To show the cytotoxicity of Porphyromonas gingivalis lipopolysaccharide (LPS) on human umbilical cord mesenchymal stem cells (HUCMSCs) to better understand the characteristics for its application in regenerative procedures under periodontopathogen LPS influence. Material and Methods: Ultrapure Porphyromonas gingivalis LPS was used in this study. This research used a frozen stock HUCMSCs, previously confirmed by flow cytometry. The biological characteristics, such as cell morphology, proliferation, and protein expression, were screened. To check the cytotoxicity, HUCMSCs were cultured and divided into two groups, the control group and LPS group with various concentrations from 25 to 0.39 µg/mL. MTT assay was done and the cells were observed and counted. The significance level was set at 5%. Results: The percentage of living HUCMSCs on LPS group were not significantly different among concentrations (p>0.05) from 25 to 0.39 µg/mL, even though there were slight mean decrease between groups, but they were not significant. The duration of 24 hours of exposure of LPS does not significantly lower HUCMSCs viability. Conclusion: LPS does not affect the viability of HUCMSCs. The lower the concentration of LPS, the higher the viability of HUCMSCs.
To examine the cytotoxicity of calcium hydroxide on human umbilical cord mesenchymal stem cells (HUCMSC) to understand the characteristics for use in regenerative dentistry procedures especially regenerative endodontics. Material and Methods: HUCMSC was isolated, cultured, and confirmed by flow cytometry. The biological characteristics, such as cell morphology, proliferation, and protein expression, were screened. To check the cytotoxicity, HUCMSC was cultured and divided into two groups, the control group (cultured in minimum essential medium (MEM) alpha) and calcium hydroxide group (cultured in MEM alpha and calcium hydroxide). Methyl-thiazole-tetrazolium (MTT) assay was done on different concentrations of calcium hydroxide (0.39 to 25 µg/mL) and the cells were observed and counted. One-way ANOVA test was used with a significance level set at 5%. Results: Flow cytometric analysis confirmed positive of CD73, CD90, CD105, negative of CD45 and CD34. A significant difference was found between the concentration of 6.25 and 3.125 µg/mL (p=0.004). There was no significant difference among 6.25, 12.5 and 25 µg/mL concentrations. There was also no significant difference among 0.39, 0.78, 1.56, and 3.125 µg/mL concentrations. Conclusion: Even though calcium hydroxide is a medicament of choice in clinical endodontics, it decreases the viability of HUCMSC. The lower the concentration of calcium hydroxide, the higher the viability of HUCMSC.
Purpose Calcium hydroxide is a gold standard dental material generally used for pulpal and periapical therapy including regenerative endodontic procedures because of its positive properties. However, evaluation about this material on stem cells is limited. Human umbilical cord mesenchymal stem cells (HUCMSCs) are potential to be used in regenerative therapy. Regenerative therapy needs a sustainable cell supply to maintain its regenerative capacity. The aim of this study was to ascertain the apoptosis result of calcium hydroxide on HUCMSCs through the expression of apoptotic protease-activating factor-1 (APAF-1), caspase-3, and caspase-9. Materials and Methods This study used a thawed frozen stock of passage 5 HUCMSCs, grown in minimum essential medium (MEM) alpha containing calcium hydroxide at concentration of 0.1 microgram/mL for 1, 3 and 7 days. Polyclonal antibody with fluorescence isothiocyanate (FITC) label was used to evaluate the expressions. APAF-1, caspase-3, and caspase-9 expressions were recorded and compared on every observation day using fluorescence microscope. Analysis of variance was performed to analyze the significance among the results of treatment groups. The results were concluded significant if p<0.05. Results The addition of calcium hydroxide in MEM alpha medium increases HUCMSCs expression of APAF-1, caspase-3 and caspase-9 significantly, compared to the control group without calcium hydroxide (p<0.05) in all the times. Day 1 showed the lowest increase followed by higher expressions on day 3 and day 7. Conclusion HUCMSCs express increased APAF-1, caspase-3 and caspase-9 after in-vitro calcium hydroxide exposure. This should be considered when using calcium hydroxide on HUCMSCs for regenerative procedures with regard to other positive properties.
Background: Irrigation is an essential step in root canal treatment (RCT). However, the complex structure of the root canal can limit the penetration of irrigants, causing RCT failure. Shock wave enhanced emission of photoacoustic streaming (SWEEPS) has been developed to improve root canal cleaning by increasing the penetration of irrigants. SWEEPS utilized the Er:YAG laser to generate micropulse, producing bubbles delivered in liquid, causing powerful photodynamic streaming. However, its superiority compared to conventional irrigation remains unclear. Thus, we aim to review the available evidence to assess the benefits of SWEEPS over conventional irrigation. Purpose: This study aims to review the available evidence to assess the benefits of SWEEPS over conventional irrigation. Reviewa: Article searches were conducted on Pubmed, ScienceDirect, EBSCOhost, and ProQuest using SWEEPS and root canal irrigation as keywords. Articles were included if they aim to assess the benefits of SWEEPS over conventional irrigation in removing smear layer, debris, pulp tissues, or bacteria. A total of 833 articles were initially retrieved from systemic search of literature and 6 articles following inclusion criteria were included in the review. Out of 6 articles, 4 articles suggested that SWEEPS could increase the removal of smear layer, debris, pulp tissues, and bacteria in the root canal compared to conventional irrigation. However, 2 articles found contradictory results, in which SWEEPS and conventional irrigation had similar outcomes in terms of penetration depth and could not completely eradicate biofilm. Conclusion: This review suggests that SWEEPS offers more benefits over conventional irrigation since it can improve the removal of smear layer, debris, pulp tissues, and bacteria in the root canal.
Introduction: Post-traumatic non-vital teeth is one of the indications for One Visit Endodontic. Trauma to the teeth may arise from conditions that cause the teeth to become necrotic so that the teeth will look darker and experience discoloration. Clinical conditions that indicate the death of the dental pulp and teeth require endodontic treatment. This situation will cause discoloration of the teeth that occur as a result of the metamorphosis of calcified pulp. Internal whitening is a treatment that can be done after the first treatment. Purpose: To provide information about discolored teeth management after trauma which causes pulp necrosis by doing root canal treatment and internal bleaching to change tooth color. Case: A 31-year-old woman came to the RSKGMP Universitas Airlangga with a referral from the orthodontics department where her teeth were darker in color and interfered with her appearance. In the previous history, the patient had an accident and trauma 10 years ago. Case Management: The first step is access opening and a good glide path. Root canal preparation was performed using the Crown Down Pressureless technique. The obturation technique used is Single Cone. The results were good and there were no symptoms during the control. Conclusion: One visit endodontic can be a treatment option for post-traumatic non-vital teeth. Internal bleaching with Walking Bleach Technique is also proven effective in restoring the original tooth color without excessive reduction of the dental crown.
Objectives To evaluate periapical inflammation through immunohistochemical analysis of interleukin 6 (IL-6) and tumor necrosis factor α (TNF-a) expression resulting from lipopolysaccharide (LPS)-induced apical periodontitis in diabetes mellitus rats, observed at 14, 28, and 42 days. Materials and Methods Diabetes model on rats was induced by streptozotocin (STZ). Fifteen rats were injected with low-dose STZ for 5 days and waited for 5 days until the blood glucose level was stable and measured above 300 mg/dL confirmed by a digital glucometer. LPS was used to induce apical periodontitis. After performing access cavity, pulpal and root canal extirpation was done on the right mandibular first molar's root canal space of rats, under anesthesia. LPS of 1 mg/mL dose was induced in the pulpal and root canal space. Apical periodontitis was expected 14 days afterward and then, the rats were randomly allocated to three groups. The first group was terminated 14 days after induction and used as control. The second group was observed 28 days after induction, and the third group was observed 42 days after induction. IL-6 and TNF-a expression was analyzed by immunohistochemistry on macrophages in the periapical area. Statistical Analysis Data were analyzed using one-way ANOVA and continued with the post hoc Tukey HSD test. Significance was considered if p < 0.05. Results LPS induced apical periodontitis in diabetes mellitus rats at control (14 days), 28 and 42 days observation showed a significant increase in the expression of IL-6 and TNF-a. There were significant differences between the control and observed groups (p < 0.05). The expression of IL-6 in the apical area was not significant at 14 and 28 days (p > 0.05) but increased significantly at 42 days (p < 0.05). The expression of TNF-a in the apical area was significantly increased after 14 days (p < 0.05) and remained stable at 28 and 42 days (p > 0.05). Conclusions The periapical inflammation of LPS-induced apical periodontitis in diabetes mellitus rats increased macrophages' expression of IL-6 at 42 days and TNF-a at 28 days.
Background: Single visit endodontics has been shown to be an effective treatment modality when compared with multiple visit therapy and it does not deviate from achieving the objectives of proper biomechanical preparation, debridement, shaping, disinfection and 3 dimensional obturation of root canal system and is more beneficial to the patient and dentist provided there is careful case selection and strict follow of standard endodontic protocols. Symptomatic teeth can also be managed by single visit after controlling the abscess infection with antibiotic, provided the root canal is dry without any discharge.Purpose: This study aims to perform single visit root canals on teeth with irreversible pulpitis and restoration with post core and crown. Case(s): A 48-years-old female comes with dental complaints of upper left rear spontaneous pain at night. The tooth has had cavities since about two years ago and has never been previously treated. The patient said had not any systematic health disorder. There is a spontaneous pain that the patient feels. Case Management: From the examination that has been carried out, a clinical diagnosis of tooth 25 were symptomatic pulpitis irreversible with normal apical tissue. The restoration endodontic treatment plan was a single visit endodontic and the restoration is post core and crown. Conclusion: Symptomatic pulpitis irreversible with normal apical tissue treatment can be carried out single visit root canal treatment. Restoration of post endodontic treatment in this case need fiber post and core using composite and finally restoration using crown that made of zirconia. Zirconia has a higher level of material resistance than lithium disilicate. This is what makes zirconia the choice, especially for posterior teeth.
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