Browsing by Subject "Pulpitis"

Now showing 1 - 5 of 5
  • Thumbnail Image
    Item
    Advanced Scaffolds for Dental Pulp and Periodontal Regeneration
    (Elsevier, 2017-10) Bottino, Marco C.; Pankajakshan, Divya; Nör, Jacques E.; Biomedical Sciences and Comprehensive Care, School of Dentistry
    No current therapy promotes root canal disinfection and regeneration of the pulp-dentin complex in cases of pulp necrosis. Antibiotic pastes used to eradicate canal infection negatively affect stem cell survival. Three-dimensional easy-to-fit antibiotic-eluting nanofibers, combined with injectable scaffolds, enriched or not with stem cells and/or growth factors, may increase the likelihood of achieving predictable dental pulp regeneration. Periodontitis is an aggressive disease that impairs the integrity of tooth-supporting structures and may lead to tooth loss. The latest advances in membrane biomodification to endow needed functionalities and technologies to engineer patient-specific membranes/constructs to amplify periodontal regeneration are presented.
  • Thumbnail Image
    Item
    Buffered vs. Unbuffered Local Anesthesia in Mandibular Molars Diagnosed with Symptomatic Irreversible Pulpitis: A Controlled, Randomized, Double-Blind Study
    (2022) Alena, Peter; Spolnik, Kenneth; Ehrlich, Ygal; Warner, Ned
    Introduction: Profound pulpal anesthesia is not always adequate in mandibular teeth after the administration of local anesthesia, especially in the presence of irreversible pulpitis. Failure to achieve anesthesia has been seen in 30–80% of patients in teeth with a diagnosis of irreversible pulpitis. Onpharma™ developed an FDA-approved device that uses sodium bicarbonate to buffer a standard local anesthetic (LA) solution so that its pH may become closer to its pKa. Claims have been made that buffering a local anesthetic increases the anesthetic’s effect. Previous studies on the anesthetic efficacy of Onpharma’s Onset buffering system were inconclusive and may be dependent on the techniques used. Objectives: The aim of this study is to determine whether a buffered local anesthetic can lead to more profound and faster pulpal anesthesia in mandibular molars diagnosed with symptomatic irreversible pulpitis as compared to a standard, unbuffered local anesthetic. Materials and Methods: 40 total subjects completed the study. Screened and eligible subjects with a mandibular molar diagnosed with symptomatic irreversible pulpitis were randomly allocated into 2 groups so 1 group received a total of 3 cartridges of a standard, unbuffered 2% lidocaine with 1:100,000 epinephrine via inferior alveolar nerve block (IANB) followed by supplemental buccal and lingual infiltrations, while the other received the equivalent yet buffered formulation. An electronic pulp tester (EPT) was used to objectively determine baseline pulpal status of the affected tooth, followed by 2-minute interval testing following the administration of all local anesthesia. The onset of pulpal anesthesia was defined by the first of 2 consecutive EPT=80 readings, and the endodontic treatment could begin. Profound pulpal anesthesia was ultimately determined if the patient reported a comfortable pulpotomy as reflected on the Wong-Baker FACES Visual Analog Scale. Null Hypothesis 1: Subjects possessing mandibular molars diagnosed with symptomatic irreversible pulpitis will not achieve pulpal anesthesia more profoundly using buffered 2% lidocaine w/ 1:100,000 epinephrine in comparison to the standard, unbuffered anesthetic formulation. Null hypothesis 2: Subjects possessing mandibular molars diagnosed with symptomatic irreversible pulpitis will not achieve pulpal anesthesia faster using buffered 2% lidocaine w/ 1:100,000 epinephrine in comparison to the standard, unbuffered anesthetic formulation. Results: We observed a local anesthetic success rate of 45% in the buffered group, 70% in the unbuffered group, and ultimately 57.5% between both groups. The findings further indicate that the VAS scores after pulpotomy is significantly different between the 2 groups (p=0.019), with the unbuffered group having a more profound mean VAS score of 1.2 (as opposed to a buffered mean of 3.1). Regarding the time of onset for pulpal anesthesia, there was no statistically significant difference noted between the buffered and unbuffered groups. Conclusion: Based on the findings of this study, the null hypothesis 1 cannot be rejected since unbuffered 2% lidocaine with 1:100,000 epinephrine had a statistically significant increase in profound pulpal anesthesia compared to the buffered equivalent. The null hypothesis 2 cannot be rejected since there was no evidence of a significant difference in the time to pulpal anesthesia between the buffered and unbuffered groups.
  • Thumbnail Image
    Item
    A method for studying the permeability of the blood vessels of the dental pulp during acute inflammation
    (1966) Page, James, 1939-
    A study was made to develop a method for investigating the quantity and location of vascular leakage during acute inflammation of the dental pulp. Use was made of the method of "vascular labelling" by which carbon particles placed in the blood are deposited in the walls of leaking vessels. Three dogs were used, with cavities of varying depth being cut in their permanent teeth. Vascular leakage was induced in the skin and in some of the teeth by applying histamine phosphate solution. The tissues were studied in normal histologic sections and as cleared specimens. It was found that the number of leaking vessels was much less in the dental pulp than in the skin and that leakage was confined to the area immediately below the cavity preparation unless histamine had been applied to the cavity, when the labelled vessels were found further apically. The number of leaking vessels depended on the depth of the cavity, becoming greater as the cavity depth increased. These findings would support the common finding that the degree of inflammation beneath cavity preparations increases with cavity depth. The conclusion was that the method developed held promise as a tool in investigating vascular changes in the dental pulp.
  • Thumbnail Image
    Item
    Non-Psychoactive Cannabinoid Modulation of Nociception and Inflammation Associated with a Rat Model of Pulpitis
    (MDPI, 2023-05-16) Laks, Elana Y.; Li, Hongbo; Ward, Sara Jane; Prosthodontics, School of Dentistry
    Despite advancements in dental pain management, one of the most common reasons for emergency dental care is orofacial pain. Our study aimed to determine the effects of non-psychoactive Cannabis constituents in the treatment of dental pain and related inflammation. We tested the therapeutic potential of two non-psychoactive Cannabis constituents, cannabidiol (CBD) and β-caryophyllene (β-CP), in a rodent model of orofacial pain associated with pulp exposure. Sham or left mandibular molar pulp exposures were performed on Sprague Dawley rats treated with either vehicle, the phytocannabinoid CBD (5 mg/kg i.p.) or the sesquiterpene β-CP (30 mg/kg i.p.) administered 1 h pre-exposure and on days 1, 3, 7, and 10 post-exposure. Orofacial mechanical allodynia was evaluated at baseline and post-pulp exposure. Trigeminal ganglia were harvested for histological evaluation at day 15. Pulp exposure was associated with significant orofacial sensitivity and neuroinflammation in the ipsilateral orofacial region and trigeminal ganglion. β-CP but not CBD produced a significant reduction in orofacial sensitivity. β-CP also significantly reduced the expression of the inflammatory markers AIF and CCL2, while CBD only decreased AIF expression. These data represent the first preclinical evidence that non-psychoactive cannabinoid-based pharmacotherapy may provide a therapeutic benefit for the treatment of orofacial pain associated with pulp exposure.
  • Thumbnail Image
    Item
    Treatment of infected dental pulps of monkeys with vancomycin and hyaluronidase
    (1968) Eggers, Eugene S. (Eugene Sherman), 1937-
    This study was undertaken to investigate histologically the effect of a combination of an antibiotic and an anti-inflammatory enzyme when used as a medication in direct pulp therapy. The pulps of 56 teeth in two Macaca Speciosa monkeys, exposed and left open to the oral environment for 24 hours to insure contamination, received direct treatment with one of four experimental medications: (1) vancomycin, starch, and hyaluronidase; (2) vancomycin, starch, and water; (3) starch and water; and (4) starch and hyaluronidase. At 30 days the teeth were removed from one animal and at 90 days•from the other for histologic interpretation. A satisfactory response was observed in 92.9 per cent of the teeth treated with vancomycin, starch, and hyaluronidase; in 71.5 per cent of the teeth treated with vancomycin, starch, and water; and in 42.9 per cent of the teeth treated with both starch and water and starch and hyaluronidase. None of the teeth treated with vancomycin, starch, and water and vancomycin, starch, and hyaluronidase became necrotic,while 35.7 per cent of the teeth treated with starch and water or starch and hyaluronidase became necrotic. Under the conditions of this investigation, vancomycin containing pulp capping agents are effective in controlling infection and in promoting reparative dentin formation in monkeys. The benefit of hyaluronidase when used in combination with vancomycin was questionable.