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Dislodgement resistance and adhesive pattern of different endodontic sealers to dentine wall after artificial ageing: an in-vitro study

Lin GSS, Ghani NRNA, Noorani TY, Ismail NH, Mamat N

Odontology, 2021 Jan;109(1):149-156.
PMID: 32623538 DOI: 10.1007/s10266-020-00535-7

To compare the dislodgement resistance and the adhesive pattern of four different endodontic sealers to root dentine walls. Ninety lower premolars were assigned to five groups (n = 18), Group 1: no sealer (control); Group 2: EndoRez (ERZ); Group 3: Sealapex (SPX); Group 4: EndoSeal MTA (ESA) and Group 5: BioRoot RCS (BRS). They were instrumented up to size 30 taper 0.06 and obturated using single cone technique with matched-taper gutta-percha cones and one of the mentioned sealers. Six teeth from each group were then randomly subjected to 100, 1000 and 10,000 thermocycles, respectively. 1 mm slice of mid root region, measuring 6 mm from the apical foramen was prepared and subjected to push-out test under a Universal Testing Machine. Adhesive patterns of sealers were assessed using a stereomicroscope at 20 × magnification and classified using a new system. Statistical analyses were performed using two-way ANOVA, complemented by Tukey HSD and Chi-square tests. ESA and BRS showed significantly higher (p 0.05) at 100, 1000 and 10,000 thermocycles, respectively. Both ESA and BRS exhibited a significant higher rate (p
The existence of butterfly effect and its impact on the dentinal microhardness and crack formation after root canal instrumentation

Lin GSS, Ghani NRNA, Noorani TY

Odontology, 2021 Jul;109(3):672-678.
PMID: 33458795 DOI: 10.1007/s10266-021-00589-1

To compare the microhardness and crack formation in root dentine presented with butterfly effect in lower premolars. Sixty mature lower premolars were selected and divided into the control and experimental groups. Teeth in the experimental group were instrumented up to size 30/.04. The roots were cut horizontally into twelve parts of 1-mm-thick cross-section and were numbered accordingly. They were divided into coronal, middle, and apical root sections. Sections were then viewed under a microscope to determine the presence of butterfly effect and subsequently scored. 8 teeth from both control and experimental groups with the highest and lowest score were selected. Crack formation was inspected and classified into four different types of cracks. Microhardness test was performed using a Vickers hardness test. Higher frequency of butterfly effect was found in the apical root section and root dentine with butterfly effect were harder mesiodistally. The middle and apical root sections with butterfly effect were harder than the coronal section. No significant difference of dentine hardness between the control and experimental groups. Cracks only occurred in the experimental group and presented in buccolingual direction with a higher rate of Type 1 and Type 2 cracks. Prevalence of butterfly effect in lower premolars increased from coronal to apical with increased hardness mesiodistally. More buccolingual cracks were found in radicular dentine with butterfly effect and most of them exhibited Type 1 and Type 2 cracks. Roots of lower premolar with butterfly effect may be susceptible to a higher rate of vertical root fracture in buccolingual direction, especially after root canal treatment. Thus, special attention should be given not to overload instruments during root canal preparation.
An in-vivo study of photobiomodulation using 403 nm and 649 nm diode lasers for molar tooth extraction wound healing in wistar rats

Astuti SD, Sulistyo A, Setiawatie EM, Khasanah M, Purnobasuki H, Arifianto D, et al.

Odontology, 2021 Sep 07.
PMID: 34491461 DOI: 10.1007/s10266-021-00653-w

PURPOSE: This study aims to examine the effects of red 649 nm 4 J/cm2 and blue 403 nm 8 J/cm2 diode laser treatment for post-extraction wounded healing in rats through histopathological and immunohistochemical analysis.
METHODS: Samples of 54 Wistar rats were divided into six groups: C- control group without treatment; C + wounded group without treatment; TB wound group with Povidone-iodine treatment; TD wounded group with doxycycline treatment; TLB wounded group with 403 nm diode laser treatment; and TLR wounded group with 649 nm diode laser treatment. Mandibular samples were observed for the number of lymphocytes and fibroblasts cells, new blood vessels formation, Interleukin 1β, and Collagen 1α expression level.
RESULTS: Based on the histopathological test results, red laser diode treatment significantly increased the number of lymphocyte, fibroblast cells and the formation of new blood vessels. Meanwhile, immunohistochemical tests showed an increase in the expression of the Colagen-1α protein which plays a role in the formation of collagen for new tissues formation after damage, as well as a decrease in Interleukin-1β expression level. Blue laser is also able to show a positive effect on wound healing even though its penetration level into the tissue is lower compared to red laser.
CONCLUSION: The red diode laser 649 nm has been shown to accelerate the process of proliferation in wound healing post molar extraction based on histopathological and immunohistochemical test results.
Is pulpotomy a promising modality in treating permanent teeth? An umbrella review

Lin GSS, Yew YQ, Lee HY, Low T, Pillai MPM, Laer TS, et al.

Odontology, 2021 Oct 11.
PMID: 34633590 DOI: 10.1007/s10266-021-00661-w

Emerging evidence suggests the use of less invasive therapy such as pulpotomy in treating permanent teeth with pulp exposure and signs of pulpitis. Hence, this umbrella review aims to evaluate the available systematic reviews on pulpotomy treated permanent teeth. Articles published between January 1970 and May 2021 were searched in ten electronic databases and five textbooks. Only systematic reviews published in English that examined the use of pulpotomy on either carious or traumatic pulpal exposed in mature or immature permanent teeth with signs of pulpitis were selected. The Corrected Covered Areas (CCAs) were calculated to identify the overlap in primary studies, whereas the AMSTAR 2 assessment tool was used to analyze the risk of bias in each included review. Nine systematic reviews were chosen of which two systematic reviews focused solely on coronal pulpotomy, one on partial pulpotomy, and the remaining focused on both coronal and partial pulpotomies. Overall, only two reviews were rated as 'High Quality'. Umbrella analyses showed that both coronal and partial pulpotomies revealed overall high success rates ranging from 88.5% to 90.6%. However, the currently available evidence on the effects of different pulpal medicaments and restorative materials on the success rate of pulpotomy were still inconclusive. Pulpotomy can be regarded as a promising modality in treating mature and immature permanent teeth with carious pulpal exposure or signs of pulpitis. Nonetheless, further high-quality clinical trials with long-term follow-up and better control of confounding factors are warranted in the future.
Vertical root fracture resistance and dentinal crack formation of root canal-treated teeth instrumented with different nickel-titanium rotary systems: an in-vitro study

Lin GSS, Singbal KP, Noorani TY, Penukonda R

Odontology, 2022 Jan;110(1):106-112.
PMID: 34269933 DOI: 10.1007/s10266-021-00643-y

To compare the vertical root fracture (VRF) resistance of root canal-treated teeth instrumented with four different nickel-titanium (NiTi) rotary file systems and examine the dentinal crack pattern and direction using a new classification. Eighty mature mandibular premolars were selected and decoronated, leaving 13 mm of the root. The root samples were mounted in acrylic resin and divided randomly into five groups of different NiTi file systems: Group 1-control, Group 2-T-Pro, Group 3-HyFlex CM, Group 4-TG6 and lastly Group 5-ZenFlex. Samples in Group 2 and Group 3 were instrumented up to size 25/0.04, whereas Group 4 and Group 5 were instrumented up to size 25/0.06. Obturation was performed with AH Plus sealer and gutta-percha using single cone technique. Subsequently, all samples were subjected to occlusal compressive force until they were fractured. The force (N) needed to cause root fracture was recorded. The crack patterns and directions were also inspected under magnification and classified using a new and simple classification. The highest (VRF) resistance was noted in the control group (453.15 ± 92.23 N), followed by T-Pro (387.43 ± 76.81 N), HyFlex CM (381.88 ± 52.73 N), ZenFlex (369.15 ± 89.41 N) and finally TG6 (346.05 ± 72.08 N), but there was no significant difference between T-Pro and HyFlex (P = 0.438). A significantly higher prevalence (P = 0.001) of Type 1 crack pattern was observed, especially in samples instrumented with TG6. Majority of the cracks ran buccolingually except in some samples instrumented with ZenFlex (P = 0.898). Smaller file taper increased the VRF resistance of root canal-treated teeth. Majority of the dentinal crack exhibited Type 1 pattern and ran buccolingually.
Characterization of the root and canal anatomy of maxillary premolar teeth in an Iraqi subpopulation: a cone beam computed tomography study

Aljawhar AM, Ibrahim N, Abdul Aziz A, Ahmed HMA, Azami NH

Odontology, 2023 Nov 13.
PMID: 37957521 DOI: 10.1007/s10266-023-00870-5

This study aims to evaluate the number of roots and root canal morphology types of maxillary premolars in relation to a patient's gender and age in an Iraqi population using two classification systems. Cone beam computed tomography (CBCT) scans of 1116 maxillary premolars from 385 patients were evaluated for the number of roots and root canal morphology types according to Vertucci's classification and Ahmed et al. classification systems. Differences in the number of roots and root canal morphology types with regard to tooth type, patients' gender and age groups were evaluated and the degree of bilateral symmetry was determined. Chi-squared test was used for statistical analysis. About 51.1% of the 1st premolars were double rooted. The majority (87.9%) of the 2nd premolars were single rooted. The three-rooted form presented in only 1.2% and 0.7% of the 1st and 2nd premolars, respectively. Vertucci Type IV (Ahmed et al. code 2MaxP B1P1) and Vertucci Type I (Ahmed et al. code 1MaxP1) were the most common canal morphology types in the 1st and 2nd premolars, respectively. Females showed a lower number of roots and a higher prevalence of Vertucci Type I configuration (P
MicroRNA and their implications in dental pulp inflammation: current trends and future perspectives

Maqbool M, Syed NH, Rossi-Fedele G, Shatriah I, Noorani TY

Odontology, 2023 Jul;111(3):531-540.
PMID: 36309897 DOI: 10.1007/s10266-022-00762-0

MicroRNAs (miRNAs) are short, 19-23 nucleotide non-coding RNA molecules that regulate gene expression by silencing or degrading the target mRNA gene. Since their discovery in the nineties of the last century, they have emerged as key inflammatory regulators. Inflammation induces the synthesis of various miRNAs that modulate the expression of multiple molecules involved in orchestrating the inflammatory response. This review aims to provide an insight into the role of miRNAs as potential biomarkers, mediators, and potential therapeutic targets of dental pulp inflammation. A literature search was conducted using the keywords; biogenesis of microRNA, human dental pulp cells, pulpitis, and inflammation in PubMed and Scopus index databases for all the published articles dealing with the role of miRNAs in pulp inflammation in the last 10 years. According to the literature, there is a clear correlation between miRNAs and several physiological events, as well as their role as mediators of innate immune response and inflammation in dental pulp cells. Our narrative review stipulates that numerous miRNAs play a key role in modulating inflammation, delaying or enhancing cell repair, cell differentiation, and survival in dental pulp diseases. However, further studies are required for the validation of miRNAs as reliable biomarkers in dental pulp pathology and their targeted therapy.
Physicochemical, mechanical and biological properties of nano-calcium silicate-based cements: a systematic review

Majeed R, Elnawawy HM, Kutty MG, Yahya NA, Azami NH, Abu Kasim NH, et al.

Odontology, 2023 Oct;111(4):759-776.
PMID: 36864211 DOI: 10.1007/s10266-023-00786-0

This systematic review evaluated the effects of nano-sized cement particles on the properties of calcium silicate-based cements (CSCs). Using defined keywords, a literature search was conducted to identify studies that investigated properties of nano-calcium silicate-based cements (NCSCs). A total of 17 studies fulfilled the inclusion criteria. Results indicated that NCSC formulations have favourable physical (setting time, pH and solubility), mechanical (push out bond strength, compressive strength and indentation hardness) and biological (bone regeneration and foreign body reaction) properties compared with commonly used CSCs. However, the characterization and verification for the nano-particle size of NCSCs were deficient in some studies. Furthermore, the nanosizing was not limited to the cement particles and a number of additives were present. In conclusion, the evidence available for the properties of CSC particles in the nano-range is deficient-such properties could be a result of additives which may have enhanced the properties of the material.
Correction: Physicochemical, mechanical and biological properties of nano-calcium silicate-based cements: a systematic review

Majeed R, Elnawawy HM, Kutty MG, Yahya NA, Azami NH, Abu Kasim NH, et al.

Odontology, 2023 Oct;111(4):777.
PMID: 37147494 DOI: 10.1007/s10266-023-00818-9
The role of MicroRNAs in the diagnosis and treatment of oral premalignant disorders

Fathima JHS, Jayaraman S, Sekar R, Syed NH

Odontology, 2024 Apr 15.
PMID: 38619695 DOI: 10.1007/s10266-024-00934-0

Oral premalignant disorders (OPMDs) are a group of potentially malignant conditions that pose a significant health burden globally. MicroRNAs (miRNAs), small non-coding RNA molecules, have emerged as crucial regulators of gene expression and have been implicated in various biological processes, including carcinogenesis. This review synthesizes existing knowledge to provide a comprehensive understanding of the molecular mechanisms underlying OPMDs and to highlight the potential of miRNAs as promising biomarkers and therapeutic targets. Additionally, this review seeks to explore the potential of miRNA-based diagnostic biomarkers for early detection of OPMDs in the current literature on miRNAs in OPMDs, examining their involvement in disease pathogenesis, diagnostic potential, and therapeutic implications. Dysregulated miRNAs can target genes involved in critical cellular processes, such as cell cycle regulation, apoptosis, and DNA repair, leading to disease progression. Notably, miR-21, miR-31, miR-135b, and miR-486-5p have shown promise as potential biomarkers for early detection of oral premalignant lesions. Furthermore, the paper discusses the therapeutic implications of miRNAs in OPMDs. Preclinical studies have demonstrated the efficacy of miRNA-targeted therapies, such as miRNA mimics and inhibitors, in suppressing the growth of oral premalignant lesions. Early-phase clinical trials have shown promising results, indicating the potential for personalized treatment approaches. The findings underscore the importance of understanding the molecular mechanisms underlying these disorders and provide insights for the development of improved diagnostic and therapeutic strategies. However, they pose certain limitations given their intrinsic variability in expression profiles, the need for optimized isolation and detection methods, and potential hurdles in transitioning from preclinical success to clinical applications. Thus, future clinical studies are warranted to fully exploit the potential of miRNAs in the management of OPMDs.