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Evaluation of genetic damage in human peripheral lymphocytes exposed to mineral trioxide aggregate and Portland cements.

summary Mineral trioxide aggregate (MTA) and Portland cement are being used in dentistry as root-end-filling material for periapical surgery and for the sealing of communications between the root canal system and the surrounding tissues. However, genotoxicity tests for complete risk assessment of these compounds have not been conducted up to now. In the present study, the genotoxic effects of MTA and Portland cements were evaluated in peripheral lymphocytes from 10 volunteers by the alkaline single cell gel (comet) assay. The results pointed out that the single cell gel (comet) assay failed to detect the presence of DNA damage after a treatment of peripheral lymphocytes by MTA and Portland cements for concentrations up to 1000 mug mL(-1). In summary, our results indicate that exposure to MTA or Portland cements may not be a factor that increases the level of DNA lesions in human peripheral lymphocytes as detected by single cell gel (comet) assay.

Adult↗

A histological and quantitative histomorphometric study of apexification of nonvital permanent incisors of vervet monkeys after repeated root filling with a calcium hydroxide paste.

The purpose of this study was to compare the effect of a monthly refilling of the root canals with calcium hydroxide paste with a single packing or replacement of the paste at 3 months on the apexification of nonvital maxillary incisors of vervet monkeys. Forty-eight maxillary incisors from 12 monkeys were used following radiographic determination that root development was incomplete. The pulps were extirpated under general anesthesia and the root canals filed and cleaned. The root canals were filled with a commercial calcium hydroxide paste, Calxyl, and a temporary cavity filling placed. Twelve teeth were left without further treatment. The calcium hydroxide paste was replaced in 12 teeth after a 3-month interval, and in the remaining 24 teeth the calcium hydroxide root filling was replaced five times at monthly intervals. The monkeys were killed after 6 months, and blocks of the teeth and surrounding tissues were embedded, decalcified and 6 microns serial sections prepared and stained. The sections were studied histologically to evaluate 11 parameters. Significant differences were found in the amount of calcium hydroxide at the apices, the presence of new cementum on the roots and the degree of inflammation, all of which were better in the monthly refill group. Histomorphometric measurements to evaluate the obturation of the open apices and the volume of new primary osteocementum showed no significant difference between the three groups. It was suggested that after the initial root filling with calcium hydroxide there was nothing to be gained by repeated root filling either monthly or after 3 months, for at least 6 months.

Analysis of Variance↗

Vital pulp therapy with mineral trioxide aggregate.

The present case report describes the treatment of complicated crown fractures using mineral trioxide aggregate (MTA). MTA was used as pulp-capping material after partial pulpotomy to preserve the vitality of the pulpal tissues in two cases. Follow-up examinations revealed that the treatment was successful in preserving pulpal vitality and continued development of the tooth.

Aluminum Compounds↗

Apexification of a replanted tooth using mineral trioxide aggregate.

The most important factors determining periodontal healing after replantation of an avulsed tooth are the extra oral period and the media in which the tooth is preserved before replantation. This case report describes an adequate periodontal healing of an avulsed immature tooth replanted after 20 min of extra alveolar dry time. Vitality was not regained and after disinfection of the pulp space mineral trioxide aggregate was used as the root filling. Follow-up confirmed complete healing periradicularly.

Aluminum Compounds↗

Maturogenesis of a cariously exposed immature permanent tooth using MTA for direct pulp capping: a case report.

Successful direct pulp capping of cariously exposed permanent teeth with reversible pulpitis and incomplete apex formation can prevent the need for root canal treatment. A case report is presented which demonstrates the use of mineral trioxide aggregate (MTA) as a direct pulp capping material for the purpose of continued maturogenesis of the root. Clinical and radiographic follow-up demonstrated a vital pulp and physiologic root development in comparison with the contralateral tooth. MTA can be considered as an effective material for vital pulp therapy, with the goal of maturogenesis.

Aluminum Compounds↗

Microthrix parvicella, a filamentous bacterium isolated from activated sludge: cultivation in a chemically defined medium.

A large number of media have been tested for cultivating Microthris parvicella, a filamentous microorganism often present in the activated sludge of oxidation ditches. The bacterium was found to utilize oleic acid (preferably as Tween 80) as the sole source of carbon and energy. Sulfur is required in the reduced form. The tested media vary from a complex to a chemically defined medium. Growth yields of 1.3 to 1.5 g/liter were obtained on media containing Tween 80 (4 g/liter), reduced nitrogen and reduced sulfur compounds, calcium and magnesium salts, phosphate buffer, trace elements, thiamin, and cyanocobalamin. The optimum temperature for growing the organism is approximately 25 degrees C, and the pH of the nutrient medium should be above 7.

Culture Media↗

Microcalcifications in breast core biopsy specimens: disappearance at radiography after storage in formaldehyde.

PURPOSE: To determine whether radiographically proved calcifications in core biopsy specimens are better preserved in a nonaqueous fixative than in aqueous solutions. MATERIALS AND METHODS: One hundred fifty core biopsy specimens were taken from two female breast specimens that had been preserved in ethanol. Forty-one of the specimens with radiographically proved microcalcifications were divided into four groups and deposited in four different solutions: 10% formaldehyde, 0.9% sodium chloride, electrolyte solution, and 74.1% ethanol with 10% 2-propanol. The core specimens were radiographed again after 1 and 3 days. Five ethanol-preserved specimens were also reexamined radiographically after 2 weeks. RESULTS: Within 3 days, total radiographic disappearance of microcalcifications was observed in all core biopsy specimens that were immersed in solutions with high water content. In those core specimens preserved in ethanol, microcalcifications showed no change. CONCLUSION: A nonaqueous fixative, such as ethanol, is a better preservative of microcalcifications in breast core biopsy specimens than various aqueous solutions, possibly because calcium compounds are water-soluble.

Biopsy↗

Salivary fluoride from fluoride dentifrices or rinses after use of a calcium pre-rinse or calcium dentifrice.

The low concentration of available calcium (Ca) in oral fluids limits the formation of Ca-mediated fluoride deposits that maintain oral fluoride (F) after a topical F treatment. The purpose of this study was to examine if a high concentration of Ca would increase salivary F when used before a F rinse or dentifrice. We found that a Ca pre-rinse (150 mmol/l Ca lactate) or Ca dentifrice (0.084 g Ca glycerolphosphate per gram dentifrice) used immediately before a 60 s 228-ppm F rinse (12 mmol/l NaF) produced a 4.6x or 3.6x increase (p < 0.05) respectively in the 1 h salivary F concentrations over the F rinse alone. Reducing the post-Ca F rinse to 10 s still produced a significant 2.2x increase in salivary F compared to the 60 s F rinse alone. Used with a conventional 1,100 ppm F (i.e. 1,100 microg F per gram) NaF dentifrice (Crest), the above Ca pre-rinse increased 1 h salivary F levels by 2.3x over the F dentifrice alone. However, a F rinse given before a Ca rinse produced no increase in 1 h salivary F concentrations. Although the persistence of these increases requires further study, these results suggest that a moderately high concentration of Ca given shortly before a F rinse or F dentifrice may increase the cariostatic effect of the F product.

Biological Availability↗

Spectroscopic studies of a multiphasic polymer-ceramic mixture material.

We report the results obtained by infrared (IR) and X-ray photoelectron spectroscopy (XPS) on the multiphasic composite material formed by the mixture of biphasic calcium phosphate (BCP) and hydroxypropylmethylcellulose (HPMC). This synthetic material, intended for bone substitution, is injectable and allows percutaneous surgery. Core level spectra of carbon, oxygen, calcium, and phosphorus were recorded on separate components before mixing and then compared to those obtained in the final product. Analysis of the spectra shows that formation of calcium carbonate has occurred upon mixing the components in agreement with IR results. An attempt to explain the formation mechanism of the composite is given involving the nature of the constituents on one hand and the possible reactions between the different components on the other.

Bone Substitutes↗

Adhesion to and decalcification of hydroxyapatite by carboxylic acids.

Fundamental to the processes of decalcification of or adhesion to mineralized tissues is the molecular interaction of acids with hydroxyapatite. This study was undertaken to chemically analyze the interaction of 1 mono-, 2 di-, 1 tri-, and 2 polycarboxylic acids with hydroxyapatite in an attempt to elucidate the underlying mechanism. Maleic, citric, and lactic acid decalcified hydroxyapatite, in contrast to oxalic acid and the two polycarboxylic acids that were chemically bonded to hydroxyapatite. Solubility tests showed that the calcium salts of the former were very soluble, whereas those of the latter could hardly be dissolved in the respective acid solutions. Based on these data, an adhesion/decalcification concept was advanced that predicts that carboxylic acids, regardless of concentration/pH, either adhere to or decalcify hydroxyapatite, depending on the dissolution rate of the respective calcium salts in the acid solution. This contrasting behavior of organic acids most likely results from their differential structural conformations.

Acrylic Resins↗

Calcium bioavailability and kinetics of calcium ascorbate and calcium acetate in rats.

The objective was to investigate the bioavailability and mechanism of calcium absorption of calcium ascorbate (ASC) and calcium acetate (AC). A series of studies was performed in adult Sprague-Dawley male rats. In the first study, each group of rats (n = 10/group) was assigned to one of the five test meals labeled with (45)Ca: (i) 25 mg calcium as heated ASC or (ii) unheated ASC, (iii) 25 mg calcium as unheated AC, (iv) 3.6 mg Ca as unheated ASC, or (v) unheated AC. Femur uptake indicated better calcium bioavailability from ASC than AC at both calcium loads. A 5-min heat treatment partly reduced bioavailability of ASC. Kinetic studies were performed to further investigate the mechanism of superior calcium bioavailability from ASC. Two groups of rats (n = 10/group) received oral doses of 25 mg Ca as ASC or AC. Each dose contained 20 micro Ci (45)Ca. Two additional groups of rats (n = 10/group) received an intravenous injection (iv) of 10 micro Ci (45)Ca after receiving an unlabeled oral dose of 25 mg calcium as ASC or AC. Sequential blood samples were collected over 48 hrs. Urine and fecal samples were collected every 12 hrs for 48 hrs and were analyzed for total calcium and (45)Ca content. Total calcium and (45)Ca from serum, urine, and feces were fitted by a compartment kinetics model with saturable and nonsaturable absorption pathways by WinSAAM (Windows-based Simulation Analysis and Modeling). The difference in calcium bioavailability between the two salts was due to differences in saturable rather than passive intestinal absorption and not to endogenous secretion or calcium deposition rate. The higher bioavailability of calcium ascorbate was due to a longer transit time in the small intestine compared with ASC.

Absorption↗

Barium hydroxide lime turns yellow after desiccation.

Ethyl violet is added to carbon dioxide absorbents and normally serves as an indicator of absorbent exhaustion. During the course of several prior studies of anesthetic breakdown, we noted (but did not publish) that barium hydroxide lime (BL), but not soda lime, turns yellow upon desiccation. We hypothesize that ethyl violet undergoes chemical reaction to produce a yellow colorant in desiccated BL. We qualitatively studied the time course of yellow color development during desiccation of these absorbents with dry oxygen. The yellow colorant was extracted from desiccated absorbent with diethyl ether, separated with chromatography, and analyzed with proton nuclear magnetic resonance and combined gas chromatography and mass spectrometry. The yellow color develops after BL has reached nearly complete desiccation. We successfully identified that ethyl violet decomposes into the yellow colorant 4,4'-bis(diethylamino)benzophenone upon desiccation of BL. The color is not intense, is not useful for identifying low levels of absorbent desiccation, and may be difficult to see through tinted canisters. It may be possible for BL to be sufficiently desiccated to allow chemical breakdown of anesthetics, but not yet show yellow coloration. However, if yellow coloration exists, one should assume that it has become desiccated.

Anesthesiology↗

Mineral trioxide aggregate: a new material for endodontics.

BACKGROUND: Mineral trioxide aggregate, or MTA, is a new material developed for endodontics that appears to be a significant improvement over other materials for procedures in bone. It is the first restorative material that consistently allows for the overgrowth of cementum, and it may facilitate the regeneration of the periodontal ligament. CASE DESCRIPTION: The authors present five cases in which MTA was used to manage clinical problems. These included vertical root fracture, apexification, perforation repair and repair of a resorptive defect. In each case, MTA allowed bone healing and elimination of clinical symptoms. CLINICAL IMPLICATIONS: Materials such as zinc oxide-eugenol cement and resin composite have been used in the past to repair root defects, but their use resulted in the formation of fibrous connective tissue adjacent to the bone. Because it allows the overgrowth of cementum and periodontal ligament, MTA may be an ideal material for certain endodontic procedures.

Adult↗

21st-century endodontics.

BACKGROUND: Endodontics as a discipline has offered patients the opportunity to maintain their natural teeth. As the population expands and ages, the demand for endodontic therapy can be expected to increase as patients seek dental options to keep their teeth for a lifetime. CLINICAL IMPLICATIONS: New materials, techniques and instruments are entering the market-place to assist dentists in providing patients with more predictable and reliable endodontic treatment. In addition, these new systems make the delivery of endodontic services more efficient. This article describes these advances in endodontic treatment for dentists interested in incorporating these advances into their clinical practice.

Aluminum Compounds↗

Anatomical redesign for the treatment of dens invaginatus type III with open apexes: a literature review and case presentation.

BACKGROUND: Dens invaginatus is a rare dental anomaly that may give rise to many complex anatomical forms. The complexity of the internal anatomy may create challenges for the complete removal of the diseased pulpal tissue and the subsequent sealing of the canal system. CASE DESCRIPTION: The authors discuss the modification of the internal anatomy under the operating microscope, allowing the clinician better access to treat predictably the canal system with conventional or alternative techniques. CONCLUSION AND CLINICAL IMPLICATIONS: Considering the anatomical variations and the challenges that a dens invaginatus may present, a practitioner may consider a modification of the internal anatomy of the canal system to gain better access for proper instrumentation, disinfection and sealing of the root canal system using conventional or contemporary techniques.

Adolescent↗