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Introduction: The American Association of Endodontics (AAE) Regenerative Endodontics Committee reports here the web-based survey data of regenerative endodontic procedures performed by the AAE members from 2008 to 2019., Methods: The web-based survey consisted of 2 questionnaires, a revascularization and a follow-up, including clinical and radiographic data at 3, 6, 12 or >12 months after treatment. Data from demographics, etiology, clinical protocols, radiographic, and clinical outcome as perceived by the clinicians were recorded. From 927 entries, 184 full cases were submitted and 126 were suitable for radiographic analysis. The data were divided into cases with 6-12 months and cases with >12 months recall time. Descriptive statistics and univariate analyses were performed., Results: Predominantly patients were male (63%), average 10 years-old with anterior teeth (77.2%) due to trauma (69.6%). A wide variation in regenerative endodontic procedures protocols was reported by the AAE members. The most common clinical protocols used minimal instrumentation (75.5%), 2.5% or higher concentrations of sodium hypochlorite (83.7%), and antibiotic paste as intracanal medication (58.7%). The majority reported blood clot formation (56%) and most common coronal capping material was white mineral trioxide aggregates (50.5%). Increases in radiographic root length, and radiographic root area were proportional to the time lapsed after treatment. Overall, case outcomes were categorized by clinicians as successful (54.3%), uncertain (23.9%), and unsuccessful (3.8%)., Conclusions: This web-based survey provides a valuable perspective on case selection, clinical protocols, and perceived outcomes for regenerative endodontic procedures and supports the need for future higher level evidence studies., (Copyright © 2024 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: Selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat depression and anxiety. The purpose of this study was to assess in real time the effect of paroxetine, an SSRI, on newly formed bone volume (NFBV) in standardized calvarial defects (SCDs) in rats., Methods: Fourteen Wistar albino female rats with a mean age of 7.5 months and a mean weight of 275 g were used. The animals were randomly divided into 2 groups. The experimental group was given paroxetine 8 weeks before the surgical procedure and throughout the experiment, and the control group was given a placebo 8 weeks before the surgical procedure and throughout the experiment. In each group, 14 SCDs measuring 4.6 mm in diameter were created on the parietal bone. In both groups, a Bio-Oss + collagen membrane was placed. All defects showed primary closure. The volume of the newly formed bone (NFBV) was measured using in vivo micro-computed tomographic imaging. Measurements were taken at days 0, 14, 28, 42, and 56 after surgery using real-time assessment with micro-computed tomographic imaging., Results: The mean NFBV was 17.12 ± 4.52 mm 3 and 12.52 ± 4.78 mm 3 for the control and experimental groups, respectively, at day 56. The differences between the 2 groups were statistically significant (P < .05) at all time intervals., Conclusions: Paroxetine intake significantly reduced the amount of regenerated NFBV and the rate of new bone formation., (Copyright © 2023 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: The shaping capacity of nickel-titanium (NiTi) rotary instruments is often assessed by photographic or micro-computed tomography (micro-CT) measurements, and these instruments are often used more than once clinically. This study was conducted to compare photographic and micro-CT measurements and to assess if the repeated use of NiTi instruments affected the shape of canal preparation., Methods: Ten new sets of ProTaper Universal instruments (Dentsply-Maillefer, Ballaigues, Switzerland) were used in 60 resin blocks simulating curved root canals. Groups 1 to 6 (n=10) represented the first to sixth use of the instrument, respectively. Digitized images of the prepared blocks were taken in both mesiodistal (MD) and buccolingual (BL) directions and area measurements (mm(2)) were calculated using AutoCAD (Autodesk Inc, San Rafael, CA). The volumes of the same prepared canals were measured using micro-CT (mm(3)). Statistical analysis was performed to detect differences between photographic and volumetric measurements and differences between uses., Results: Two-way repeated-measures analysis of variance revealed significant differences between groups (P < .001). Regarding measurement type, there were no significant differences between BL and MD measurements, but there were significant differences between micro-CT and BL measurements (P < .001) and micro-CT and MD measurements (P=.001). Significant differences were also noted between uses., Conclusions: Within the limitations of the present study, micro-CT scanning is more discriminative of the changes in canal space associated with repeated instrument use than photographic measurements. Canal preparations are significantly smaller after the third use of the same instrument., (Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Introduction: This study evaluated the formation of reparative hard tissues in baboon pulps after Emdogain (EMD) application in conjunction with 3 pulp-capping materials., Methods: Thirty-two premolars in four 3-year-old baboons were randomly assigned to 1 of 3 pulp-capping materials. A split-mouth design and intra-animal side randomization were applied to 3 experimental groups (calcium hydroxide, ProRoot White mineral trioxide aggregate, white Portland cement) and the control group (no pulp-capping material). In the hybrid EMD approach, a small drop of EMD was placed over the exposure site after arrest of hemorrhage. The designated pulp-capping material was placed over the EMD, followed by placement of resin-modified glass ionomer cement over the set/unset pulp-capping material. The animals were killed after 4 months. Histomorphometric analysis and micro-computed tomography were performed on the retrieved specimens., Results: All groups capped with EMD and 1 of the 3 capping materials exhibited similar reparative tissue thickness (P > .05). Dentin tunnel defects were absent in the mineral trioxide aggregate and Portland cement groups after the use of EMD. However, only a tubular was identified from all specimens., Conclusions: Mineral trioxide aggregate produces a better quality reparative hard tissue response with the adjunctive use of Emdogain, when compared with the use of calcium hydroxide., (Copyright © 2011 American Association of Endodontists. All rights reserved.)

Introduction: This study evaluated the responses of baboon dental pulps after the application of 3 pulp capping materials., Methods: Thirty premolar teeth in four 3-year old baboons were randomly assigned to 1 of 3 pulp capping materials. A split-mouth design was used, and intra-animal side randomization was applied to the 3 experimental groups (calcium hydroxide, ProRoot white mineral trioxide aggregate, white Portland cement) and the control group (no pulp capping material). Animals were divided into 4 groups (n = 8 teeth/pulp capping material). The animals were killed after 4 months. Histomorphometric analysis and micro-computed tomography were performed on the retrieved specimens., Results: Pulps capped with ProRoot white mineral trioxide aggregate and white Portland cement exhibited thicker reparative hard tissue deposition over the exposed pulps when compared with those that were capped with calcium hydroxide (P < .007), but they were not significantly different from one another (P > .05). No tubular reparative dentin could be identified from any of the specimens. Dentin tunnel defects were evident in all groups. There was no reparative hard tissue formation in the negative control group., Conclusions: Reparative hard tissue formation in pulps capped with Portland cement-based materials differs only in quantity (thickness) but not in quality from those that were formed after direct pulp capping with calcium hydroxide. It appears that other growth factors and up-regulation of transcription factors are required apart from those sequestered via the application of alkaline pulp capping materials for dental pulp stem cells to commit to the odontoblast lineage., (Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

The antibacterial effects of gray-colored MTA (GMTA) and white-colored MTA (WMTA) against Enterococcus faecalis and Streptococcus sanguis were assessed in vitro using the tube dilution test. Broth tubes were prepared and divided into experimental and control groups. Aliquots of each of the tested microorganisms were taken from a stock culture and added to each experimental and positive control group. All groups were incubated at 37 degrees C and evaluated for turbidity at 0, 1, 24, 48, and 72-hour time periods. A direct correlation was found between GMTA and WMTA concentrations and their antibacterial effect. Tubes containing GMTA in concentrations of 50, 25, and 12.5 mg/ml did not show E. faecalis growth at any of the time periods tested whereas tubes containing WMTA showed E. faecalis growth at all concentrations and time periods tested. Statistically significant differences were found between tubes containing GMTA in concentrations of 50, 25 and 12.5 mg/ml and tubes containing similar concentrations of WMTA (p < 0.001). Tubes containing GMTA in concentrations of 50, 25, 12.5, 6.25, and 3.12 mg/ml and tubes containing WMTA in concentrations of 50, 25, and 12.5 mg/ml did not show S. sanguis growth at any of the time periods tested. Statistically significant differences were found between tubes containing GMTA in concentrations 6.25 and 3.12 mg/ml and tubes containing similar concentrations of WMTA (p < 0.001). It appears that the susceptibility of E. faecalis and S. sanguis to MTA differed and that GMTA requires lower concentrations than WMTA to exert the same antibacterial effect against each of the microorganisms tested.

The killing effect of similar concentrations of white-colored MTA and gray-colored MTA against Candida albicans was assessed in vitro using the tube dilution test. A direct correlation was found between MTA concentration and its killing effect on C. albicans. At time period zero, both white-colored and gray-colored MTA samples showed Candida growth regardless of the concentration. Tubes containing gray-colored MTA in concentrations of 50, 25, 12.5, 6.25, and 3.125 mg/ml and tubes containing white-colored MTA in concentrations of 50 and 25 mg/ml did not show C. albicans growth at any of the other time periods tested. Tubes containing white-colored MTA in concentrations of 12.5 mg/ml or less showed Candida growth at all the time periods tested. Statistically, a significant difference was found between tubes containing either 50 mg/ml or 25 mg/ml and tubes containing lower concentrations of white-colored MTA (p < 0.001). A significant difference was also found between tubes containing gray-colored MTA in concentrations of 12.5 mg/ml or less and tubes containing similar concentrations of white-colored MTA (p < 0.001). It appears that both gray-colored and white-colored MTA in concentrations of 50 mg/ml and 25 mg/ml are effective in killing C. albicans for periods of up to 1 wk. Lower concentrations of gray-colored MTA may still be effective while lower concentrations of white-colored MTA may not.

The antifungal action of different concentrations of white-colored mineral trioxide aggregate (MTA) against Candida albicans was assessed in vitro. Fresh mix of MTA was prepared at concentrations varying from 0.78 mg/ml to 50 mg/ml by dilution with 10 ml molten agar at 45 degrees C. The MTA-agar compound was thoroughly mixed and the uniform mix was then poured into sterile Petri dishes and allowed to set. A total of 348 agar plates were prepared and divided into experimental groups of 11 plates each and control groups of 5 plates each. Plates of agar without MTA served as positive control and plates without C. albicans served as negative control. Fresh inoculate of C. albicans was prepared by growing an overnight culture from a stock culture. Aliquots of C. albicans were then taken from the stock culture and plated on the agar compound of the experimental and positive control groups. All plates were incubated at 37 degrees C for 1, 24, 48, and 72-h periods. At each time period, the presence of C. albicans colonies was assessed and recorded. A direct correlation was found between MTA concentration and its inhibition effect on C. albicans growth. Plates containing MTA in concentration of 50 mg/ml showed significantly better killing action against C. albicans in all of the time periods tested (p < 0.001). Plates containing MTA in concentration of 25 mg/ml showed antifungal activity only at 1 and 24-h time periods. Plates containing lower concentrations of MTA did not show any antifungal activity. It appears that under the conditions of this study, white-colored MTA in concentration of 50 mg/ml is effective in killing C. albicans for periods of up to 3 days. Lower MTA concentrations may not be effective.

The sealing ability of orthograde mineral trioxide aggregate (MTA) root canal filling against human saliva was assessed in vitro. Leakage of gray-colored MTA, white-colored MTA and vertically condensed gutta-percha and sealer were compared. Forty-three extracted single-rooted human teeth were serially instrumented to a file size 40/0.06 at the apex and obturated with either gray-colored MTA (group A), white-colored MTA (group B), or gutta-percha and Kerr Canal Sealer EWT (group C). The teeth were then mounted in a model to test for saliva leakage. After 42 days, one root in group A (9.1%), four roots in group B (36.4%), and nine roots in group C (81.8%) showed saliva leakage. Statistically, a significant difference was found between group A and group C (p < 0.001). No statistical difference was found between group A and group B. Out of the root samples that leaked, the one sample in group A leaked after 36 days. Of the four samples in group B, one sample leaked after 32 days, one sample after 33 days, and two samples after 39 days. All nine samples in group C had leaked after 19 days. It appears that under the conditions of this study both MTA preparations may be more resistant to human saliva leakage than vertically condensed gutta-percha and sealer.