Endodontic irrigants from a comprehensive perspective

This review article explores the fundamental principles of modern endodontics with a focus on root canal cleaning and shaping.It reviews commonly used endodontic irrigant,namely sodium hypochlorite(NaOCl),herbal extracts,chlorhexidine(CHX),and chelating agents,highlighting their properties,applications,and potential drawbacks.NaOCl,a key antimicrobial agent,demonstrates effectiveness against various microorganisms but poses challenges such as high cytotoxicity.Herbal extracts,gaining recognition in endodontics,present an alternative with potential advantages in preserving dentin integrity.CHX,known for its broad-spectrum antimicrobial activity,is discussed in both liquid and gel formulations,emphasizing its role in reducing smear layer formation and preserving hybrid layer durability.Chelating agents,specifically ethylenediaminetetraacetic acid and citric acid,play a vital role in removing the smear layer,enhancing dentin permeability,and facilitating the penetration of antimicrobial agents.The review article underscores the importance of careful application and consideration of each irrigant's properties to ensure safe and effective endodontic procedures.It serves as a valuable guide for clinicians in selecting appropriate irrigants based on specific treatment requirements.

Autologous platelet-rich-fibrin-induced revascularization sequelae:Two case reports Autologous platelet-rich-fibrin-induced revascularization sequelae:Two case reports

BACKGROUND A key requirement for biomimetic regeneration of tissues is a 3D scaffold.The gold standard scaffold for revascularization is the blood clot,however,an adequate blood clot cannot always be achieved in narrow canals or mature roots.Hereby,we document the effects of platelet-rich fibrin(PRF)for the regenerative endodontic treatment(RET)of two immature permanent teeth with necrotic pulps for up to 48 mo.CASES SUMMARY The first patient was a 22-year-old female with history of trauma in tooth#9 with a sinus tract and a large periapical lesion.The second was a 9-year-old male presenting with a badly decayed tooth#14.Both cases were treated with RET and PRF prepared from the patients’blood.PRF and its extract were used as a scaffold for RET.Patients were followed-up to 9 and 48 mo(4 years),respectively.Both patients,were asymptomatic after treatment.At the 9-mo-follow-up of case#1,there was radiographic evidence of periapical bone healing,however,the root apex was still open.In case#2,the roots exhibited apical closure and normal periapical bone architecture at 12-mo follow-up,while no root lengthening was observed.After 48 mo,case#2 showed extensive intracanal calcification in all root canals that complicated conventional root canal treatment.CONCLUSION RET with PRF and its extract could be used in revascularization of immature permanent teeth.However,proper case selection to comply with long-term follow-up is necessary and adverse events such as calcification and canal obliteration should be planned for.

Loss of KDM4B impairs osteogenic differentiation of OMSCs and promotes oral bone aging

Aging of craniofacial skeleton significantly impairs the repair and regeneration of trauma-induced bony defects,and complicates dental treatment outcomes.Age-related alveolar bone loss could be attributed to decreased progenitor pool through senescence,imbalance in bone metabolism and bone-fat ratio.Mesenchymal stem cells isolated from oral bones(OMSCs)have distinct lineage propensities and characteristics compared to MSCs from long bones,and are more suited for craniofacial regeneration.However,the effect of epigenetic modifications regulating OMSC differentiation and senescence in aging has not yet been investigated.In this study,we found that the histone demethylase KDM4B plays an essential role in regulating the osteogenesis of OMSCs and oral bone aging.Loss of KDM4B in OMSCs leads to inhibition of osteogenesis.Moreover,KDM4B loss promoted adipogenesis and OMSC senescence which further impairs bone-fat balance in the mandible.Together,our data suggest that KDM4B may underpin the molecular mechanisms of OMSC fate determination and alveolar bone homeostasis in skeletal aging,and present as a promising therapeutic target for addressing craniofacial skeletal defects associated with age-related deteriorations.