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This canine in vivo study assessed the effect of recombinant human platelet-derived growth factor (rhPDGF) on the healing of periapical tissues following apical surgery. From a total of 96 premolar teeth, 64 teeth from six beagle dogs (2 years old) were classified as experimental and were randomly assigned to four experimental groups (16 teeth per group). After having the pulp extirpated, leaving teeth open to the oral cavity for 1 week, and sealing with an immediate restorative material for 8 weeks, nonsurgical endodontic treatment was performed. A split-mouth design was used, and intra-animal randomization of treatment sides was applied to the groups as follows: apical curettage + 1.5-mm root-end resection (Group 1); apicoectomy + mineral trioxide aggregate (MTA) root-end filling (Group 2); apicoectomy + MTA root-end filling + rhPDGF (Group 3); and apical curettage + rhPDGF (Group 4). The animals were sacrificed 24 months after apical surgery, and histologic and µCT analyses were performed for bone volume loss (BVL). Group 1 showed partial resolution of the periapical lesions without signs of tissue regeneration (BVL: 49.09 ± 10.97 mm3). Group 2 had minimal bone regeneration and showed cementum reformation in 9 teeth, with no direct attachment to the MTA (BVL: 35.34 ± 10.97 mm3). Group 3 showed regeneration of all damaged apical tissues without direct contact between the cementum and MTA (BLV: 4.51 ± 1.55 mm3). Group 4 showed regeneration of PDL, bone, and cementum and attachment of functional cementum fibers (BVL: 2.82 ± 2.3 mm3). The difference in BVL was statistically significant only for Groups 1 and 2 (P < .05). rhPDGF may help regenerate apical tissue structures following apical surgery. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the prevalence of acute periapical abscesses (PAs) in obese patients. Methods: Integrated data of hospital patients was used. Data from the corresponding diagnosis codes for obesity and PAs was retrieved by identifying the appropriate ICD 10 codes in the database. Results: Out of 1,874,214 hospital patients studied, 147.195 patients were classified as obese, of which 3,349 had acute PAs. The difference in prevalence of PAs between obese and average-weight patients was statistically significant (OR 4.22, 95%CI: 4.05-4.39. P< 0.0001) Adjustment for diabetes comorbidity reduced the OR to 2.55; however, the difference remained statistically significant (95%CI: 2.43-2.68. P< 0.0001). Adjustment for smoking reduced the OR to 2.63; however, the difference remained statistically significant (95%Cl: 2.51-2.87, P< 0.0001). Adjustment for periodontal disease comorbidity reduced the OR to 3.85; however, the difference remained statistically significant (95%Cl: 3.70-4.01. P< 0.0001). Females were more affected than males; adults were more affected than children; and African Americans were more affected than Whites. [ABSTRACT FROM AUTHOR]

Aim: To assess the prevalence of acute periapical abscesses (PAs) in patients with a history of extracranial carotid artery aneurysms (ECAA). Materials and methods: History of acute PAs and ECAA diagnosis was retrieved by searching the appropriate query in the database. All cases were diagnosed for acute PAs by calibrated dentists for patients admitted to urgent care. The odds ratio (OR) for the prevalence of acute PAs and its association with history of ECAA were then calculated. Results: The prevalence of acute PAs in patients with a history ECAA was significantly higher as compared to the general hospital patient population (p < 0.0001). The OR was 5.5. Females were more affected than males by 1.7 folds (p < 0.001). Whites were more affected than African Americans by 1.6 folds (p < 0.00001). Conclusions: The high prevalence of acute PAs in patients with a history of ECAA may suggest an association between these two conditions warranting a thorough medical examination.

Aim: To assess the prevalence of acute periapical abscesses (PAs) in patients infected with herpes simplex type 1 (HS-1) and herpes zoster (HZ). Materials and methods: Integrated data of hospital patients was used. History of HS-1 and HZ diagnosis was retrieved by searching the appropriate query in the database. All cases were diagnosed for acute PAs by calibrated dentists in a hospital setting for patients admitted to urgent care. Diagnosis was made based on clinical examination and imaging data confirming the diagnosis of acute PAs without sinus tract. The odds ratio (OR) for the prevalence of acute PAs and its association with history of HS-1 and HZ were then calculated. Results: The prevalence of acute PAs in patients with a history HS-1 was 2.43% as compared to 0.59% in the general patient population of the hospital. The OR was 4.12 and the difference in prevalence was statistically significant (p < 0.0001). The prevalence of acute PAs in patients with a history HZ was 2.78% as compared to 0.59% in the general patient population of the hospital. The OR was 4.71 and the difference in prevalence was statistically significant (p < 0.0001). Conclusions: Under the conditions of this study, it appears that the prevalence of acute PAs is significantly higher in patients with a history of HS-1 and HZ infections and may warrant an antiviral therapy in certain resistant periapical abscesses.

Aims: Depression and anxiety are severe health problems affecting millions of individuals worldwide. Consequently, the use of antidepressants has constantly been on a rise. Selective serotonin reuptake inhibitors (SSRIs) antidepressant are now commonly used due to fewer side effects as compared to other types of antidepressants. The aim of this study was to assess the prevalence of periapical abscesses (PAs)in patients using SSRIs. Methods and Results: Integrated data of hospital patients was used. Data from the corresponding diagnosis codes for SSRIs and acute PAs was retrieved by searching the appropriate query in the database. The different diagnoses were coded using the international coding systems ICD 10. Diagnosis was made by calibrated dentists in a hospital setting based on clinical examination and imaging data. The odds ratio (OR) for the prevalence of acute PAs and its association with the use of SSRIs were calculated and analyzed statistically. It was found that the prevalence of acute PAs was significantly higher in patients using SSRIs as compared to the other hospital patient population. The OR was 2.8 and the difference between patients using SSRIs and patients who do not was statistically significant (p <.0001). Conclusion: Under the conditions of this study, it appears that the prevalence of acute PAs is higher in patients using SSRIs. [ABSTRACT FROM AUTHOR]

This in vivo study assessed calcium hydroxide’s effect as a matrix carrier for recombinant human platelet-derived growth factor (rhPDGF) and enamel matrix protein (EMD) on pulp tissue healing following pulp capping. Intact premolar sites (n = 18) were included. Coronal access and pulpotomy were performed, and each tooth was exposed to the oral cavity for 1 hour before pulp capping was performed. Teeth were randomly assigned to one of the following pulp-capping groups (n = 6 each): Group 1 (CaOH2 only); Group 2 (CaOH2+EMD); and Group 3 (CaOH2+rhPDGF). Coronal access cavities were then sealed. Immediate preoperative, postoperative, and 4-month follow-up radiographs were taken. At 4 months, teeth were extracted atraumatically and histomorphometric and micro-CT analyses were performed. Group 1 showed formation of thin, uneven, highly porous dentin-like structure with tunnel defects (average thickness: 0.18 to 0.19 mm). Lack of continuity of the newly formed tissue and interrupted communication tunnels were seen between the pulpal space and pulp-capping material. Group 2 showed formation of highly dense, nonporous, even-thickness dentin-like structure obliterating multiple areas of the pulp space (average thickness: 0.9 to 0.94 mm). Abundant odontoblast lacunae were present in the pulp and structure. Group 3 showed formation of an inconsistent, uneven dentin-like structure that appeared highly porous (average thickness: 1.04 to 1.05 mm). It was without tunneling, and abundant odontoblastic lacunae were present. No statistically significant differences were found between Groups 2 and 3, but both were richer in newly formed dentin-like structure with more thickness than Group 1 (P < .05). Addition of EMD to CaOH2 can result in multiple root canal calcifications, mostly in the coronal and apical thirds of the canals. The calcified tissue does not appear to resemble secondary dentin in form, shape, amount, or density. Addition of rhPDGF to CaOH2 may not cause root canal calcifications. The newly formed structure differs from secondary dentin in degree of mineralization, porosity, and density. [ABSTRACT FROM AUTHOR]

This in vivo study assessed the effect of mineral trioxide aggregate (MTA) as a matrix carrier for recombinant human platelet-derived growth factor (rhPDGF) and enamel matrix protein (EMP) on pulp tissue healing following pulp capping. Eighteen intact human premolars scheduled for extraction were included. Coronal access and pulpotomy were performed, and each tooth was left exposed to the oral cavity for 1 hour before pulp capping was performed. Teeth were randomly assigned to one of the following pulp-capping groups (n = 6 each): Group 1 (MTA only); Group 2 (MTA+EMP); or Group 3 (MTA+rhPDGF). Coronal access cavities were then sealed. Immediate preoperative, postoperative, and 4-month follow-up radiographs were taken. At 4 months, the teeth were extracted atraumatically, and histomorphometric and micro-computed tomography (µCT) analyses were performed. Group 1 showed a thin, uneven, irregular dentin-like structure. Its average thickness was 0.3 ± 0.084 mm measured histologically and 0.29 ± 0.091 mm measured by µCT. Group 2 showed of a nonporous, even-thickness dentin-like structure with multiple root-canal obliterations. Highly dense, atubular dentin-like structures associated with presence of odontoblastic lacunae were seen. The structure's average thickness was 0.87 ± 0.09 mm (histologically) and 0.81 ± 0.17 mm (µCT). Group 3 showed a thick and complete 3D continuous seal of newly formed dentin-like structure covering the pulpal space. It resembled secondary dentin in form, porosity, and tubular structural organization, and its average thickness was 0.94 ± 0.02 mm (histologically) and 0.91 ± 0.09 mm (µCT). Groups 2 and 3 showed higher amounts of newly formed dentin-like structure, that was also thicker, than Group 1 (P < .05). No statistically significant differences in structure thickness were found between Groups 2 and 3. The nature of the structure can differ if rhPDGF or EMP is added to MTA for pulp-capping purposes. Combination of rhPDGF and MTA resulted in a newly formed structure resembling secondary dentin, whereas a combination of EMP and MTA produced a nonporous, highly dense dentinal-like structure associated with significant root-canal obliterations. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to assess the prevalence of acute periapical lesions in patients with pSS. Methods: Integrated data of hospital patients was used. Data from the corresponding diagnosis codes for pSS and acute periapical abscess was retrieved by searching the appropriate query in the database. The patient population analyzed was mixed, presenting with different disease conditions including periapical abscesses without sinus. The different diagnoses were coded using the international coding systems ICD 10. Diagnosis was made by calibrated dentists in a hospital setting based on clinical examination and imaging data. Patients with ICD 10 diagnosis code of acute periapical abscess were recorded and the prevalence of acute periapical abscesses in patients with primary Sjögren syndrome were compared to the prevalence in the total hospital patient population. The odds ratio (OR) for the prevalence of acute periapical abscesses and its association with pSS were calculated with a 95% confidence interval and the statistical difference between the groups was assessed. Results: The odds ratio (OR) for the prevalence of acute apical abscesses and its association with pSS were calculated and analyzed statistically. The prevalence of periapical abscesses in patients with pSS was 1.87% as compared to 0.58% in the general patient population of the hospital. The OR was 3.11 and the difference was statistically significant (p<0.0001). Conclusions: Under the conditions of this study, it appears that the prevalence of acute periapical abscesses is significantly higher in patients with pSS. [ABSTRACT FROM AUTHOR]

Aims: To assess the prevalence of periapical abscesses in patients with systemic lupus erythematosus (SLE), and to evaluate the effect of glucocorticoids (GCs) used to treat SLE, on the prevalence of such lesions. Methods: Integrated data of hospital patients was used. Data from the corresponding diagnosis codes for SLE and periapical abscess was retrieved by searching the appropriate query in the database. The odd ratio (OR) of periapical abscesses and its association with SLE and intake of GCs were calculated and analyzed statistically. Results: The prevalence of periapical abscesses in patients treated with GCs was 1.5% compared to 0.39% in patients who were not treated with GCs. The OR for periapical abscesses in patients treated with GCs was 2.53 compared with OR of 0.66 in patients not treated with GCs. The differences were statistically significant (p <.0001). The prevalence of periapical abscesses in patients with SLE was 1.88%. The OR was 3.18 and the difference statistically significant (p <.0001). Conclusions: Under the conditions of this study, it appears that the prevalence of periapical abscesses is higher in patients with SLE. Patients receiving GCs therapy, either for SLE or for other conditions, may present higher prevalence of periapical abscesses [ABSTRACT FROM AUTHOR]