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Present status and future directions:Apexification

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World Journal of Methodology 2025年第1期15卷 26-32页

作者： Sachin Chauhan Radha Chauhan Prashant Bhasin Bhavna G Sharaf department of conservative Dentistry and endodontics Sudha Rustagi College of Dental Sciences and ResearchFaridabad 121002HaryanaIndia department of Prosthodontics and Crown and Bridge and Oral Implantology Mahatma Gandhi Dental College&HospitalJaipur 302022RajasthanIndia department of Pedodontics and Preventive Dentistry Sudha Rustagi College of Dental Sciences and ResearchFaridabad 121002HaryanaIndia

The success rate of apexification is primarily determined by multiple factors,including the material used,the size of the open apex compared to the length of the root,and the technique used in each *** main objective of this review was to provide an update on the present management of open apex to identify factors and circumstances that may influence the success of apexification using different materials and *** research on apexification should focus on how to treat open apices with wide periapical lesions without ***,the predictability of these parameters with non-surgical procedures was uncertain,but now,with the use of a dental operating microscope,it has become more *** reason could be that extra visits are no longer required due to major advances in the armamentarium and materials used for apexification.

关键词： Bioceramics Magnification Biodentine Mineral trioxide aggregate Apexification Open apex

Clinical Management of Mid-Root Fracture in Maxillary Central Incisors:Case Reports

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International Journal of Oral Science 2010年第4期2卷 215-221页

作者： Deepak J. Parekh Ramarao Sathyanarayanan Mangala Tiptur Manjunath department of conservative Dentistry and endodontics Bapuji Dental College and Hospital

Management of mid-root fractures presents a formidable challenge for clinicians because of the difficulty of achieving a stable reunion of fracture fragments. This article presents two varied treatment options for mid-root fractures. A 15-year-old female reported an impact injury to the maxillary anterior teeth 2 days after its occurrence. Clinically,the maxillary left central incisor was palatally-extruded with a negative vitality response and radiographic evidence of an oblique fracture at the middle third of the root. An endodontic implant was employed which utilized an open technique and has been on follow-up for ten months. A 32-year-old male reported an injury,which resulted in a mobile maxillary right central incisor,three months after its occurrence. Through clinical and radiographic means,a discolored,extruded,and non-vital maxillary right central incisor with an oblique root fracture at the alveolar-crest level was observed. Exploratory surgery was performed; an apical barrier was created with a mineral trioxide aggregate and obturated with gutta percha. The fragments were stabilized with a fiber post and patient has been on follow-up for five months. Short-term follow-up for both of the cases showed promising results both clinically and radiographically.

关键词： endodontic implant fiber post maxillary central incisor root fracture titanium min screw

HSP25 Affects the Proliferation and Differentiation of Rat Dental Follicle Cells

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International Journal of Oral Science 2009年第2期1卷 72-80页

作者： Yu Du Hai-jing Gu Qi-mei Gong Fang Yang Jun-qi Ling department of conservative Dentistry and endodontics Guanghua School of Stomatology Sun Yat-sen UniversityGuangzhou China

Aim To detect the expression of HSP25 in rat dental follicles both in vivo and vitro, and explore the underlying mechanism of HSP25 on the proliferation and differentiation of rat dental follicle cells （DFCs）. Methodology Immunohistochemistry was performed to detect the expression of HSP25 in mandibles of postnatal rats on days 1, 3, 5, 7, 9 and 11 in vivo. In vitro, the expression of HSP25 in DFCs was detected by an indirect immunofluorescence assay. Thiazolyl blue tetrazolium bromide （MTT） assay, flow cytometry and alkaline phosphatase （ALP） assay were used to identify the time-course effect mediated by different concentrations of recombinant murine HSP25 of 0, 1, 10, 50 and 100 ng/mL on rat DFCs. Results Expression of HSP25 was not detected in dental follicles of the rats until day 5 after birth, but became up-regulated in a time-dependent manner till day 11. HSP25 was detected in the cytoplasm of cultured rat DFCs. No significant difference could be observed in the proliferation of DFCs after stimulation with different concentrations of HSP25 on days 1, 2 and 3 （P〉0.05）. HSP25 at concentrations of 50 ng/mL and 100 ng/mL up-regulated the ALP activity of DFCs on day 9 （P〈0.05）. Conclusion HSP25-immunoreactivity increased chronologically during the development of dental follicles. The protein had no significant effect on cell proliferation but may play a role in cementoblast/osteoblast differentiation of DFCs.

关键词： dental follicle HSP25 cell proliferation cell differentiation alkaline phosphatase (ALP)

Pulp health and calcific healing of a complicated crown–root fracture with additional root fracture in a maxillary incisor: A case report

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World Journal of Clinical Cases 2025年第3期13卷 42-49页

作者： Na Li Yue-Yue Ren Ying Tang Qi Yang Tian-Tian Meng Song Li Jing Zhang Stomatological Hospital and College Anhui Medical UniversityHefei 230032Anhui ProvinceChina department of endodontics The Affiliated Stomatological Hospital of Xuzhou Medical UniversityXuzhou 221000Jiangsu ProvinceChina

BACKGROUND Complicated crown–root fracture (CRF) involves severe injury to the crown, root,and pulp, and may be accompanied by multiple root fractures. The loss of a toothhas lifelong consequences for children and teenagers, but the maintenance of pulphealth and the calcific healing of multiple root fractures are rarely reported in *** SUMMARY This case reports healing of a permanent tooth with complicated crown–root andadditional root fractures, in which pulp health was maintained. A 10-year-old girlfell and fractured the root of her maxillary left central incisor at the cervical *** the coronal fragment was repositioned, the tooth was splinted until thetooth was no longer mobile, 2 years later. Eight years after treatment, the toothhas remained asymptomatic with vital pulp and localized gingival ***-beam computed tomography revealed not only calcified healing of the CRFbut also spontaneous healing in an additional undiagnosed root fracture. Thefracture line on the enamel could not be healed by hard tissue and formed agroove in the cervical crown. It was speculated that the groove was related to thelocalized gingival *** This case provides a clinical perspective of the treatment of a tooth with acomplicated CRF and an additional root fracture.

关键词： Complicated crown-root fracture Multiple root fracture Spontaneous healing Cone-beam computed tomography Long-term follow-up Case report

Long-term observation of the mineral trioxide aggregate extrusion into the periapical lesion:a case series

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International Journal of Oral Science 2013年第1期5卷 54-57页

作者： Seok-Woo Chang Tae-Seok Oh WooCheol Lee Gary Shun-Pan Cheung Hyeon-Cheol Kim department of conservative Dentistry School of DentistryKyung Hee University department of conservative Dentistry The Institute of Oral Health ScienceSamsung Medical CenterSungkyunkwan University School of Medicine department of conservative Dentistry School of DentistryDental Research InstituteSeoul National University Area of endodontics Faculty of Dentistrythe University of Hong Kong department of conservative Dentistry School of DentistryPusan National UniversityDental Research Institute

One-step apexification using mineral trioxide aggregate(MTA) has been reported as an alternative treatment modality with more benefits than the use of long-term calcium hydroxide for teeth with open ***,orthograde placement of MTA is a challenging procedure in terms of length *** case series describes the sequence of events following apical extrusion of MTA into the periapical area during a one-step apexification procedure for maxillary central incisor with an infected immature *** long-term observation revealed complete resolution of the periapical radiolucent lesion around the extruded *** cases revealed that direct contact with MTA had no negative effects on healing of the periapical ***,intentional MTA overfilling into the periapical lesion is not to be recommended.

关键词： extrusion immature apex mineral trioxide aggregate one-step apexification open apex periapical healing

Effect of addition of chitosan to self-etching primer:antibacterial activity and push-out bond strength to radicular dentin

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The Journal of Biomedical Research 2012年第4期26卷 288-294页

作者： Shaymaa Elsaka Amr Elnaghy department of Dental Biomaterials Faculty of DentistryMansoura University department of conservative Dentistry and endodontics Faculty of DentistryMansoura University

The purpose of this study was to evaluate the antibacterial activity of a modified self-etching primer incorporating chitosan and whether this modification affected the bond strength to radicular dentin.A modified self-etching primer was prepared by adding chitosan solutions at 0.03%,0.06%,0.12% and 0.25%（W/W） to RealSeal selfetching *** primer without chitosan was used as the *** antibacterial activity of the modified self-etching primer was evaluated using the direct contact test against Enterococcus *** bonding ability of the RealSeal system to radicular dentin was evaluated using the push-out bond strength *** modes of failure were examined under a *** were analyzed using analysis of variance（ANOVA） and Tukey’s test,with a P-value 〈 0.05 indicating statistical *** results showed that the antibacterial properties of the freshly prepared and aged modified self-etching primer incorporating chitosan exhibited potent antibacterial effect against Enterococcus faecalis compared with the unmodified *** RealSeal system with the aged modified self-etching primer incorporating chitosan showed no significant differences in the bond strength as compared with the control（P = 0.99）.The findings suggest that modified self-etching primer incorporating chitosan is a promising antibacterial primer which does not adversely affect the bond strength of the RealSeal system to radicular dentin.

关键词： Enterococcus faecalis antibacterial activity chitosan push-out primer radicular dentin

Differentiation of periapical granulomas and cysts by using dental MRI: a pilot study

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International Journal of Oral Science 2018年第3期10卷 152-159页

作者： Alexander Juerchott Thorsten Pfefferle Christa Flechtenmacher Johannes Mente Martin Bendszus Sabine Heiland Tim Hilgenfeld department of Neuroradiology Heidelberg University Hospital Division of endodontics and Dental Traumatology Department of Conservative Dentistry Heidelberg University Hospital Institute of Pathology Heidelberg University Hospital Division of Experimental Radiology Department of Neuroradiology Heidelberg University Hospital

The purpose of this pilot study was to evaluate whether periapical granulomas can be differentiated from periapical cysts in vivo by using dental magnetic resonance imaging(MRI). Prior to apicoectomy, 11 patients with radiographically confirmed periapical lesions underwent dental MRI, including fat-saturated T2-weighted(T2 wFS) images, non-contrast-enhanced T1-weighted images with and without fat saturation(T1 w/T1 wFS), and contrast-enhanced fat-saturated T1-weighted(T1 wFS+C) images. Two independent observers performed structured image analysis of MRI datasets twice. A total of 15 diagnostic MRI criteria were evaluated, and histopathological results(6 granulomas and 5 cysts) were compared with MRI characteristics. Statistical analysis was performed using intraclass correlation coefficient(ICC), Cohen’s kappa(κ), Mann–Whitney U-test and Fisher’s exact test. Lesion identification and consecutive structured image analysis was possible on T2 wFS and T1 wFS+C MRI images. A high reproducibility was shown for MRI measurements of the maximum lesion diameter(intraobserver ICC = 0.996/0.998; interobserver ICC = 0.997), for the "peripheral rim" thickness(intraobserver ICC = 0.988/0.984; interobserver ICC = 0.970), and for all non-quantitative MRI criteria(intraobserver-κ = 0.990/0.995; interobserver-κ = 0.988). In accordance with histopathological results, six MRI criteria allowed for a clear differentiation between cysts and granulomas:(1) outer margin of lesion,(2) texture of "peripheral rim" in T1 wFS+C,(3)texture of "lesion center" in T2 wFS,(4) surrounding tissue involvement in T2 wFS,(5) surrounding tissue involvement in T1 wFS+C and(6) maximum "peripheral rim" thickness(all: P < 0.05). In conclusion, this pilot study indicates that radiation-free dental MRI enables a reliable differentiation between periapical cysts and granulomas in vivo. Thus, MRI may substantially improve treatment strategies and help to avoid unnecessary surgery in apical periodontitis.

关键词： Differentiation of periapical granulomas and cysts by using dental MRI a pilot study

Bilateral maxillary fused second and third molars:a rare occurrence

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International Journal of Oral Science 2012年第4期4卷 231-234页

作者： Rui-Zhen Liang Jin-Tao Wu You-Nong Wu Roger J Smales Ming Hu Jin-Hua Yu Guang-Dong Zhang Institute of Stomatology Nanjing Medical University department of conservative Dentistry and endodontics School of StomatologyNanjing Medical University Visiting Research Fellow Dental SchoolFaculty of Health SciencesThe University of Adelaide

This case report describes the diagnosis and endodontic therapy of maxillary fused second and third molars, using cone-beam computed tomography （CBCT）. A 31-year-old Chinese male, with no contributory medical or family/social history, presented with throbbing pain in the maxillary right molar area following an unsuccessful attempted tooth extraction. Clinical examination revealed what appeared initially to be a damaged large extra cusp on the buccal aspect of the distobuccal cusp of the second molar. However, CBCT revealed that a third molar was fused to the second molar. Unexpectedly, the maxillary left third molar also was fused to the second molar, and the crown of an unerupted supernumerary fourth molar was possibly also fused to the apical root region of the second molar. Operative procedures should not be attempted without adequate radiographic investigation. CBCT allowed the precise location of the root canals of the right maxillary fused molar teeth to permit successful endodontic therapy, confirmed after 6 months.

关键词： cone-beam computed tomography scans endodontic therapy fusion of teeth maxillary molar

Ameloblastic carcinoma: Report of a rare case

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World Journal of Clinical Cases 2014年第2期2卷 48-51页

作者： Mandadi Dakshinamurthy Srikanth Besta Radhika Kiran Metta Nukala Valli Renuka department of Oral Medicine and Radiology MNR Dental College and Hospital department of conservative Dentistry and endodontics Midsr Dental College and Hospital department of Periodontics Army College of Dental Sciences

Ameloblastic carcinoma is a rare odontogenic tumor exhibiting histological evidence of malignancy in the primary or recurrent tumor. It is characterized by rapid, painful expansion of the jaw, unlike conventional ameloblastomas. The tumor most frequently involves the mandible. The expanding lesion causes perforation of the buccal and lingual plates of the jaw and invades the surrounding soft tissue. Rapidly growing large tumor mass may cause tooth mobility. A mandibular tumor involving the mental nerve leads to paresthesia of the nerve. A maxillary tumor can produce a fistula in the palate and paresthesia of the infraorbital nerve. Most ameloblastic carcinomas are presumed to have arisen de novo with a few cases of malignant transformation of ameloblastomas. Although rare, these lesions have been known to metastasize, mostly to the regional lymph nodes or lungs. A case of ameloblastic carcinoma in a 60-year-old man is reported here and its clinical, radiological and histological features are discussed.

关键词： Ameloblastic carcinoma Squamous metaplasia