation and promotes more uniform, thicker dentine bridges, indicating improved pulp healing.

This study investigated the biological response of human peripheral blood mononuclear cells (PBMCs) to zinc polycarboxylate (ZP) cement modified with 5% or 10% potassium nitrate (KNO₃) and assessed its mechanical properties. Discs of unmodified ZP, ZP + 5% KNO₃, ZP + 10% KNO₃, or mineral trioxide aggregate (MTA) were indirectly exposed to PBMCs using a transwell system. Cells were incubated with or without lipopolysaccharide (LPS) stimulation. Cytotoxicity (LDH release), viability, IL-6 and TGF-β secretion were evaluated. Material pH, ion release, compressive strength and microhardness were also assessed. ZP + 5% KNO₃ significantly reduced LDH and IL-6 levels and increased TGF-β release compared to ZP alone. Mechanical strength was maintained in ZP + 5% KNO₃ but decreased at 10% KNO₃. MTA showed lower strength but higher cell viability. ZP + 5% KNO₃ demonstrated a balanced profile of immunomodulation, regenerative signalling and mechanical integrity, supporting its potential use in vital pulp therapy. Further in vivo investigations are recommended.

This in vitro study evaluated the effects of intracanal medications on the metabolic activity and adhesion of human periodontal ligament-derived mesenchymal stem cells. Tested groups included Control (without medication), Triple Antibiotic Paste (TAP), Double Antibiotic Paste (DAP), calcium hydroxide with saline, calcium hydroxide with 2% chlorhexidine gel and Bio-C Temp. After conditioning, roots were stored in phosphate-buffered saline at 37°C for 21 days. Medications were then removed using 17% EDTA and saline, and dentine samples were used as substrates for cell culture at 3, 5 and 7 days. Metabolic activity was assessed via MTT assay, and adhesion via scanning electron microscopy. None of the medications negatively affected cell viability or adhesion compared to control. TAP showed higher metabolic activity than calcium hydroxide with saline at Day 7. DAP induced earlier cell morphology changes. Bio-C Temp and chlorhexidine gel showed no significant differences at Day 7, confirming overall biocompatibility.

This study aimed to investigate the biomechanical impact of root canal anatomical variations and restoration techniques on endodontically treated mandibular second molars using finite element analysis. Five root morphologies were modelled: separated-rooted (S), fused-rooted with V-shaped (F-V), U-shaped (F-U) or Ω-shaped (F-Ω) radicular grooves and single-canal fused-rooted (F-O). Micro-CT scans were performed before and after endodontic instrumentation to generate the finite element models: intact teeth, post-and-core crowns with 2- to 3-mm ferrules and endocrowns with 3- to 4-mm pulp chamber extensions. Under axial/oblique loading, von Mises stress distribution was evaluated. Results showed endocrowns had lower peak stresses than post-and-core crowns in common anatomical variations (S, F-U, F-Ω); F-V showed comparable peak stresses; post-and-core crowns with sufficient ferrule height minimised oblique-load stresses in single-canal teeth (F-O). Pronounced stress concentrations were observed at Ω-shaped groove in post-and-core restored teeth. Comprehensive evaluation of root morphology is critical for optimal restoration planning.

This systematic review examined the relationship between sickle cell disease (SCD), an inherited genetic hemoglobinopathy, and avascular pulp necrosis (APN) in intact teeth. A comprehensive search of eight electronic databases was performed up to December 2024. Eligible studies included observational or interventional designs reporting APN in intact teeth of individuals with SCD. Risk of bias was assessed with the Joanna Briggs Institute Critical Appraisal Checklists, and certainty of evidence with GRADE. The search retrieved 407 records; four observational studies (two cohort and two case-control) met inclusion criteria, comprising 311 individuals with sickle cell anaemia (SCA). There is a relationship between SCA and APN. However, all included studies presented a risk of bias of 30% or higher, and the certainty of evidence was rated very low. These results provide weak scientific support for the association between APN and SCA, underscoring methodological limitations in the current dental literature.

This study investigated the biomechanical behaviour of simulated external cervical resorption (ECR) lesions of varying 3D extent, before and after restoration, using finite element analysis (FEA). Seven maxillary incisors were modelled, representing Patel's classification stages: Group 1-2Bp, 2-2Cp, 3-2Cd, 4-3 Bd, 5-3Cd, 6-3Bp and 7-Control. ECR lesions were restored using Biodentine, with endodontic treatment when the pulp was involved. CBCT scans were used to generate 3D models, and a 240 N bite force was applied to evaluate stress via Von Mises and principal stress values. Pre-treatment, all ECR lesions showed concentrated stress, highest in Group 3Bp (538.11 MPa), correlating directly with lesion height, circumferential spread and pulp proximity. Post-treatment, biodentine reduced stress and improved the safety factor (SF), although most groups still had a failure index > 1, indicating residual fracture risk. Pulp involvement had the greatest biomechanical impact, highlighting the importance of early detection and classification-based treatment planning.

To evaluate treatment outcomes of directly and indirectly restored root filled teeth (RFT). Electronic databases (MEDLINE/PubMed, Scopus, Embase) were systematically searched for studies comparing indirect and direct restorations on RFT. Outcomes were tooth survival and periapical healing. Minimum follow-up time was 2 years. The quality of included studies was assessed using GRADE. A total of 2063 articles were screened; eventually, 11 studies were included (Ten cohort studies and one RCT). Ten studies reporting tooth survival and four studies on periapical healing were included in meta-analyses. Overall, RFT restored with indirect coronal restorations survived significantly better compared to directly restored RFT (p = 0.01), whereas no statistical difference in periapical healing was demonstrated (p = 0.72). Indirect restorations appear to be associated with improved survival in RFT, but this finding should be interpreted cautiously. No significant difference in periapical healing was found regardless of restoration type.

Trial Registration: International Prospective Register of Systematic Reviews (PROSPERO) ID: CRD42024594890