Restorative Dentistry & Endodontics

Research Articles

Concentrated growth factor scaffold-based pulpotomy of permanent molars with symptomatic irreversible pulpitis: Arthi K. Harith, Vishnupriya Koteeswaran, Dinesh Kowsky, Natanasabapathy Velmurugan, Suresh Nandini; Restor Dent Endod 2025;50(1):e1. Published online January 17, 2025; DOI: https://doi.org/10.5395/rde.2025.50.e1

Abstract PDF PubReader ePub: Objectives
Pulpotomy is a minimally invasive procedure that aims to retain the vitality of the radicular pulp by removing the inflamed coronal pulp tissue. This case series presents the successful management of symptomatic irreversible pulpitis by pulpotomy with concentrated growth factor (CGF) scaffolds.
Methods
Six permanent mandibular molars with a diagnosis of symptomatic irreversible pulpitis were included. Under Local anesthesia and rubber dam isolation, caries were excavated using high-speed bur under coolant. Full coronal pulpotomy was done and hemostasis was achieved. CGF membrane was prepared and placed over the radicular pulp and layered with Biodentine (Septodont). Final restoration of type IX glass ionomer cement and bulk fill composite resin was placed. Patients were assessed for various clinical and radiographic parameters at intervals of 1 week and 3, 6, and 12 months. Five patients fulfilled the success criteria at the end of 1 year.
Results
Pulpotomy is considered an alternative treatment modality for root canal treatment in symptomatic irreversible pulpitis aiming at alleviating symptoms and maintaining vitality. CGF scaffold when used as a capping material acts as a reservoir for growth factors with anti-inflammatory properties and enhances healing.
Conclusions
Scaffold-based pulpotomy can be considered a biological approach to healing inflamed pulp.

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A novel antimicrobial-containing nanocellulose scaffold for regenerative endodontics: Victoria Kichler, Lucas Soares Teixeira, Maick Meneguzzo Prado, Guilherme Colla, Daniela Peressoni Vieira Schuldt, Beatriz Serrato Coelho, Luismar Marques Porto, Josiane de Almeida; Restor Dent Endod 2021;46(2):e20. Published online March 16, 2021; DOI: https://doi.org/10.5395/rde.2021.46.e20

Abstract PDF PubReader ePub

Objectives

The aim of this study was to evaluate bacterial nanocellulose (BNC) membranes incorporated with antimicrobial agents regarding cytotoxicity in fibroblasts of the periodontal ligament (PDLF), antimicrobial activity, and inhibition of multispecies biofilm formation.

Materials and Methods

The tested BNC membranes were BNC + 1% clindamycin (BNC/CLI); BNC + 0.12% chlorhexidine (BNC/CHX); BNC + nitric oxide (BNC/NO); and conventional BNC (BNC; control). After PDLF culture, the BNC membranes were positioned in the wells and maintained for 24 hours. Cell viability was then evaluated using the MTS calorimetric test. Antimicrobial activity against Enterococcus faecalis, Actinomyces naeslundii, and Streptococcus sanguinis (S. sanguinis) was evaluated using the agar diffusion test. To assess the antibiofilm activity, BNC membranes were exposed for 24 hours to the mixed culture. After sonicating the BNC membranes to remove the remaining biofilm and plating the suspension on agar, the number of colony-forming units (CFU)/mL was determined. Data were analyzed by 1-way analysis of variance and the Tukey, Kruskal-Wallis, and Dunn tests (α = 5%).

Results

PDLF metabolic activity after contact with BNC/CHX, BNC/CLI, and BNC/NO was 35%, 61% and 97%, respectively, compared to BNC. BNC/NO showed biocompatibility similar to that of BNC (p = 0.78). BNC/CLI showed the largest inhibition halos, and was superior to the other BNC membranes against S. sanguinis (p < 0.05). The experimental BNC membranes inhibited biofilm formation, with about a 3-fold log CFU reduction compared to BNC (p < 0.05).

Conclusions

BNC/NO showed excellent biocompatibility and inhibited multispecies biofilm formation, similarly to BNC/CLI and BNC/CHX.

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Topic: Perspectives on Success and Failure of Endodontic Treatments
Ilma Robo, Manola Kelmendi, Eva Habazaj, Kleves Elezi, Rialda Xhizdari, Nevila Alliu
SN Comprehensive Clinical Medicine.2025;[Epub] CrossRef
Prospective and applications of bacterial nanocellulose in dentistry
Yasmin Alimardani, Esmaeel Mirzakhani, Fereshteh Ansari, Hadi Pourjafar, Nadia Sadeghi
Cellulose.2024; 31(13): 7819. CrossRef
Bacterial nanocelluloses as sustainable biomaterials for advanced wound healing and dressings
Atefeh Zarepour, Bahar Gok, Yasemin Budama-Kilinc, Arezoo Khosravi, Siavash Iravani, Ali Zarrabi
Journal of Materials Chemistry B.2024; 12(48): 12489. CrossRef
Sulfated endospermic nanocellulose crystals prevent the transmission of SARS-CoV-2 and HIV-1
Enrique Javier Carvajal-Barriga, Wendy Fitzgerald, Emilios K. Dimitriadis, Leonid Margolis, R. Douglas Fields
Scientific Reports.2023;[Epub] CrossRef
A Novel Approach for the Fabrication of 3D-Printed Dental Membrane Scaffolds including Antimicrobial Pomegranate Extract
Hatice Karabulut, Songul Ulag, Basak Dalbayrak, Elif Arisan, Turgut Taskin, Mehmet Guncu, Burak Aksu, Alireza Valanezhad, Oguzhan Gunduz
Pharmaceutics.2023; 15(3): 737. CrossRef
Current advances of nanocellulose application in biomedical field
M.Y. Leong, Y.L. Kong, M.Y. Harun, C.Y. Looi, W.F. Wong
Carbohydrate Research.2023; 532: 108899. CrossRef
Bacterial cellulose as a potential biopolymer in biomedical applications: a state-of-the-art review
Prachi Shrivastav, Sheersha Pramanik, Gayatri Vaidya, Mohamed A. Abdelgawad, Mohammed M. Ghoneim, Ajeet Singh, Bassam M. Abualsoud, Larissa Souza Amaral, Mohammed A. S. Abourehab
Journal of Materials Chemistry B.2022; 10(17): 3199. CrossRef
Nanocelluloses as new generation materials: natural resources, structure-related properties, engineering nanostructures, and technical challenges
Ahmed Barhoum, Vibhore K. Rastogi, Bhupender K. Mahur, Amit Rastogi, Fatehy M. Abdel-Haleem, Pieter Samyn
Materials Today Chemistry.2022; 26: 101247. CrossRef
The current natural/chemical materials and innovative technologies in periodontal diseases therapy and regeneration: A narrative review
Peyman Esmaeili Fard Barzegar, Reza Ranjbar, Mohsen Yazdanian, Elahe Tahmasebi, Mostafa Alam, Kamyar Abbasi, Hamid Tebyaniyan, Keyvan Esmaeili Fard Barzegar
Materials Today Communications.2022; 32: 104099. CrossRef

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Coronal tooth discoloration induced by regenerative endodontic treatment using different scaffolds and intracanal coronal barriers: a 6-month ex vivo study: Noushin Shokouhinejad, Hassan Razmi, Maryam Farbod, Marzieh Alikhasi, Josette Camilleri; Restor Dent Endod 2019;44(3):e25. Published online July 16, 2019; DOI: https://doi.org/10.5395/rde.2019.44.e25

Abstract PDF PubReader ePub

Objective

The aim of this study was to evaluate discoloration of teeth undergoing regenerative endodontic procedures (REPs) using blood clot or platelet-rich fibrin (PRF) as the scaffolds and different calcium silicate-based materials as the intracanal coronal barriers in an ex vivo model.

Materials and Methods

Forty-eight bovine incisors were prepared and disinfected using 1 mg/mL double antibiotic paste (DAP). The specimens were then randomly divided into 2 groups (n = 24) according to the scaffolds (blood or PRF). After placement of scaffolds each group was divided into 2 subgroups (n = 12) according to the intracanal coronal barriers (ProRoot MTA or Biodentine). The pulp chamber walls were sealed with dentin bonding agent before placement of DAP and before placement of scaffolds. The color changes (∆E) were measured at different steps. The data were analyzed using 2-way analysis of variance.

Results

Coronal discoloration induced by DAP was not clinically perceptible (ΔE ≤ 3.3). Regarding the type of the scaffold, coronal discoloration was significantly higher in blood groups compared with PRF groups at the end of REP and after 1 month (p < 0.05). However, no significant difference was found between PRF and blood clot after 6 months (p > 0.05). Considering the type of intracanal coronal barrier, no significant difference existed between ProRoot MTA and Biodentine (p > 0.05).

Conclusions

With sealing the dentinal tubules of pulp chamber with a dentin bonding agent and application of DAP as an intracanal medicament, coronal color change of the teeth following the use of PRF and blood sealed with either ProRoot MTA or Biodentine was not different at 6-month follow-up.

Citations

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Effect of pH on the solubility and volumetric change of ready-to-use Bio-C Repair bioceramic material
Luana Raphael da SILVA, Jader Camilo PINTO, Juliane Maria GUERREIRO-TANOMARU, Mário TANOMARU-FILHO
Brazilian Oral Research.2024;[Epub] CrossRef
Efficacy of Potassium Iodide and Glutathione for Correlation of Dentin Discoloration Caused by Silver Diamine Fluoride
Mahsa Samani, Hamid Majzoub, Faramarz Zakavi, Ayyub Mojaddami
Cureus.2024;[Epub] CrossRef
Intracanal medicaments and coronal sealing materials influence on root fracture resistance and coronal discoloration: An in vitro study
Rasoul Sahebalam, Marzie Boskabady, Maryam Naghavi, Samira Dehghanitafti
Saudi Endodontic Journal.2024; 14(2): 199. CrossRef
Potential Crown Discoloration Induced by the Combination of Various Intracanal Medicaments and Scaffolds Applied in Regenerative Endodontic Therapy
NB Altun, A Turkyilmaz
Nigerian Journal of Clinical Practice.2024; 27(7): 897. CrossRef
Evaluation of the effectiveness of different treatment approaches in preventing coronal discoloration caused by regenerative endodontic treatment
Melis Oya Ateş, Zeliha Uğur Aydın
Clinical Oral Investigations.2023; 27(8): 4595. CrossRef
Evaluation of the Effectiveness of Laser-Assisted Bleaching of the Teeth Discolored due to Regenerative Endodontic Treatment
Noushin Shokouhinejad, Mehrfam Khoshkhounejad, Fatemeh Hamidzadeh, Murilo Baena Lopes
International Journal of Dentistry.2022; 2022: 1. CrossRef
Effectiveness of Teeth Whitening after Regenerative Endodontics Procedures: An In Vitro Study
Irini Fagogeni, Joanna Metlerska, Tomasz Falgowski, Maciej Górski, Mariusz Lipski, Alicja Nowicka
Journal of Clinical Medicine.2022; 11(23): 7016. CrossRef
Microstructure and color stability of calcium silicate-based dental materials exposed to blood or platelet-rich fibrin
Noushin Shokouhinejad, Ibrahim Abu Tahun, Shima Saber Tahan, Fatemeh Mohandes, Mohammad H. Nekoofar, Paul M. H. Dummer
Clinical Oral Investigations.2022; 27(3): 1193. CrossRef
Spectrophotometric analysis of internal bleaching of traumatized teeth with coronal discoloration following regenerative endodontic procedures
Jaqueline Lazzari, Walbert Vieira, Vanessa Pecorari, Brenda Paula Figueiredo de Almeida Gomes, José Flávio Affonso de Almeida, Adriana De-Jesus-Soares
Brazilian Journal of Oral Sciences.2021;[Epub] CrossRef
Biological parameters, discolouration and radiopacity of calcium silicate‐based materials in a simulated model of partial pulpotomy
Lilian Vieira Oliveira, Gabriela Leite de Souza, Gisele Rodrigues da Silva, Thamara Eduarda Alves Magalhães, Gabrielle Alves Nunes Freitas, Ana Paula Turrioni, Gabriella Lopes de Rezende Barbosa, Camilla Christian Gomes Moura
International Endodontic Journal.2021; 54(11): 2133. CrossRef
Effect of hydrogel-based antibiotic intracanal medicaments on crown discoloration
Rayan B. Yaghmoor, Jeffrey A. Platt, Kenneth J. Spolnik, Tien Min Gabriel Chu, Ghaeth H. Yassen
Restorative Dentistry & Endodontics.2021;[Epub] CrossRef
The effect of different calcium silicate-based pulp capping materials on tooth discoloration: an in vitro study
Ahmad S. Al-Hiyasat, Dana M. Ahmad, Yousef S. Khader
BMC Oral Health.2021;[Epub] CrossRef
Knowledge, attitudes, and practices of undergraduate students concerning Regenerative Endodontics
Ligia B. da Silva, Mariana Gabriel, Márcia M. Marques, Fernanda C. Carrer, Flávia Gonçalves, Giovanna Sarra, Giovanna L. Carvalho, Ana Armas-Vega, Maria S. Moreira
Minerva Stomatologica.2020;[Epub] CrossRef
Coronal Discoloration Related to Bioceramic and Mineral Trioxide Aggregate Coronal Barrier in Non-vital Mature Teeth Undergoing Regenerative Endodontic Procedures
Mazen Doumani, Mohammad Yaman Seirawan, Kinda Layous, Mohammad Kinan Seirawan
World Journal of Dentistry.2020; 11(1): 52. CrossRef

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Biocompatibility of two experimental scaffolds for regenerative endodontics: Dephne Jack Xin Leong, Frank C. Setzer, Martin Trope, Bekir Karabucak; Restor Dent Endod 2016;41(2):98-105. Published online March 28, 2016; DOI: https://doi.org/10.5395/rde.2016.41.2.98

Abstract PDF PubReader ePub

Objectives

The biocompatibility of two experimental scaffolds for potential use in revascularization or pulp regeneration was evaluated.

Materials and Methods

One resilient lyophilized collagen scaffold (COLL), releasing metronidazole and clindamycin, was compared to an experimental injectable poly(lactic-co-glycolic) acid scaffold (PLGA), releasing clindamycin. Human dental pulp stem cells (hDPSCs) were seeded at densities of 1.0 × 10⁴, 2.5 × 10⁴, and 5.0 × 10⁴. The cells were investigated by light microscopy (cell morphology), MTT assay (cell proliferation) and a cytokine (IL-8) ELISA test (biocompatibility).

Results

Under microscope, the morphology of cells coincubated for 7 days with the scaffolds appeared healthy with COLL. Cells in contact with PLGA showed signs of degeneration and apoptosis. MTT assay showed that at 5.0 × 10⁴ hDPSCs, COLL demonstrated significantly higher cell proliferation rates than cells in media only (control, p < 0.01) or cells co-incubated with PLGA (p < 0.01). In ELISA test, no significant differences were observed between cells with media only and COLL at 1, 3, and 6 days. Cells incubated with PLGA expressed significantly higher IL-8 than the control at all time points (p < 0.01) and compared to COLL after 1 and 3 days (p < 0.01).

Conclusions

The COLL showed superior biocompatibility and thus may be suitable for endodontic regeneration purposes.

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Advances in scaffolds used forpulp–dentinecomplex tissue engineering: A narrative review
Parisa Noohi, Mohammad J. Abdekhodaie, Mohammad H. Nekoofar, Kerstin M. Galler, Paul M. H. Dummer
International Endodontic Journal.2022; 55(12): 1277. CrossRef
In vitro performance of a nanobiocomposite scaffold containing boron-modified bioactive glass nanoparticles for dentin regeneration
Reza Moonesi Rad, Engin Pazarçeviren, Elif Ece Akgün, Zafer Evis, Dilek Keskin, Sıla Şahin, Ayşen Tezcaner
Journal of Biomaterials Applications.2019; 33(6): 834. CrossRef
Biological effects of silk fibroin 3D scaffolds on stem cells from human exfoliated deciduous teeth (SHEDs)
M. Collado-González, M. P. Pecci-Lloret, D. García-Bernal, S. Aznar-Cervantes, R. E. Oñate-Sánchez, J. M. Moraleda, J. L. Cenis, F. J. Rodríguez-Lozano
Odontology.2018; 106(2): 125. CrossRef
Pulp Regeneration Concepts for Nonvital Teeth: From Tissue Engineering to Clinical Approaches
Valérie Orti, Pierre-Yves Collart-Dutilleul, Sofía Piglionico, Orsolya Pall, Frédéric Cuisinier, Ivan Panayotov
Tissue Engineering Part B: Reviews.2018; 24(6): 419. CrossRef
Investigation of Human Dental Pulp Cells on a Potential Injectable Poly(lactic-co-glycolic acid) Microsphere Scaffold
Huiru Zou, Guanhua Wang, Fang Song, Xudong Shi
Journal of Endodontics.2017; 43(5): 745. CrossRef
Biocompatibility of hydrogel-based scaffolds for tissue engineering applications
Sheva Naahidi, Mousa Jafari, Megan Logan, Yujie Wang, Yongfang Yuan, Hojae Bae, Brian Dixon, P. Chen
Biotechnology Advances.2017; 35(5): 530. CrossRef

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Review Article

Platelet rich fibrin - a novel acumen into regenerative endodontic therapy: Kavita Hotwani, Krishna Sharma; Restor Dent Endod 2014;39(1):1-6. Published online January 20, 2014; DOI: https://doi.org/10.5395/rde.2014.39.1.1

Abstract PDF PubReader ePub

Research into regenerative dentistry has added impetus onto the field of molecular biology. It can be documented as a prototype shift in the therapeutic armamentarium for dental disease. Regenerative endodontic procedures are widely being added to the current armamentarium of pulp therapy procedures. The regenerative potential of platelets has been deliberated. A new family of platelet concentrates called the platelet rich fibrin (PRF) has been recently used by several investigators and has shown application in diverse disciplines of dentistry. This paper is intended to add light on the various prospects of PRF and clinical insights to regenerative endodontic therapy.

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Apicoectomy versus apical curettage in combination with or without L-PRF application: a randomized clinical trial
Serap Gulsever, Seyda Ersahan, Yelda Erdem Hepsenoglu, Alperen Tekin
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Pulp regeneration treatment using different bioactive materials in permanent teeth of pediatric subjects
Dina Abdellatif, Alfredo Iandolo, Giuseppina De Benedetto, Francesco Giordano, Davide Mancino, Edouard Euvrard, Massimo Pisano
Journal of Conservative Dentistry and Endodontics.2024; 27(5): 458. CrossRef
Analysis of Pulp Tissue Viability and Cytotoxicity of Pulp Capping Agents
Pratima Panda, Shashirekha Govind, Sanjit Kumar Sahoo, Satabdi Pattanaik, Rachappa M. Mallikarjuna, Triveni Nalawade, Sanjay Saraf, Naseer Al Khaldi, Salma Al Jahdhami, Vinay Shivagange, Amit Jena
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