A preliminary report on histological outcome of pulpotomy with endodontic biomaterials vs calcium hydroxide

Ali Nosrat,Ali Peimani,Saeed Asgary 대한치과보존학회 2013 Restorative Dentistry & Endodontics Vol.38 No.4

Objectives: The purpose of the study was to evaluate human dental pulp response topulpotomy with calcium hydroxide (CH), mineral trioxide aggregate (MTA), and calciumenriched mixture (CEM) cement. Materials and Methods: A total of nine erupted thirdmolars were randomly assigned to each pulpotomy group. The same clinician performedfull pulpotomies and coronal restorations. The patients were followed clinically forsix months; the teeth were then extracted and prepared for histological assessments. The samples were blindly assessed by an independent observer for pulp vitality, pulpinflammation, and calcified bridge formation. Results: All patients were free of clinicalsigns/symptoms of pulpal/periradicular diseases during the follow up period. In CHgroup, one tooth had necrotic radicular pulp; other two teeth in this group had vitaluninflamed pulps with complete dentinal bridge formation. In CEM cement and MTAgroups all teeth had vital uninflamed radicular pulps. A complete dentinal bridgewas formed beneath CEM cement and MTA in all roots. Odontoblast-like cells werepresent beneath CEM cement and MTA in all samples. Conclusions: This study revealedthat CEM cement and MTA were reliable endodontic biomaterials in full pulpotomytreatment. In contrast, the human dental pulp response to CH might be unpredictable.

A preliminary report on histological outcome of pulpotomy with endodontic biomaterials vs calcium hydroxide

Nosrat, Ali,Peimani, Ali,Asgary, Saeed The Korean Academy of Conservative Dentistry 2013 Restorative Dentistry & Endodontics Vol.38 No.4

Objectives: The purpose of the study was to evaluate human dental pulp response to pulpotomy with calcium hydroxide (CH), mineral trioxide aggregate (MTA), and calcium enriched mixture (CEM) cement. Materials and Methods: A total of nine erupted third molars were randomly assigned to each pulpotomy group. The same clinician performed full pulpotomies and coronal restorations. The patients were followed clinically for six months; the teeth were then extracted and prepared for histological assessments. The samples were blindly assessed by an independent observer for pulp vitality, pulp inflammation, and calcified bridge formation. Results: All patients were free of clinical signs/symptoms of pulpal/periradicular diseases during the follow up period. In CH group, one tooth had necrotic radicular pulp; other two teeth in this group had vital uninflamed pulps with complete dentinal bridge formation. In CEM cement and MTA groups all teeth had vital uninflamed radicular pulps. A complete dentinal bridge was formed beneath CEM cement and MTA in all roots. Odontoblast-like cells were present beneath CEM cement and MTA in all samples. Conclusions: This study revealed that CEM cement and MTA were reliable endodontic biomaterials in full pulpotomy treatment. In contrast, the human dental pulp response to CH might be unpredictable.

Periodontal healing following non-surgical repair of an old perforation with pocket formation and oral communication

Ali Nosrat,Prashant Verma,Saeed Asgary 대한치과보존학회 2018 Restorative Dentistry & Endodontics Vol.43 No.2

Iatrogenic perforations negatively impact the outcome of endodontic treatments. Studies on prognostic factors showed that perforations in the coronal third of the root with periodontal pocket formation have an unfavorable prognosis. A 36-year-old female was referred for endodontic evaluation of tooth #13 with a history of an iatrogenic perforation, happened 3 years ago. There was a sinus tract associated with perforation, 10 mm probing on the mesial and mesio-palatal, bleeding on probing, radiolucent lesion adjacent to the perforation and complete resorption of the interdental bone between teeth #13 and #12. After the treatment options were discussed, she chose to save the tooth. The tooth was accessed under rubber dam isolation, the perforation site was cleaned and disinfected using 0.5% sodium hypochlorite and sealed with calcium-enriched mixture cement. Eighteen months after treatment the tooth was functional and asymptomatic. The probing depths were normal without bleeding on probing. Radiographically, the interdental crestal bone formed between teeth #13 and #12. Despite all negative prognostic factors in this case (i.e., perforations in the coronal third, pocket formation, and radiolucent lesion), healing was unexpectedly achieved via non-surgical repair of the perforation. Further research on biological aspects of healing in the periodontium following iatrogenic perforations are recommended.

Periodontal healing following non-surgical repair of an old perforation with pocket formation and oral communication

Asgary, Saeed,Verma, Prashant,Nosrat, Ali The Korean Academy of Conservative Dentistry 2018 Restorative Dentistry & Endodontics Vol.43 No.2

Iatrogenic perforations negatively impact the outcome of endodontic treatments. Studies on prognostic factors showed that perforations in the coronal third of the root with periodontal pocket formation have an unfavorable prognosis. A 36-year-old female was referred for endodontic evaluation of tooth #13 with a history of an iatrogenic perforation, happened 3 years ago. There was a sinus tract associated with perforation, 10 mm probing on the mesial and mesio-palatal, bleeding on probing, radiolucent lesion adjacent to the perforation and complete resorption of the interdental bone between teeth #13 and #12. After the treatment options were discussed, she chose to save the tooth. The tooth was accessed under rubber dam isolation, the perforation site was cleaned and disinfected using 0.5% sodium hypochlorite and sealed with calcium-enriched mixture cement. Eighteen months after treatment the tooth was functional and asymptomatic. The probing depths were normal without bleeding on probing. Radiographically, the interdental crestal bone formed between teeth #13 and #12. Despite all negative prognostic factors in this case (i.e., perforations in the coronal third, pocket formation, and radiolucent lesion), healing was unexpectedly achieved via non-surgical repair of the perforation. Further research on biological aspects of healing in the periodontium following iatrogenic perforations are recommended.

Surgical management of a failed internal root resorption treatment: a histological and clinical report

Saeed Asgary,Mohammad Jafar Eghbal,Leili Mehrdad,Sanam Kheirieh,Ali Nosrat 대한치과보존학회 2014 Restorative Dentistry & Endodontics Vol.39 No.2

This article presents the successful surgical management of a failed mineral trioxide aggregate (MTA) orthograde obturation of a tooth with a history of impact trauma and perforated internal root resorption. A symptomatic maxillary lateral incisor with a history of perforation due to internal root resorption and nonsurgical repair using MTA was referred. Unintentional overfill of the defect with MTA had occurred 4 yr before the initial visit. The excess MTA had since disappeared, and a radiolucent lesion adjacent to the perforation site was evident radiographically. Surgical endodontic retreatment was performed using calcium enriched mixture (CEM) cement as a repair material. Histological examination of the lesion revealed granulation tissue with chronic inflammation, and small fragments of MTA encapsulated within fibroconnective tissue. At the one and two year follow up exams, all signs and symptoms of disease had resolved and the tooth was functional. Complete radiographic healing of the lesion was observed two years after the initial visit. This case report illustrates how the selection of an appropriate approach to treatment of a perforation can affect the long term prognosis of a tooth. In addition, extrusion of MTA into a periradicular lesion should be avoided.

Evaluation of the effect of blood contamination on the compressive strength of MTA modified with hydration accelerators

Kaveh Oloomi,Eshaghali Saberi,Hadi Mokhtari,Hamid Reza Mokhtari Zonouzi,Ali Nosrat,Mohammad Hossein Nekoofar,Paul Michael Howell Dummer 大韓齒科保存學會 2013 Restorative Dentistry & Endodontics Vol.38 No.3

Objectives: This study was performed to evaluate the effect of blood contamination on the compressive strength (CS) of Root MTA (RMTA) modified with Calcium chloride (CaCl2) and Disodium hydrogen phosphate (Na2HPO4) as setting accelerators over time. Materials and Methods: A total of 110 cylindrical specimens of RMTA were divided into 6 experimental groups as follows: Group1, RMTA, Group 2, RMTA modified with CaCl2 (RMTA-C), Group 3, RMTA modified with Na2HPO4 (RMTA-N), Group 4, RMTA contaminated with blood, Group 5, RMTA-C contaminated with blood, Group 6, RMTA-N contaminated with blood. The CS of specimens in all groups was evaluated after 3hr, 24 hr, and 1 wk. In the modified groups (groups 2, 3, 5, and 6) the CS of five specimens per group was also evaluated after 1 hr. Results: Blood contamination significantly reduced the CS of all materials at all time intervals (p < 0.05). After 3hr, the CS of specimens in the RMTA groups (with and without blood contamination)was significantly lower than those in the RMTA-C and RMTA-N groups (p < 0.05). The CS values were not significantly different at the other time intervals. In all groups,the CS of specimens significantly increased over time (p < 0.05). Conclusions: Blood contamination decreased the CS of both original and accelerated RMTA.

Surgical management of a failed internal root resorption treatment: a histological and clinical

Asgary, Saeed,Eghbal, Mohammad Jafar,Mehrdad, Leili,Kheirieh, Sanam,Nosrat, Ali The Korean Academy of Conservative Dentistry 2014 Restorative Dentistry & Endodontics Vol.39 No.2

This article presents the successful surgical management of a failed mineral trioxide aggregate (MTA) orthograde obturation of a tooth with a history of impact trauma and perforated internal root resorption. A symptomatic maxillary lateral incisor with a history of perforation due to internal root resorption and nonsurgical repair using MTA was referred. Unintentional overfill of the defect with MTA had occurred 4 yr before the initial visit. The excess MTA had since disappeared, and a radiolucent lesion adjacent to the perforation site was evident radiographically. Surgical endodontic retreatment was performed using calcium enriched mixture (CEM) cement as a repair material. Histological examination of the lesion revealed granulation tissue with chronic inflammation, and small fragments of MTA encapsulated within fibroconnective tissue. At the one and two year follow up exams, all signs and symptoms of disease had resolved and the tooth was functional. Complete radiographic healing of the lesion was observed two years after the initial visit. This case report illustrates how the selection of an appropriate approach to treatment of a perforation can affect the long term prognosis of a tooth. In addition, extrusion of MTA into a periradicular lesion should be avoided.

Evaluation of the effect of blood contamination on the compressive strength of MTA modified with hydration accelerators

Oloomi, Kaveh,Saberi, Eshaghali,Mokhtari, Hadi,Mokhtari Zonouzi, Hamid Reza,Nosrat, Ali,Nekoofar, Mohammad Hossein,Dummer, Paul Michael Howell The Korean Academy of Conservative Dentistry 2013 Restorative Dentistry & Endodontics Vol.38 No.3

Objectives: This study was performed to evaluate the effect of blood contamination on the compressive strength (CS) of Root MTA (RMTA) modified with Calcium chloride ($CaCl_2$) and Disodium hydrogen phosphate ($Na_2HPO_4$) as setting accelerators over time. Materials and Methods: A total of 110 cylindrical specimens of RMTA were divided into 6 experimental groups as follows: Group1, RMTA; Group 2, RMTA modified with $CaCl_2$ (RMTA-C); Group 3, RMTA modified with $Na_2HPO_4$ (RMTA-N); Group 4, RMTA contaminated with blood; Group 5, RMTA-C contaminated with blood; Group 6, RMTA-N contaminated with blood. The CS of specimens in all groups was evaluated after 3 hr, 24 hr, and 1 wk. In the modified groups (groups 2, 3, 5, and 6) the CS of five specimens per group was also evaluated after 1 hr. Results: Blood contamination significantly reduced the CS of all materials at all time intervals (p < 0.05). After 3 hr, the CS of specimens in the RMTA groups (with and without blood contamination) was significantly lower than those in the RMTA-C and RMTA-N groups (p < 0.05). The CS values were not significantly different at the other time intervals. In all groups, the CS of specimens significantly increased over time (p < 0.05). Conclusions: Blood contamination decreased the CS of both original and accelerated RMTA.