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"Pulp"
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Short-term dentin-pulp complex repair with four pulp capping materials: a double-blind randomized crossover histological study
This study aimed to evaluate the histological short-term response of intact premolars following direct pulp capping (DPC) using four bioactive materials: Neo MTA Plus (NMP), Neo Putty (NP), Total Fill BC Fast set putty (FSP), and Total Fill BC RRM Paste (BCP). Thirty-two intact premolars in eight patients scheduled for orthodontic extraction were included. Teeth were randomly assigned into four groups based on the bioactive material applied during pulpotomy. Each patient will experience the four direct pulp capping materials, randomly assigned to their four premolars: NMP group (n = 8), NP group (n = 8), FSP group (n = 8), and BCP group (n = 8). Premolars were extracted after four weeks. Histological evaluations assessed pulpal inflammation intensity (PII) and dentinal bridge continuity (DBC). Kruskal–Walis and Mann–Whitney U tests were used to analyze the data. Statistical significance was set at α = 0.05. There were significant differences in the PII among groups (
p
= 0.001). The NMP group was lower than the other three material groups (NP, FSP, and BCP). Moreover, there were significant differences in the DBC among groups (
p
< 0.001). DBC in the NMP group was lower than that of the other three material groups (NP, FSP, and BCP). Additionally, the DBC in the FSP group was higher than in the NP and BCP groups. The short-term histological examination suggests that the NMP group exhibited the lowest PII but was associated with inferior continuity of the formed dentin bridge. In contrast, the FSP group demonstrated superior continuity of the formed dentin bridge.
Journal Article
Clinical and radiographic assessment of mineral trioxide aggregate with platelet rich fibrin as pulp capping biomaterials: a 12-month randomized trial
This study aimed to comparatively assess the clinical success and radiographic regenerative dentin formation of Platelet Rich Fibrin (PRF) and mineral trioxide aggregate (MTA) when used as direct pulp capping agents. This double-blinded two parallel armed randomized controlled clinical trial comprised the allocation of 108 patients with traumatically exposed dental pulp during the management of deep carious lesions by undergraduate students after fulfilling inclusion and exclusion criteria. Patients were randomized into two groups (
n
= 54 in each group) using computer-generated simple randomization, wherein one group Platelet Rich Fibrin (PRF) was prepared from patients’ blood samples and applied directly over exposed pulp followed by MTA application and in the other group MTA was applied directly over pulp exposure. In both groups, cavities were restored with resin-modified glass ionomer liner and resin composite restoration. The overall success of treatment was calculated at 6 and 12 months after assessing pulp sensibility, history of pain, tenderness on percussion and the existence of any periapical pathosis using in periapical radiographs. Moreover CBCT was used at 12 months to determine the presence or absence of dentin bridge as a secondary outcome. After 12 months follow-up, there was no statistically significant difference in overall success of pulp capping in both groups. As the both groups showed 92.59% success rate. CBCT evaluation of dentin bridge formation by Platelet Rich Fibrin (PRF) demonstrated a significantly higher percentage than that formed in cases treated with MTA alone (
p
< 0.001). Direct pulp capping with Platelet Rich Fibrin (PRF) exhibited a clinical and radiographic success rate comparable to that of MTA. Platelet Rich Fibrin (PRF) can be implemented as a direct pulp capping agent in forthcoming clinical applications.
Journal Article
Correlation between pulp sensibility and magnetic resonance signal intensity following regenerative endodontic procedures in mature necrotic teeth- a retrospective cohort study
Background
With increasing studies being published on regenerative endodontic procedures (REPs) as a treatment modality for mature necrotic teeth, the assessment of outcomes following regenerative endodontic procedures has become more challenging and the demand for a better understanding of the regenerated tissues following this treatment is rising. The study aimed to correlate cold, electric pulp testing (EPT), and magnetic resonance imaging (MRI) signal intensity (SI) in mature necrotic teeth treated with regenerative endodontic procedures.
Methodology
This retrospective cohort study included eighteen adult patients who experienced tooth necrosis in mature maxillary anterior teeth recruited from the outpatient clinic, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt from July 2017 until December 2018 with 12 months of follow-up. regenerative endodontic procedures via blood clot were performed. The canals were instrumented by ProTaper Next (PTN) files until final sizes X3 or X5. Biodentine was used as cervical plug material. Pre and post-operative clinical follow-up was done where the patients’ responses to cold and electric pulp testing were given a scoring system and were compared to the normal contralateral tooth. Pre and post-operative magnetic resonance imaging signal intensity of both the involved tooth and its contralateral at the middle and the apical thirds of the root canals were assessed after 3, 6, and 12 months. Data was analyzed using the ANOVA, Friedman and Bonferroni tests. Significance was set at a
p
-value < 0.05.
Results
All 18 teeth scored a baseline score of “2” for cold and electric pulp testing. There was a significant difference between scores of the cold test at baseline and 12-month follow-up (
p
< 0.001). There was a significant difference between scores of the electric pulp testing of baseline and 12-month follow-up (
p
< 0.001). There was a moderately significant indirect (inverse) correlation between magnetic resonance imaging signal intensity and cold test in both the middle and apical thirds at 12 months. No significant correlations were detected between magnetic resonance imaging signal intensity and electric pulp testingat any of the time intervals (
p
> 0.05).
Conclusion
Magnetic resonance imaging is a successful non-invasive method to assess outcomes of regenerative endodontic procedures and correlating it with another reliable method of assessing pulpal responses, cold test, could validate these outcomes.
Clinical trial registration
The study was registered with ClinicalTrials.gov (ID: NCT03804450).
Journal Article
Clinical and radiographic evaluation of Er: YAG laser-assisted direct pulp capping in permanent teeth with carious exposure
Purpose
The study aimed to evaluate the clinical and radiographic outcomes of three treatment modalities: Biodentine alone, Er: YAG laser followed by Biodentine, and Er: YAG laser alone. The primary objective was to determine whether the use of Er: YAG laser enhances the success rate of direct pulp capping (DPC) in cariously exposed permanent teeth.
Methods
This study included 42 participants with mature permanent teeth requiring DPC, randomly assigned to three groups of 14 patients each. Group 1 received Biodentine alone, Group 2 underwent Er: YAG laser irradiation followed by Biodentine application, and Group 3 was treated with Er: YAG laser. The laser parameters used for enamel cutting and cavity preparation were: output power 8.0 W, energy 400 mJ, fluence 10 J/cm², spot size 0.8 mm, frequency 20 Hz, air 80%, and water 60%, in contact mode. For carious dentin removal, parameters were adjusted to 4.0 W power, 200 mJ energy, fluence 3 J/cm², frequency 20 Hz, air 90%, and water 30%, maintaining the same spot size. Pulp irradiation was performed using a 0.6 mm spot size, 0.5 W output power, 30 mJ energy and frequency 15 Hz in non-contact mode with no water spray, at a distance of 1.5 mm from the pulp. Laser was applied in a sweeping motion for 15 s per application, repeated 5–20 times until hemostasis was achieved. Clinical and radiographic evaluations were conducted at baseline, 3 months, 6 months and 12 months. Success was defined as the absence of pain, sensitivity, or pathology and evidence of dentin bridge formation on radiographs. Statistical analysis was performed to compare outcomes across groups.
Results
All three groups demonstrated favourable clinical and radiographic success rates. Group 2 (Er: YAG laser + Biodentine) showed a statistically significant higher success rate compared to the other groups, particularly in terms of dentin bridge formation (
p
= 0.01) and reduced postoperative sensitivity (
p
= 0.03). Group 1 and Group 3 also performed well, but the outcomes in Group 3 were slightly inferior due to limited dentin bridge formation (
p
= 0.04).
Conclusion
The inclusion of Er: YAG laser in DPC procedures enhances treatment outcomes, particularly when combined with Biodentine. This approach offers a promising alternative for vital pulp therapy in mature permanent teeth, ensuring better dentin bridge formation and clinical success.
Clinical trial registration
Clinical trial registration details (Registry-Clinical Trials Registry - India, Trial registration number-CTRI/2022/04/041678, and date of registration-06/04/2022).
Journal Article
Dime novels and the roots of American detective fiction
\"Why is detective fiction so popular? What connects such diverse characters as the armchair sleuth, the hardboiled dick, and the police detective? Dime Novels and the Roots of American Detective Fiction uncovers the significance of often-neglected dime novels in revealing early examples of the subgenres of detective fiction--drawing-room mysteries, hardboiled 'tough guy' fiction, police procedurals, and postmodern detective fiction--in the genre's first mass instantiation in the dime novels (1860-1915). A study of over 100 dime novel endings shows the prevalence of subversive representations of gender, race and class, while new readings of iconic detectives like Nick Carter and Allan Pinkerton reveal the enormous influence of these figures on future developments in the detective genre. The book argues that inherent tensions between subversive and conservative impulses--theorized as contamination and containment--explain detective fiction's ongoing popular appeal to readers and to writers such as Twain and Faulkner, whose detective writings are clearly informed by dime novels. \"-- Provided by publisher.
Book
Second Generation Bioethanol Production: On the Use of Pulp and Paper Industry Wastes as Feedstock
Due to the health and environment impacts of fossil fuels utilization, biofuels have been investigated as a potential alternative renewable source of energy. Bioethanol is currently the most produced biofuel, mainly of first generation, resulting in food-fuel competition. Second generation bioethanol is produced from lignocellulosic biomass, but a costly and difficult pretreatment is required. The pulp and paper industry has the biggest income of biomass for non-food-chain production, and, simultaneously generates a high amount of residues. According to the circular economy model, these residues, rich in monosaccharides, or even in polysaccharides besides lignin, can be utilized as a proper feedstock for second generation bioethanol production. Biorefineries can be integrated in the existing pulp and paper industrial plants by exploiting the high level of technology and also the infrastructures and logistics that are required to fractionate and handle woody biomass. This would contribute to the diversification of products and the increase of profitability of pulp and paper industry with additional environmental benefits. This work reviews the literature supporting the feasibility of producing ethanol from Kraft pulp, spent sulfite liquor, and pulp and paper sludge, presenting and discussing the practical attempt of biorefineries implementation in pulp and paper mills for bioethanol production.
Journal Article