Chronic osteomyelitis with proliferative periostitis, known as Garre’s osteomyelitis, is a type of osteomyelitis characterized by a distinctive gross thickening of the periosteum of bones. Peripheral reactive bone formation can be caused by mild irritation or infection. Garre’s osteomyelitis is usually diagnosed in children and young adults, and the mandible is more affected than the maxilla. The following is a case report of a 12-year-old female patient with Garre’s osteomyelitis of the mandible due to an infection of a root canal-treated tooth. Without surgical intervention, the patient’s symptoms were relieved through nonsurgical root canal re-treatment with long-term calcium hydroxide placement. A cone-beam computed tomography image obtained 6 months after treatment completion displayed complete healing of the periapical lesion and resolution of the peripheral reactive buccal bone. Due to the clinical features of Garre's osteomyelitis, which is characterized by thickening of the periosteum, it can be mistaken for other diseases such as fibrous dysplasia. It is important to correctly diagnose Garre's osteomyelitis based on its distinctive clinical features to avoid unnecessary surgical intervention, and it can lead to minimally invasive treatment options.
Mucopolysaccharidosis (MPS) is an inherited metabolic disorder caused by a deficiency in enzymes that participate in the degradation of glycosaminoglycans (GAGs) such as heparin sulfate and dermatan sulfate. Left untreated, patients show progressive mental and physical deterioration due to deposition of GAGs in organs. Death often occurs due to cardiac or respiratory failure before patients reach their early twenties. MPS has several oral and dental manifestations. An enlarged head, short neck, and open mouth associated with a large tongue are major characteristics of MPS patients. Dental complications can be severe, including unerupted dentition, dentigerous cyst-like follicles, malocclusions, condylar defects, and gingival hyperplasia. A 21-year-old female patient with MPS was described in this article, with special emphasis on oral manifestations and dental treatment.
In this study, we characterized human dental pulp cells (HDPCs) obtained by different culture methods to establish the most suitable methodology for dental tissue engineering and regenerative endodontic applications.
HDPCs were isolated by the outgrowth method (HDPCs-OG), the enzymatic digestion method (collagenase/dispase/trypsin, HDPCs-ED), or the combination of both methods (HDPCs-Combined). The expression of mesenchymal stem cell markers (CD105, CD90, and CD73) was investigated.
Our data indicated that whole HDPCs-ED, HPDCs-OG, and HDPCs-Combined could be differentiated into adipogenic, chrondrogenic, and osteogenic cell types. However, we found that the methods for isolating and culturing HDPCs influence the differentiation capacities of cells. HDPCs-OG and HDPCs-ED were preferably differentiated into adipogenic and osteogenic cells, respectively. Differentiation markers shown by RT-PCR and western blotting analysis were mostly upregulated in the treated groups compared with the control groups.
Our findings confirmed that cell populations formed by two different culture methods and the combined culture method exhibited different properties. The results of this study could provide an insight into regenerative endodontic treatment using HDPCs.
This case report presents surgical endodontic management outcomes of maxillary incisors that were infected via the lateral canals. Two cases are presented in which endodontically-treated maxillary central incisors had sustained lateral canal infections. A surgical endodontic treatment was performed on both teeth. Flap elevation revealed vertical bone destruction along the root surface and infected lateral canals, and microscopy revealed that the lateral canals were the origin of the lesions. After the infected lateral canals were surgically managed, both teeth were asymptomatic and labial fistulas were resolved. There were no clinical or radiographic signs of surgical endodontic management failure at follow-up visits. This case report highlights the clinical significance and surgical endodontic management of infected lateral canal of maxillary incisor. It is important to be aware of root canal anatomy variability in maxillary incisors. Maxillary central incisors infected via the lateral canal can be successfully managed by surgical endodontic treatment.
In dentistry, the term 'fusion' is used to describe a developmental disorder of dental hard tissues. In the permanent dentition, fusion of a normal tooth and a supernumerary tooth usually involves the incisors or canines. However, a few cases of fusion involving premolars have also been reported to date. We present a rare case in which fusion of the maxillary left second premolar and a supernumerary tooth in a 13-year-old girl was diagnosed using cone beam computed tomography (CBCT, Alphard-3030, Asahi Roentgen Ind. Co., Ltd.). The tooth was bicuspidized after routine nonsurgical root canal treatment, and the separated teeth underwent appropriate restoration procedures. The second premolar and supernumerary tooth remained asymptomatic without any signs of inflammation after a follow-up period of 9 years. Identification of anatomical anomalies is important for treatment in cases involving fusion with supernumerary tooth, and therefore the microscopic examinations and CBCT are essential for the diagnosis. Fused teeth can be effectively managed by the comprehensive treatment which includes both endodontic and periodontal procedures.
This study analyzed the difference in color caused by different thickness in enamel layer of composite resins when applied with single and layering placement technique, and evaluated if the results agreed with the shade guide from the manufacturers to verify reliability of the color matching process of the manufacturers.
For single composite resin samples, 6 mm diameter and 4 mm thickness cylindrical samples were fabricated using Ceram-X mono (DENTSPLY DeTrey) and CIE L*a*b* values were measured with spectrophotometer. Same process was done for layering composite resin samples, making 3 dentinal shade samples, 4 mm thickness, for each shade using Ceram-X duo (DENTSPLY DeTrey) and enamel shade resins were layered in 2 mm thickness and CIE L*a*b* values were measured. These samples were ground to 0.2 mm thickness each time, and CIE L*a*b* values were measured to 1 mm thickness of enamel shade resin.
Color difference (ΔE*) between single and layering composite resin was 1.37 minimum and 10.53 maximum when layering thicknesses were between 1 mm and 2 mm and 6 out of 10 same shade groups suggested by manufacturer showed remarkable color difference at any thickness (ΔE* > 3.3).
When using Ceram-X mono and duo for composite resin restoration, following the manufacturer's instructions for choosing the shade is not appropriate, and more accurate information for Ceram-X duo is needed on the variation and expression of the shades depending on the thickness of the enamel.
This study examined the effect of the uncured dentin adhesives on the bond interface between the resin inlay and dentin.
Dentin surface was exposed in 24 extracted human molars and the teeth were assigned to indirect and direct resin restoration group. For indirect resin groups, exposed dentin surfaces were temporized with provisional resin. The provisional restoration was removed after 1 wk and the teeth were divided further into 4 groups which used dentin adhesives (OptiBond FL, Kerr; One-Step, Bisco) with or without light-curing, respectively (Group OB-C, OB-NC, OS-C and OS-NC). Pre-fabricated resin blocks were cemented on the entire surfaces with resin cement. For the direct resin restoration groups, the dentin surfaces were treated with dentin adhesives (Group OB-D and OS-D), followed by restoring composite resin. After 24 hr, the teeth were assigned to microtensile bond strength (µTBS) and confocal laser scanning microscopy (CLSM), respectively.
The indirect resin restoration groups showed a lower µTBS than the direct resin restoration groups. The µTBS values of the light cured dentin adhesive groups were higher than those of the uncured dentin adhesive groups (
Light-curing of the dentin adhesive prior to the application of the cementing material in luting a resin inlay to dentin resulted in definite, homogenous hybrid layer formation, which may improve the bond strength.
This
Thirty two mature human single rooted mandibular premolars in similar size and dentin thickness without decay or restorations were hand and rotary instrumented and 16 teeth vertically packed with calcium hydroxide paste and sealed coronally with caviton to imitate the endodontic procedure and the other 16 teeth was left empty as a control group. The apicies of all the samples were sealed with resin, submerged in normal saline and put in a storage box at 37℃ to mimic the oral environment. After 1 and 4 wk, 8 samples out of 16 samples from each group were removed from the storage box and fracture strength test was performed. The maximum load required to fracture the samples was recorded and data were analysed statistically by the two way ANOVA test at 5% significance level.
The mean fracture strengths of two groups after 1 wk and 4 wk were similar. The intracanal placement of calcium hydroxide weakened the fracture strength of teeth by 8.2% after 4 wk: an average of 39.23 MPa for no treatment group and 36.01 MPa for CH group. However there was no statistically significant difference between experimental groups and between time intervals.
These results suggest that short term calcium hydroxide application is available during endodontic treatment.