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Objective: An altered sensation during endodontic treatment can occur due to the extrusion of endodontic materials. This study aims to discuss intentional replantation to address paresthesia resulting from an endodontic file penetrating the inferior alveolar nerve canal and provide a protocol for managing nerve injuries in such incidents. Case presentation: A 12-year-old girl developed paresthesia when an endodontic file separated and was inadvertently pushed through the apical foramen into the inferior alveolar nerve canal during root canal treatment of the mandibular left first molar. A CBCT scan revealed the file penetrating the canal towards the inferior border of the mandible. After considering the treatment options, intentional replantation was deemed suitable. The tooth was atraumatically extracted and preserved in sterile saline. The surgeon then carefully cleaned and irrigated the socket. The radiographic assessment confirmed successful file removal from the socket. The root ends were resected, and retrograde preparation and obturation were conducted using ultrasonic tips and mineral trioxide aggregate. The tooth was then replanted into the socket. Successful replantation was confirmed by tooth stability and an audible click. The patient was prescribed antibiotics and steroids. After completion of the endodontic treatment, a stainless steel crown was cemented. The successful intentional replantation procedure resulted in rapid improvement in the patient's condition. The normal sensation had been restored, indicating nerve recovery. At the 15-month follow-up, periapical bone healing and the eruption of the adjacent second molar were observed, affirming the treatment protocol's overall success. Conclusion: Prompt intervention and immediate intentional replantation facilitated direct inspection of the separated file within the socket. Collaboration between an oral maxillofacial surgeon and an endodontist ensures expedited and targeted treatment, leading to favorable outcomes. [ABSTRACT FROM AUTHOR]

This retrospective study evaluated the clinical outcomes of surgical crown reattachment in the treatment of complicated crown-root fractures in permanent teeth in 35 patients. Treatments were defined as follows: surgical crown reattachment combined with internal fixation with a fiber-reinforced core post, ostectomy, and reattachment of the original crown fragment. Patients were examined to record the periodontal pocket depth (PD), marginal bone loss, tooth migration, and coronal fragment looseness or loss. In most cases, the fracture lines on the palatal aspect were located below the alveolar crest. About 20% to 30% of teeth had periodontal pockets ≥ 3 mm present at least 1 year after surgery. Significant PD differences were observed between the traumatized teeth and adjacent untraumatized teeth at 6 months. The available evidence suggests that surgical crown reattachment is a feasible and effective technique for managing complicated crown-root fractures in permanent teeth. [ABSTRACT FROM AUTHOR]

Successful rehabilitation of the anterior maxilla remains a challenge, primarily due to postextraction ridge collapse, which can lead to gingival recession and a nonesthetic appearance. The socket shield technique presents a viable alternative for immediate dental implant placement in the esthetic zone. This pilot study aimed to evaluate the survival, complication rates, and marginal bone loss around body-shift implants placed in fresh extraction sockets with the socket shield technique to replace maxillary incisors. After socket shield preparation, 14 hopeless incisors were extracted and immediately replaced by a body-shift implant (Inverta, Southern Implants) at baseline. Patients were followed up for 12 to 39 months (mean: 18.1 ± 8.2 months). The average age was 52.3 ± 16.9 years, and the survival rate was 100%. One socket shield presented minimal internal exposure that was successfully treated with a connective tissue graft. The mean PES score was 12.9 ± 1.2. Mean interproximal marginal bone loss was -0.4 ± 0.5 mm. Body-shift implants can be a promising alternative for immediate tooth replacement combined with the socket shield technique. The superior esthetic outcomes remained stable, suggesting that the extra space created by the narrow cervical portion of the implant is beneficial for preserving the alveolar bone and limiting internal shield exposure. [ABSTRACT FROM AUTHOR]

Dental implants are currently the preferred choice to restore function and esthetics. Nonetheless, explantation is sometimes inevitable in cases with advanced bone loss, implant fracture, or improper implant position. This study aimed to propose an algorithm for reimplantation at sites of previous failure. There is limited evidence on the replacement of failed implants, most of which are case reports or clinical trials with a small number of patients. To the best of the authors' knowledge, this is the first study proposing a clinical-decision algorithm to help clinicians manage implant failures with new implants. There are a variety of reasons contributing to implant failure: The etiologic factor of failure and the morphology of the residual defect have paramount importance on implant removal techniques and subsequent treatment modalities. There is no consensus on a distinct protocol to replace failed implants. However, the clinicians and patients should know that placing a new implant in an area with a history of failure, regardless of early or late implant failure, may have a lower survival rate. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusion The prognosis of an avulsed permanent tooth depends on the time elapsed from injury to replantation in the injured socket. Wide variability exists in the terminologies used to describe this period. Hence, the aim of this study was to identify and categorize the terminologies related to this aspect of tooth avulsion, grade the explanations provided by the authors, and develop a consensus about the most appropriate terminology through a Delphi approach.This study involved a scoping review to identify and analyze the terminologies. It was performed according to PRISMA‐ScR with a systematic search performed in PubMed, Scopus, EMBASE, LILACS, and Web of Science. The terminologies were extracted, categorized, and evaluated for correctness. On the basis of the results of the review and expert group discussion, an ideal terminology was proposed. A Delphi study with 20 global experts in dental traumatology was conducted to develop a consensus for the proposed terminology and its description.A total of 92 studies were included. They were distributed into five categories according to the terminology used: (a) dry period alone, (b) total period with dry and/or wet times, (c) extra‐alveolar period, (d) extraoral period, and (e) miscellaneous. The explanations provided were correct in 37.5% of the studies that used an extraoral period. In the Delphi study, the lowest scores were given to the term dry period. There was an agreement of 95% for the proposed terminology.A wide variation in terminologies was observed that could be distributed into five categories. The correctness of explanations was highest in the studies that described total periods with dry and wet times. The Delphi study revealed excellent agreement for the proposed term “total extra‐alveolar period,” with precise and clear recordings of both nonphysiologic (dry) periods and physiologic (wet) periods. [ABSTRACT FROM AUTHOR]

Background/Aims: The preservation of avulsed teeth is critical in dental trauma management, necessitating effective storage media to ensure viable tooth reimplantation. The urgent need for accurate information has led both professional and non‐professional individuals to increasingly seek guidance from video‐sharing platforms such as YouTube™ and TikTok™. These platforms have become key resources for advice on such dental emergencies, but the reliability and accuracy of this information have not yet been systematically evaluated. This study aimed to assess the quality, accuracy, and reliability YouTube™ and TikTok™ of videos regarding storage solutions for avulsion injuries. Material and Methods: A search was conducted on YouTube™ and TikTok™ on February 4th, 2023, using terms related to traumatic dental injuries, and 53 videos were included. Video demographics such as platform, duration, type, upload date, likes, and comments were recorded. Video content quality, reliability, and accuracy were measured using the Global Quality Scale (GQS), Journal of the American Medical Association (JAMA) benchmarks, and Video Information and Quality Index (VIQI). Research data were analyzed using SPSS IBM 24.0 at a 95% confidence interval. Result s : In total, 53 videos were examined. The average scores were JAMA: 1.70/4.00, modified DISCERN: 54.3/80.00, GQS: 3.88/5.00, and VIQI: 13.8/20.00. According to the modified DISCERN index, there were no "very poor" or "poor" quality videos, 49.05% were "moderate," 22.6% were "good," and 28.3% were "very good." No difference was found between YouTube™ and TikTok™ videos in terms of the modified DISCERN index, JAMA scores, GQS, and VIQI scoring (p >.05). Conclusions: Traumatic dental injuries are a common problem among children, and evaluating the reliability of available contents is becoming crucial for appropriate intervention. The study reveals that despite being sourced mainly from dental professionals, the overall quality of videos on avulsed tooth management was mediocre, underscoring the risks associated with misleading or incomplete information in such critical situations. [ABSTRACT FROM AUTHOR]

The article discusses the immediate treatment of tooth avulsion, the follow-up interval for patients and the reduction of infection risk by citing studies that described an approach to dental trauma from the years 2013 to 2023. Cited are tooth anatomy during a tooth avulsion, the primary and secondary traumas included in the initial assessment of a patient with dental trauma, and contraindications to tooth reimplantation in an avulsed primary tooth.

Introduction: The success of any prosthetic rehabilitation depends on acceptable occlusion and muscle coordination. Occlusal therapy should be an integral part of restorative and prosthetic treatment. A thorough diagnosis of bite force and muscle activity is required to ensure the patient's masticatory function and comfort. The current system of digitisation lacks devices for the simultaneous evaluation of muscle activity and occlusal bite force, representing a significant limitation in understanding and managing restorative and rehabilitation therapy. Aim: To assess the efficacy of an ingeniously designed integrated device that records occlusal bite force and muscle activity. Materials and Methods: An observational study was conducted among 112 healthy volunteers in the Department of Prosthodontics at Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India, for a period of one month and 45 days, from February 5, 2024 to March 20, 2024. The study aimed to validate the efficacy of a device designed to record bite force and muscle action potential simultaneously. The device consists of two key components: a square Forcesensitive Resistor (FSR) that records changes in resistance in response to applied force and a MyoWare 2.0 muscle sensor with Arduino (Advancer Technologies) for measuring the electrical activity of muscles. Study participants, aged between 21 and 35 years, were seated in an upright position. Muscle activity was recorded with surface electrodes placed on the masseter region, following Surface Electromyography for the Non Invasive Assessment of Muscles (SENIAM) guidelines, while a ground electrode was placed on the neck. Maximum Bite Force (MBF) was measured by placing intraoral pressure sensors, with recordings taken in maximum intercuspation three times, spaced one minute apart for each recording. Both muscle activity and bite force were recorded simultaneously. The Pearson's correlation coefficient was used to evaluate the correlation between bite forces and muscle action potential with standard average values. Results: The results revealed a strong positive correlation between the masseter muscle activity action potential and the bite force values of the right molar (r=0.964, p<0.001), left molar (r=0.980, p<0.001) and incisor (r=0.550, p=0.002). Conclusion: The device synergistically records muscle activation patterns and bite force distribution, displaying the values in an integrated digital interface. The results of the study reveal that this device can serve as a diagnostic tool in prosthodontic treatment planning. [ABSTRACT FROM AUTHOR]

Dental avulsion is a traumatic dental injury with complete displacement of the tooth outside the bony socket. Both primary and permanent teeth are predisposed to such traumatic incidents. The most effective treatment in such cases is tooth replantation. Additionally, a short‐term flexible splint is needed to stabilize the avulsed/replanted tooth. This case report describes orthodontic braces as a standardized flexible splint option for the treatment of tooth avulsion. Herein, the case of a 9‐year‐old female patient who presented to a private dental clinic with an avulsed upper left central incisor, 1 h after the accident has occurred. Once the tooth was replanted with all the necessary precautions, orthodontic braces and wire were utilized to stabilize the tooth. Most dental splints are custom‐made, requiring thorough professional knowledge and expertise for their fabrication and placement. The protocol described in this report is aimed at easing tooth stabilization using materials within the scope of a basic dental setup consultation room. [ABSTRACT FROM AUTHOR]

Objective: To evaluate tooth displacement and periodontal stress generated by the dual action vertical intra-arch technique (DAVIT) for open-bite correction using three-dimensional finite element analysis. Methods: A three-dimensional model of the maxilla was created by modeling the cortical bone, cancellous bone, periodontal ligament, and teeth from the second molar to the central incisor of a hemiarch. All orthodontic devices were designed using specific software to reproduce their morpho-dimensional characteristics, and their physical properties were determined using Young's modulus and Poisson's coefficient of each material. A linear static simulation was performed to analyze the tooth displacements (mm) and maximum stresses (Mpa) induced in the periodontal ligament by the posterior intrusion and anterior extrusion forces generated by the DAVIT. Results: The first and second molars showed the greatest intrusion, whereas the canines and lateral incisors showed the greatest extrusion displacement. A neutral zone of displacement corresponding to the fulcrum of occlusal plane rotation was observed in the premolar region. Buccal tipping of the molars and lingual tipping of the anterior teeth occurred with intrusion and extrusion, respectively. Posterior intrusion generated compressive stress at the apex of the buccal roots and furcation of the molars, while anterior extrusion generated tensile stress at the apex and apical third of the palatal root surface of the incisors and canines. Conclusions: DAVIT mechanics produced a set of beneficial effects for open-bite correction, including molar intrusion, extrusion and palatal tipping of the anterior teeth, and occlusal plane rotation with posterior teeth uprighting. [ABSTRACT FROM AUTHOR]

Synthetic oligodeoxynucleotides (ODNs) containing unmethylated cytosine–phosphate–guanine (CpG) motifs (CpG-ODNs) are ligand molecules for Toll-like receptor 9 (TLR9), which is expressed by odontoblasts in vitro and dental pulp cells. This study determined the effects of CpG-ODNs on pulpal immunomodulatory response and repair following injury. Briefly, the upper right first molars of three-week-old mice were extracted, immersed in Type A (D35) or B (K3) CpG-ODN solutions (0.1 or 0.8 mM) for 30 min, and then replanted. Pulpal healing and immunomodulatory activity were assessed by hematoxylin–eosin and AZAN staining, as well as immunohistochemistry. One week following the operation, inflammatory reactions occurred in all of the experimental groups; however, re-revascularization and newly formed hard tissue deposition were observed in the pulp chamber of all groups at week 2. A positive trend in the expression of immune cell markers was observed toward the CpG-ODN groups at 0.1 mM. Our data suggest that synthetic CpG-ODN solutions at low concentrations may evoke a long-lasting macrophage–TLR9-mediated pro-inflammatory, rather than anti-inflammatory, response in the dental pulp to modulate the repair process and hard tissue formation. Further studies are needed to determine the effects of current immunomodulatory agents in vitro and in vivo and develop treatment strategies for dental tissue regeneration. [ABSTRACT FROM AUTHOR]

Chronic post-surgical pain (CPSP) significantly impacts patients' recovery and quality of life. Although environmental risk factors are well-established, genetic risk remains less understood. A meta-analysis of genome-wide association studies followed by partitioned heritability was performed on 1350 individuals across five surgery types: hysterectomy, mastectomy, abdominal, hernia, and knee. In subsequent animal studies, withdrawal thresholds to evoked mechanical stimulation were measured in Rag1 null mutant and wild-type mice after plantar incision and laparotomy. Cell sorting by flow cytometry tracked recruitment of immune cell types. We discovered 77 genome-wide significant single-nucleotide polymorphism (SNP) hits, distributed among 24 loci and 244 genes. Meta-analysis of all cohorts estimated a SNP-based narrow-sense heritability for CPSP at ∼39%, indicating a substantial genetic contribution. Partitioned heritability analysis across a wide variety of tissues revealed enrichment of heritability in immune system-related genes, particularly those associated with B and T cells. Rag1 null mutant mice lacking both T and B cells exhibited exacerbated and prolonged allodynia up to 42 days after surgery, which was rescued by B-cell transfer. Recruitment patterns of B cells but not T cells differed significantly during the first 7 days after injury in the footpad, lymph nodes, and dorsal root ganglia. These findings suggest a key protective role for the adaptive immune system in the development of chronic post-surgical pain. [ABSTRACT FROM AUTHOR]

This research focused on analyzing gene expression changes in the periodontal ligament (PDL) after tooth re-plantation to identify key genes and pathways involved in healing and regeneration. Utilizing a mouse model, mRNA was extracted from the PDL at various intervals post-replantation for RNA sequencing analysis, spanning from 3 to 56 days. The results revealed significant shifts in gene expression, particularly notable on day 28, supported by hierarchical clustering and principal component analysis. Gene ontology (GO) enrichment analysis highlighted an upregulation in olfactory receptor and G protein-coupled receptor signaling pathways at this time point. These findings were validated through reverse transcription-quantitative PCR (RT-qPCR), with immunochemical staining localizing olfactory receptor gene expression to the PDL and surrounding tissues. Moreover, a scratch assay indicated that olfactory receptor genes might facilitate wound healing in human PDL fibroblasts. These results underscore the importance of the 28-day post-transplant phase as a potential "tipping point" in PDL healing and regeneration. In conclusion, this research sheds light on the potential role of olfactory receptor genes in PDL regeneration, providing a foundation for developing new therapeutic approaches in tooth replantation and transplantation, with broader implications for regenerative medicine in oral health. [ABSTRACT FROM AUTHOR]

Background: Intentional replantation (IR) is an emerging and cost-effective last-resort treatment for persistent apical periodontitis. Adjunctive phototherapy for IR aims to improve the management of challenging cases by enhancing disinfection, stimulating healing and promoting regeneration. Objective: We report a novel phototherapy-assisted IR protocol conducted on a compromised lateral incisor with an extensive periapical infection (Ø > 10 mm) in a 68-year-old diabetic male. Methods: The IR protocol involved pre- and postoperative photobiomodulation (660 nm, 0.2 J/cm², 60 sec/site), antimicrobial photodynamic therapy of the root surface (660 nm, 0.6 J/cm2, 30 sec, methylene blue photosensitizer), and Er:YAG root and socket debridement (2940 nm, 21 J/cm², 30 sec). The total time from extraction to replantation was 14 min 35 sec. Results: The tooth at 3.5-year follow-up remained clinically functional with radiographic resolution of the infection indicating a successful reimplantation. Conclusions: This case report demonstrated that an adjunctive phototherapy IR protocol can effectively treat a compromised tooth with extensive periapical infection. [ABSTRACT FROM AUTHOR]

The evaluation of pulp status is crucial for avulsed immature permanent teeth after replantation. In addition to commonly used clinical and radiographic examinations providing clinical evidence, the oxygen saturation test may offer valuable assistance. The aim of this study was to analyze the efficacy of a pulse oximeter in evaluating pulp status in avulsed and replanted immature permanent teeth. A prospective observational study was performed including 51 avulsed and replanted immature permanent teeth. Routine clinical and radiographic examinations were performed and used as the basis for the diagnosis of pulp status during the 1-year follow-up period. Meanwhile, the oxygen saturation values of these teeth were recorded using a modified pulse oximeter at each visit. Seven teeth completed pulp revascularization (success group), whereas 44 teeth failed to revascularize (failure group). Abnormal clinical and/or radiographic manifestations in the failure group were observed at an average period of 42.7 days, which was too late because a high incidence of inflammatory root resorption (43.18%) had occurred. For oxygen saturation tests, teeth in the success group showed an immediate postreplantation oxygen value of 70.71 ± 3.35, then an upward trend starting from the 2-week postreplantation visit, and a significantly increased final value of 81.86 ± 2.34 at the 1-year visit. In contrast, no increase trend was found for teeth in the failure group because abnormal clinical and/or radiographic manifestations emerged. The oxygen saturation test is a reliable diagnostic method to evaluate pulp status of avulsed teeth as early as 2 weeks after replantation. [ABSTRACT FROM AUTHOR]

Intentional replantation (IR) is considered as a viable treatment option to preserve the teeth with apical periodontitis. This study aimed to compare the treatment outcomes of IR in teeth with or without periodontal involvement, and to investigate the influence of related factors. A total of 157 teeth with a documented history of IR between September 2012 and November 2022 and a follow-up duration of more than 1 year were included. The samples included 100 teeth with simple apical periodontitis and 57 teeth with combined periodontal-endodontic lesions (CPEL). Clinical and radiographic criteria were used to evaluate treatment outcomes including functional retention and extraction. Chi-square analyses and Fisher's exact tests were used to compare bivariate associations between outcomes and clinical or demographic variables. Kaplan–Meier analyses were used to evaluate the cumulative survival rate of the intentionally replanted teeth. The overall cumulative survival rates were 93.0% at 1 year, 76.7% at 5 years, and 56.2% at 10 years. Among the 100 teeth with simple apical periodontitis, the survival rates were 93.0%, 86.7%, and 78.8% at the same time points. In contrast, 57 teeth with CPEL exhibited survival rates of 93.0%, 65.0%, and 36.9%, respectively. The primary postoperative complications that led to extraction were periodontal involvement (51.9%), tooth fracture (18.5%), external root resorption (18.5%), and persistent apical periodontitis (11.1%). The outcomes of teeth with CPEL were significantly affected by the presence of a sinus tract and crown restoration. In contrast, no significant prognostic factors were identified for teeth without periodontal involvement. The long-term prognosis of teeth with CPEL is significantly worse than those with simple apical periodontitis. The main reason of extraction was periodontal involvement. Regular periodontal maintenance and appropriate crown restoration may help to improve the prognosis for teeth with CPEL. [ABSTRACT FROM AUTHOR]

Background: Tooth avulsion represents the most severe form of dental trauma, necessitating tooth replantation as the primary treatment. However, the risk of replacement root resorption (RRR) poses a significant threat to tooth retention following replantation. This study preliminarily aimed to investigate the effect of physiological occlusal force on RRR after the replantation of avulsed teeth and to explore the potential underlying mechanisms. Methods: Thirty-six 4-week-old male Sprague-Dawley rats underwent extraction and immediate replantation of their left maxillary molars. The rats were randomly divided into two major groups: the occluded (n = 18) group, where the opposite mandibular teeth were preserved; non-occluded (n = 18) group, where the opposite mandibular teeth were extracted. Within each major group, there were three subgroups corresponding to 7 days, 14 days, and 2 months, resulting in a total of six subgroups, (n = 6 per subgroup). The right maxillary first molars served as the normal control. Various periodontal characteristics were assessed using haematoxylin-eosin (H&E), tartrate-resistant acid phosphatase (TRAP) staining, and micro-computed tomography (micro-CT). Results: Histological staining revealed that under occlusal force, the early stage (day 7) after tooth replantation mainly manifested as root surface resorption, especially in the non-occluded group, which gradually diminished over time. Cementum and periodontal ligament (PDL) repair was observed on day 14. Micro-CT analysis indicated a significant decrease in PDL width in the non-occluded group two months after replantation, consistent with the histological findings, signifying severe RRR in the non-occluded group. Conclusions: This study provides preliminary evidence that physiological occlusal force may attenuate osteoclastogenesis during the early stage of tooth replantation, thereby reducing the occurrence of RRR and promoting periodontal healing. [ABSTRACT FROM AUTHOR]

Aim of the Study: This study aims to assess the effect of apical foraminal enlargement on inflammatory markers and pain in patients with asymptomatic single-rooted mandibular teeth with apical periodontitis. Materials and Methods: The study included 60 patients based on inclusion and exclusion criteria. Before beginning root canal treatment (RCT), a blood sample was obtained from the antecubital fossa to evaluate the inflammatory markers, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Access opening was done and initial irrigation was done. Working length (WL) was determined with an electronic apex locator and verified with a radiograph. In the control group, the determined WL was maintained, while in the experimental group, the WL was set till the apical foramen. Biomechanical preparation was done in both groups till F2 or F3 based on the initial apical file, followed by final irrigation and obturation based on the master apical file size. Patients were given a Visual Analog Scale to record pain sensations at 24, 48, and 72 h postoperative. After 72 h, patients were recalled for follow-up appointments, and blood was taken from the antecubital fossa again to evaluate inflammatory markers. Statistical Analysis: The resultant findings for the reduction in inflammatory markers before and after RCT with or without foraminal enlargement were statistically analyzed using the Student's t-test. The pain was statistically examined with one-way "analysis of variance" and Tukey's post hoc test for inter-group comparison of pain. The level of significance was set at P < 0.05. The statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 23 for Windows (SPSS Inc., Chicago, IL, USA). As pain in the control groups is zero before and after RCT, statistical analysis is not required as the overall pain score is zero. Results: The P values of the CRP and ESR of the control group were 0.02 and 0.03, respectively, which indicates it is significant whereas the P values of the ESR and CRP of the experimental group were 0.0002 and 0.0008 which indicates it is highly significant. Results indicate that the experimental group is more effective compared to the control group in reducing inflammatory markers. Pain in the control group after RCT was zero at the end of 24, 48, and 72 h. In the experimental group, where RCT was done with apical foraminal enlargement, mild pain was present at the end of 24 h which gradually decreased at the end of 48 h and no pain was reported at the end of 72 h. Conclusion: Reduction in inflammatory markers was more effective in RCT with apical enlargement than without apical enlargement. RCT with apical enlargement caused mild pain in the patients immediately after treatment which gradually decreased over time. [ABSTRACT FROM AUTHOR]

The viscoelasticity of mechanically sensitive tissues such as periodontal ligaments (PDLs) is key in maintaining mechanical homeostasis. Unfortunately, PDLs easily lose viscoelasticity (e.g., stress relaxation) during periodontitis or dental trauma, which disrupt cell–extracellular matrix (ECM) interactions and accelerates tissue damage. Here, Pluronic F127 diacrylate (F127DA) hydrogels with PDL‐matched stress relaxation rates and high elastic moduli are developed. The hydrogel viscoelasticity is modulated without chemical cross‐linking by controlling precursor concentrations. Under cytomechanical loading, F127DA hydrogels with fast relaxation rates significantly improved the fibrogenic differentiation potential of PDL stem cells (PDLSCs), while cells cultured on F127DA hydrogels with various stress relaxation rates exhibited similar fibrogenic differentiation potentials with limited cell spreading and traction forces under static conditions. Mechanically, faster‐relaxing F127DA hydrogels leveraged cytomechanical loading to activate PDLSC mechanotransduction by upregulating integrin–focal adhesion kinase pathway and thus cytoskeletal rearrangement, reinforcing cell–ECM interactions. In vivo experiments confirm that faster‐relaxing F127DA hydrogels significantly promoted PDL repair and reduced abnormal healing (e.g., root resorption and ankyloses) in delayed replantation of avulsed teeth. This study firstly investigated how matrix nonlinear viscoelasticity influences the fibrogenesis of PDLSCs under mechanical stimuli, and it reveals the underlying mechanobiology, which suggests novel strategies for PDL regeneration. [ABSTRACT FROM AUTHOR]

The article examines the effect of photobiomodulation (PBM) therapy on root resorption in orthodontic treatment with clear aligners, utilizing cone-beam computed tomography (CBCT) to analyze changes in tooth root volume. It discusses the comparison between PBM and control groups regarding orthodontically induced external root resorption, emphasizes the need for cautious interpretation due to study limitations such as sample size and measurement errors in root segmentation.

This document, titled "Dental Traumatology research and education—Foundations for a better tomorrow," provides a collection of research articles on various topics related to dental trauma. The articles cover subjects such as the treatment and storage of avulsed permanent teeth, oral injuries in basketball, dental trauma education, educational materials for lay individuals, knowledge of dental trauma among laypeople, maxillofacial trauma epidemiology, tooth autotransplantation, and the impact of the International Association of Dental Traumatology (IADT) guidelines. The articles aim to provide valuable information for dental professionals, educators, and individuals seeking knowledge on dental trauma. [Extracted from the article]

Background/Aim: Frondoside A is a sea cucumber extract which is well known for its anti‐inflammatory and immunomodulatory properties. The purpose of this study was to evaluate the effect of Frondoside A application in the alveolar socket on inflammatory responses after delayed replantation in rat teeth. Materials and Methods: Human periodontal ligament cells were cultured and exposed to Frondoside A. Cell‐counting kit‐8 assay was performed to evaluate the cell viability and nitric oxide assay was performed to assess the anti‐inflammatory effect of Frondoside A. Molars were extracted from 32 Sprague–Dawley rats and randomly divided into control and Frondoside A groups. After 30 min of extra‐oral dry time, molars were replanted. In the Frondoside A group, Frondoside A solution was applied in the alveolar socket before replantation. The animals were sacrificed after 28 days and histologically and immunohistochemically evaluated. Results: 0.5 μM Frondoside A showed higher cellular viability at 6 h and lower production of nitric oxide compared with other Frondoside A solutions (p <.05). The Frondoside A group demonstrated lower inflammatory resorption scores in both middle 1/3 and apical 1/3 of root compared to the control group (p <.05). The Frondoside A group showed lower levels of expression in both cathepsin K and CD45 compared with the control group (p <.05). Conclusions: Within the limits of this study, intra‐alveolar delivery of Frondoside A alleviates inflammatory root resorption in delayed replantation of rat teeth. [ABSTRACT FROM AUTHOR]

Periodontal ligament stem cells (PDLSCs) have the potential for regenerating periodontal tissue. The study aims to investigate the impact of demographics (ages, gender, disease) and culture techniques (shipping storage time and culture method) on the success of primary culture. PDLSCs were collected from 51 teeth of 26 patients and cultured via outgrowth (OG) and enzymatic digestion (ED) methods. Cells characteristics were confirmed by flow cytometry, MTT, and ARS. The primary culture success rate was evaluated with a serial chi-square test to determine the relationship with culture technique (ED/OG and ≤4 h/prolonged culture) and patient demographics (Young/Old, Female/Male, and Health/Periodontitis). The overall success rate of Health group (69.7%) was higher than Periodontitis (38.9%). Culturing within 4 h possessed a higher success rate (71.8%) than prolonged group (16.7%) regardless of patient demographics, and using OG method (81.5%) revealed more promising. Subgroup analysis of 39 cases (culture within 4 h) found that the success rate of OG was higher than ED in the Old group (87.5%–25.0%) and in the Periodontitis group (83.3%–25.0%). Primary culturing of PDLSCs within 4 h and using the outgrowth method led to higher success rates regardless of patient demographics. It can achieve successful PDLSCs culture of older patients or patients with periodontal disease by appropriate culture technique. [ABSTRACT FROM AUTHOR]

Background/Aim: Tooth avulsion and delayed replantation may cause inflammatory responses and root resorption of the tooth. The aim of this study is to investigate the effect of a doxycycline-loaded nitric oxide-releasing nanomatrix (DN) gel on the delayed replantation of avulsed rat teeth, with a focus on assessing the gel's potential to promote regeneration and inhibit complications associated with the replantation process. Materials and Methods: Twenty-four right maxillary first molars from male Sprague-Dawley rats were atraumatically extracted using sterile extraction forceps. The molars were dried for 1 h at room temperature (approximately 23 °C) and divided into four groups according to the root conditioning methods after extra-alveolar 60-min drying: Group 1, no root conditioning treatment prior to replantation; Group 2, soaking in 2% NaF solution for 5 min before replantation; Group 3, 5-min soaking in NO gel and injection of the gel into the alveolar socket; Group 4, 5-min soaking in DN gel and injection of the gel into the alveolar socket before replantation. The animals were euthanized four weeks after the operation and the specimens were evaluated histologically. Results: The use of NO gel alone showed better anti-inflammatory and periodontal effects than the control group, but it did not show a significant effect compared to the group using NaF. When using NO gel loaded with doxycycline, it showed a significant anti-inflammatory effect compared to the control group and showed a similar inhibitory effect to the group using NaF. Conclusions: Within the limits of this study, in delayed replantation situations, the control of inflammatory resorption and replacement resorption is an important factor for achieving a better prognosis of replanted teeth. Root surface treatment with DN gel decreased root resorption after delayed replantation. [ABSTRACT FROM AUTHOR]

An apicoectomy involves surgical intervention to treat a tooth afflicted with a periapical lesion that remains unresolved despite standard endodontic procedures. The primary objective of apical surgery is to prevent the spread of bacteria and their associated by-products from the root canal system into the surrounding periradicular tissues. This research endeavours to underscore the potential efficacy of endodontic surgical intervention in cases where nonsurgical treatment of the right maxillary anterior teeth is ineffective. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical effect of implant-assisted dental intentional replantation (IR) for the treatment of “drifted” anterior periodontally hopeless teeth (PHT). Methods: The present authors recruited 22 patients with stage III/IV periodontitis who suffered drifting of the maxillary anterior teeth, with a total of 25 teeth. The PHT were extracted for in vitro root canal treatment (RCT). The root surface was smoothed and the shape was trimmed, and the alveolar socket was scratched. The dental implant system was used to prepare the alveolar socket according to the direction, depth and shape of the tooth implantation. The PHT were reimplanted into the prepared alveolar socket. The periodontal indicators were analysed statistically before and after surgery. Result: Twenty-two patients who completed the full course of treatment, with a total of 25 PHT, had a successful retention rate of 88%. Mean periodontal probing depth (PPD) decreased by 2.880 ± 0.556 mm and 3.390 ± 0.634 mm at 6 months and 1 year, respectively, and clinical attachment loss (CAL) decreased by 2.600 ± 0.622 mm and 2.959 ± 0.731 mm at the same time points, respectively, showing significant improvement (P < 0.05). Conclusion: Dental implant system–assisted IR can effectively preserve “drifted” natural PHT in patients with stage III/IV periodontitis. [ABSTRACT FROM AUTHOR]

This report presents the therapeutic approach and results of a case of impacted undeveloped double teeth using 3D simulation in a school-age child. A 10-year-old girl was referred to hospital for the evaluation and treatment of fully impacted premolar double teeth in the left maxillary area. After evaluation, the double teeth were surgically removed, hemisected, and replanted after modification. For accurate surgery, replicas were made of the double teeth using CBCT and a 3D printer, and several mock surgeries were performed. Although remarkable signs for clinical and radiologic pathology were not found at the 5-month follow-up, short root with infraocclusion was found at the 30-month follow-up. This treatment widened the treatment spectrum with modern diagnostic approaches and preparation in large double teeth in children. [ABSTRACT FROM AUTHOR]

Traumatic dental injuries (TDIs) are frequently associated with an injury pattern that requires accurate diagnosis for developing the appropriate treatment plan. When children with special healthcare needs, i.e., Hemophilia experience TDIs, managing the situation becomes a challenging task for pediatric dentists due to the requirement of a multidisciplinary approach in their care. This case report highlights the successful management of extrusive luxation injury of a young permanent tooth with an open apex in an eight-year-old male child with severe Hemophilia A. After a follow-up of nine years, the pulp showed significant healing with physiological closure of the apical foramen. The study further emphasizes that timely management of such injuries can lead to improved tooth prognosis.

Traumatic dental injuries (TDIs) are frequently associated with an injury pattern that requires accurate diagnosis for developing the appropriate treatment plan. When children with special healthcare needs, i.e., Hemophilia experience TDIs, managing the situation becomes a challenging task for pediatric dentists due to the requirement of a multidisciplinary approach in their care. This case report highlights the successful management of extrusive luxation injury of a young permanent tooth with an open apex in an eight-year-old male child with severe Hemophilia A. After a follow-up of nine years, the pulp showed significant healing with physiological closure of the apical foramen. The study further emphasizes that timely management of such injuries can lead to improved tooth prognosis. [ABSTRACT FROM AUTHOR]

Background: The hypothyroid phenotype associated with resistance to thyroid hormone alpha (RTH‐α) is associated with a diverse clinical picture. On the other hand, thyroid‐stimulating hormone (TSH) levels are normal. Free triiodothyronine (fT3) and free thyroxine (fT4) levels can also be normal; however, normo‐ or macrocytic anaemia is usually present in reported cases. Diagnosis is challenging and there is limited data regarding screening methods. Objective: The study aimed to assess the efficiency of a screening strategy for RTH‐α. Subjects and Methods: Out of a total of 6540 children evaluated at the outpatient clinics of paediatric neurology over 2 years and who underwent complete blood count and thyroid function tests, 432 were found to have anaemia. Within this group, we identified 42 children without an underlying specific neurological aetiology who exhibited normo‐ or macrocytic anaemia, normal TSH levels, fT3 levels in the upper half of the normal range or high, and fT4 levels in the lower half of the normal range or low. We excluded one patient who had already been diagnosed with RTH‐α and nine patients could not be reached. Subsequently, clinical evaluation, biochemical assessment, and THRA sequencing analysis were conducted on 32 children. The findings were compared with those of the known RTH‐α patients in our unit. Results: The median age of the patients was 5.7 (5.1–7.4) years, and 22 of them were males (69%). The main reasons for assessment in paediatric neurology clinics were autism spectrum disorder (n = 12, 38%), epilepsy (n = 11, 34%), and delay in developmental stages (n = 8, 25%). Constipation was present in five of the cases (16%), while the closure of the anterior fontanelle and tooth eruption were delayed in two cases (6%) and one case (3%), respectively. The median length/height and weight standard deviation (SD) scores were 0.3 [(−0.8)–(1.1)] and −0.1 [(−0.8)–(0.3)], respectively. The median fT3, fT4, and TSH levels were 4.6 (4.2–5.0) pg/mL, 0.9 (0.8–1.0) ng/dL, and 2.2 (1.8–3.1) uIU/mL, respectively. Thirteen of the patients (41%) had high fT3 levels, while none of them had low fT4 levels. The normo‐ or macrocytic anaemia rate was 47% (normocytic/macrocytic, n = 8/7) at the time of reassessment. Serum creatine kinase (CK) was elevated in five patients (16%; one had anaemia). None of the subjects had a pathological variant in THRA. Known RTH‐α patients had significantly lower median height SD score, higher rates of delayed tooth eruption and closure of the anterior fontanelle, lower haemoglobin levels, and higher mean corpuscular volume (MCV) and CK levels as compared to those found without RTH‐α. Conclusions: This approach found one known patient with RTH‐α but did not reveal any new cases. Notably, normo‐ or macrocytic anaemia did not persist in nearly half of the screened patients. A screening strategy that takes clinical findings and prominent laboratory features suggestive of RTH‐α into account could lower unnecessary genetic analysis of THRA in patients presenting with neurological problems. [ABSTRACT FROM AUTHOR]

Intentional replantation (IR) is the intentional extraction of a tooth followed by its replacement back into its socket fur the purpose of performing a root-end surgery or other necessary repairs. The procedure may be considered a favorable alternative to conventional microsurgery, especially when surgical access is restricted due to specific anatomical challenges. With advancements in magnification, bioceramics, and instrumentation, IR has become a well-established, scientifically supported treatment modality and is cost-effective when compared to single-implant placement. This article discusses the rationale and indications fur IR, describes treatment protocols, and reports on its outcomes. [ABSTRACT FROM AUTHOR]

The article focuses on determining the correlation between orthodontically induced root resorption (OIRR) and periodontal ligament (PDL) compression in rats. Topics include assessing PDL compression and OIRR in response to orthodontic force application, investigating the correlation between the extent of PDL compression and OIRR induction at different stages, and comparing the effects of bodily versus tipping tooth movement on OIRR and PDL compression.

Background: Double teeth are dental anomalies that can lead to aesthetic and orthodontic problems. Case presentation: This report discusses two cases involving the multidisciplinary management of permanent maxillary left lateral incisors fused with a supernumerary tooth in two girls aged 9 and 10. Following intraoral and radiographic examinations, one was diagnosed with fusion, and the other was diagnosed with concrescence. The crown of the fused incisor was separated using a burs and extracted intraorally. The concrescent incisor was separated along its length using a laser and intentionally replanted extraorally. After a 6-year follow-up, no pathological signs were observed in the fused incisor. However, after an 11-year follow-up, external resorption was observed in the concrescent incisor. Conclusions: Both incisors remained asymptomatic throughout the observation period. This case report highlights two different and effective methods employed to preserve the natural function, form, and aesthetics of double incisors. [ABSTRACT FROM AUTHOR]

Background/Aim: There is no thorough overview of intentional tooth replantation techniques. We performed a bibliometric analysis of the development of intentional tooth replantation. Materials and Methods: A comprehensive search of the Web of Science and SCOPUS databases was conducted in February 2023. Original articles and reviews of human studies with "intentional replantation" or synonyms in the titles, abstracts, or keywords were included. A descriptive analysis of bibliographic data, co‐occurrence analysis, and coupling of publications was performed. Multivariate analysis was used to explore the bibliometric parameters associated with the citation counts. Results: The study included 171 papers, which were co‐authored by 500 individuals affiliated with 217 institutions from 28 countries/regions. The USA contributed the greatest number of publications, followed by China, and Japan. The USA had 694 citations, followed by Japan (210), and Turkey (210). The Journal of Endodontics and Dental Traumatology contributed the most citations. Five directions for future research were identified based on the coupling relationships of publications, including "managing vertical root fractures with adhesive resin using the intentional replantation technique," "intentional replantation for periodontally hopeless or endodontically compromised teeth," "intentional replantation for treating abnormalities of morphological development," "outcomes and prognosis factors of intentional replantation," and "treating root replacement resorption by intentional replantation." Multivariate analysis showed that the publication year, Journal Citation Reports ranking of journals, study design, and disease type were predictors of citation counts. Conclusions: This bibliometric analysis provides a comprehensive description of the intentional replantation technique. The USA published the greatest volume of papers and generated the most citations. The Journal of Endodontics and Dental Traumatology are considered the most influential. The Journal Citation Reports journal ranking (Q1, Q2), study design (case reports, cohort studies), and disease type (crown root fractures) were associated with the citation counts. [ABSTRACT FROM AUTHOR]

The article provides an overview of autotransplantation, a procedure that involves moving a tooth from one position in the mouth to another within the same person. It can be used to replace missing or compromised teeth. The success rate of autotransplanted teeth is about 80%, with the highest success rates seen in certain tooth movements. The article emphasizes the importance of a team approach, involving different dental professionals, in planning and carrying out autotransplantation procedures. Autotransplantation can be a viable option for patients with missing teeth, but careful planning and monitoring are crucial for successful outcomes. [Extracted from the article]

This systematic review evaluated preclinical studies to assess whether PBM has a more favorable histological response than other treatments used before delayed replantation of avulsed teeth. This review followed the PRISMA checklist and was registered in PROSPERO. MEDLINE (PubMed), Embase, Scopus and Web of Science were searched from their inception to July 14, 2022. Data were independently extracted by two reviewers. Data were collected about species, number of animals, number and type of teeth, groups evaluated, extra-alveolar time, parameters for PBM and other study groups, presence and characteristics of containment, observation time points, evaluation methods, characteristics evaluated, and significant results. The ARRIVE and SYRCLE tools were used to assess the methodological quality and risk of bias (RoB) of the studies. After screening, six studies were included in the review synthesis. Three of the four studies that evaluated root resorption as an outcome found that PBM decreases its occurrence after delayed tooth replantation. A meta-analysis was not conducted because some data were missing in the included studies. Half of the studies evaluating ankylosis found an increase in its occurrence after PBM. Two studies evaluated inflammatory responses and found a reduction of inflammation after PBM. In general, studies had high methodological heterogeneity, intermediate reporting quality and high RoB. Despite the methodological quality and RoB limitations of the studies, the histological responses after delayed tooth replantation were more favourable in the PBM groups. Preclinical studies supported by guidelines should define laser parameters for future clinical studies. [ABSTRACT FROM AUTHOR]

Background/Aim: The ideal treatment of tooth avulsion is replantation. However, replanting teeth may lead to root resorption. Fibroblast growth factor-2 (FGF-2) is a cytokine that plays an important role in wound repair and tissue regeneration. Recently, FGF-2 has been studied a potential regenerative agent to prevent root resorption and ankylosis. The aim of this review is to analyze and summarize the currently available literature focusing on using FGF-2 based regenerative modalities to improve the outcomes of tooth replantation. Materials and Methods: An electronic search was conducted via PubMed/Medline, Google Scholar and ISI Web of Knowledge, using the Medical Subject Headings (MeSH) terms “Basic fibroblast growth factor,” “Fibroblast growth factor-2,” “tooth replantation,” and “replantation” for studies published between January 2001 and June 2021. Data was extracted and quality assessment was carried using the ARRIVE guidelines. Results: Nine animal studies were included in this review. In six studies, FGF-2 had a favorable effect on the tissue regeneration around roots of replanted teeth when compared to other treatment groups. However, quality assessment of the studies revealed many sources of bias and deficiencies in the studies. Conclusions: Within the limitations of this study, it may be concluded that FGF-2 may improve the outcomes of delayed replantation of avulsed teeth. However, more long-term animal studies, with improved experimental designs, and clinical trials are required to determine the clinical potential of the growth factor in improving the outcomes of delayed tooth replantation. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the knowledge of Physical Education students about tooth avulsion (TA) in both dentitions before and after receiving an informative leaflet (IL). Material and Methods: The questionnaire contained information about TA in dentition and its management and was applied to the Physical Education students before and after reading an IL. Results: A total of 118 students, 96.61%, attended a first aid course, and 17.80% received information about TA. Most students (88.98%) never had an experience with TA, and 90.68% considered its management important. The other questions, before and after reading the IL, respectively, were: would not perform deciduous tooth replantation (42%; 88%); knew how to handle the avulsed permanent tooth (APT) (38%; 92%); knew how to clean the APT (50%; 99%); knew that permanent tooth replantation (PTR) must be immediate (15%; 95%); knew the ideal time to seek for the dentist right after TA without performing PTR (6%; 83%); knew how to store APT (31%; 97%). Conclusion: The knowledge of Physical Education students in this research revealed a limited understanding of dental tooth avulsion. After receiving an informative leaflet, the students showed a significant improvement in knowledge about traumatic avulsion management, including tooth replantation and proper actions. [ABSTRACT FROM AUTHOR]

External cervical resorption (ECR) is an aggressive form of root resorption, which etiology is unclear and its prognosis remains unpredictable. The purpose of this study was to investigate the prognosis and potential prognostic factors of ECR-affected teeth after surgical intervention for external repair with/without root canal treatment. Treated ECR cases from 2009 to 2019 were collected retrospectively. The survival of the teeth and the status of root resorption were assessed during the follow-up period. Potential prognostic factors were analyzed with log-rank test and Kaplan–Meier statistics. A total of 42 treated ECR-affected teeth were enrolled. The two-year survival rate was 71.20% [54.16%, 93.59%]. Persistent root resorption was the main complication after treatment. Patients with multiple ECR-affected teeth had greater recurrent potential than patients with solitary ECR-affected teeth. Prolonged calcium hydroxide dressing may contribute to a more favorable clinical outcome. Gender, age, tooth position and the need for root canal treatment did not show statistically significant effect on the prognosis. The current surgical method was able to arrest ECR in most cases. However, the case type (the number of ECR-affected teeth per patient) could highly affect the prognosis of the teeth. Clinicians should consider long-term calcium hydroxide dressing in case of pulp involvement to achieve better results. [ABSTRACT FROM AUTHOR]

To investigate the effect of ELVAX polymer subgingival implants incorporated with echistatin peptide on incisor reimplanted tooth in rats. Forty-two male Wistars rats were divided into two groups: echistatin-treated rats (E) and control rats (C). The animals had their right maxillary incisors extracted and treated according to the International Association of Dental Traumatology replantation protocol. The extra-alveolar dry period was 30 and 60 min, and the post-surgical experimental periods were 15, 60, and 90 days. The samples were stained with H&E and analyzed for the presence of an inflammatory response, incidence of resorptions, and dental ankylosis. Results were statistically analyzed (p < 0.05). The presence of inflammatory resorption was significantly higher in group C at 30 and 60 min extra-alveolar time, in the 15-day postoperative period as compared with the E group (p < 0.05). Dental ankylosis was significantly more prevalent in group E in 30 min extra-alveolar time and 15 days postoperative period (p < 0.05). However, in 60 min extra-alveolar time and 60 days postoperative period, dental ankylosis was more prevalent in C group (p < 0.05). The use of ELVAX subgingival implants with echistatin demonstrated therapeutic potential in preventing the experimental resorption process after replantation of maxillary incisors in rats. [ABSTRACT FROM AUTHOR]

Aim: The objective of this review is to conduct a thorough systematic literature search and evaluate the risks and benefits of replanting avulsed primary teeth, which will aid clinicians in proper decision-making. Materials and Methods: In this review, a systematic search of five electronic databases (Web of Science, PubMed-MEDLINE, Scopus, Ovid SP, and Embase) was independently conducted by two reviewers. After following the eligibility criteria, the collated data was uploaded to Zotero and Excel Workbooks. Any disagreement was resolved through adjudication by the third reviewer. For case reports and case series, the Joanna Briggs Institute checklist was used to assess quality. Results: Following the application of the eligibility criteria, 15 papers were deemed eligible for final analysis, and full texts were acquired. Among 26 replanted teeth, adverse effects were seen in 19 primary teeth and 7 permanent successors. The primary teeth that were replanted had the following unfavorable effects: mobility, resorption of the bone, fistula formation, radicular cyst formation, crown discoloration, and pulp necrosis. Similarly, the adverse effects on the permanent successors were impaction, enamel hypoplasia, dilacerations, and infra-occlusion. Conclusions: Following the biological principles, such as the condition of the tooth, the time elapsed since avulsion and age of the child, and replantation of avulsed primary teeth, can be a feasible treatment option. However, the feasibility is case-dependent and cannot be generalized because of the paucity of high-quality research with sufficient sample sizes and long follow-up periods. [ABSTRACT FROM AUTHOR]

Introduction: The intentional perforation of the pulp chamber floor before tooth replantation promotes pulpal healing by facilitating the revascularization of the pulp cavity. This study aimed to elucidate the effects of this method on the dynamics of quiescent dental pulp stem cells (DPSCs). Methods: The right and left maxillary first molars of Crlj:CD1 mice and TetOP-histone 2B (H2B)-green fluorescent protein (GFP) mice were extracted. The left molars were immediately replanted as the control group (CG), whereas the pulp chamber floor of the right molars were perforated before the tooth was replanted as the experimental group (EG). Immunohistochemistry for Nestin and GFP, and quantitative RT-PCR for Nestin, Opn, CD11c, and Oct3/4 mRNA were performed. Results: The rate of Nestin-positive perimeter along the pulp–dentin border in the EG tended to be higher than that of the CG at days 5 and 7 and was significantly increased between days 3 and 7. The rate of GFP-positive cells in the EG was significantly higher than that of the CG at days 5 and/or 7 in the mesial and middle coronal pulp. CD11c mRNA in the EG at day 5 was significantly higher than that of the CG and tended to be higher than that of the CG during the observation period. Oct3/4 mRNA expression in the EG was significantly higher than that of the CG at day 7. Conclusions: The current experimental model demonstrated the promotion of the survival of DPSCs and their differentiation into odontoblast-like cells (OBLCs). Thus, the use of this model is expected to clarify the crosstalk mechanism between immune cells, including macrophages and dendritic cells, and DPSCs with regards to pulpal healing after tooth replantation. It also provides insight into the differentiation process of DPSCs into OBLCs.

الملخص: أهداف البحث: يعرف قلع الأسنان بأنه إزاحة كاملة للأسنان من التجويف السنخي وأفضل علاج هو إعادة زرع السن. يؤثر حليب الأم على صحة الجسم ونموه وتطوره المرتبط بوجود مكونات غذائية دقيقة وكبيرة. صممت الدراسة لتسجيل تأثير اللبأ البشري كوسيط تخزين على نجاح إعادة زرع السن. طريقة البحث: تم إشراك ثلاثين من ذكور الجرذان البالغة في قلع القاطع الأيسر العلوي ووفقا لوسط تخزين الأسنان المقتطعة لإعادة الزرع، تم تقسيم الجرذان إلى 3 مجموعات. مجموعة محلول هانك ومجموعة مياه الصنبور ومجموعة اللبأ. تم إجراء اختبار الجدوى باستخدام 3- (4،5-ثنائي ميثيل ثيازول-2-يل) -2،5-ثنائي فينيل -2 لفحص المواد والتقييم النسيجي، وقدر التحليل النسيجي في فترة 45 يوما بعد الجراحة لتحديد نخر اللب، والتطعيم اللثوي، والنسبة المئوية للمنطقة التي تمت إعادة امتصاصها وربط الرباط اللثوي. النتائج: أظهر وسط اللبأ نسبة مئوية أعلى من صلاحية الخلية متبوعا بمحلول هانك مع قيمة فرق كبيرة. أظهرت النتائج النسيجية للسن المخلوع المعاد زرعه والذي تم غرسه في ماء الصنبور كوسيط تخزين ارتشاف جذر خارجي وداخلي واضح. نخر اللب وتلطخ الرباط اللثوي مع وجود اختلافات كبيرة في القيم مقارنة بمحلول هانك ومجموعات اللبأ. بينما تظهر مجموعة اللبأ رباطا جديدا معاد ربطه جيدا مع اللب الطبيعي ولا يوجد دليل على ارتشاف الجذر. الاستنتاجات: يتم تقليل فقدان الأسنان إلى الحد الأدنى باستخدام اللبأ البشري كوسيط تخزين في إعادة زرع الأسنان المخلوعة بعد فترة ساعة واحدة مقارنة بمحلول هانك والماء. Abstract: Objectives: Tooth avulsion is defined as total tooth displacement from the alveolar socket; the best treatment is replantation of the tooth. Human milk influences body health, growth, and development related to the presence of micro and macro nutrient components. This study assessed the effects of human colostrum as a storage medium on the success of tooth replantation. Methods: The upper left incisor of 30 adult male Wistar rats was extracted, and the rats were divided into three groups according to the storage medium of the extracted tooth for replantation: Hank's balanced salt solution (HBSS), tap water, and colostrum groups. The MTT cell viability assay was conducted, and histological evaluation and histomorphometric analyses were performed on postoperative day 45 for identification of pulp necrosis, periodontal hyalinization, percentage of resorbed area, and the periodontal ligament attachment. Results: The colostrum medium showed a higher percentage of cell viability followed by HBSS with statistical significance. Histological findings of the replanted avulsed tooth that soaked in tap water as storage medium showed obvious external and internal root resorption. Pulp necrosis and periodontal ligament hyalinization and with a significant differences values in comparison to HBSS and colostrum groups (p > 0.05), whereas the colostrum group showed new well-reattached periodontal ligament with normal pulp and no evidence of root resorption. Conclusion: Tooth loss is minimized by using human colostrum as storage medium in replantation of an avulsed tooth after a 1 h period compared to HBSS and water.

Endodontic surgery is a surgical treatment aimed at excising the apical segment of an infected root canal, eliminating necrotic and inflammatory tissue in the periapical area of the tooth. Apicoectomy aimed to eliminate necrotic and inflammatory apical tissue that could not be remedied with traditional endodontic treatment following the extrusion of calcium root canal debris. A 24-year-old female patient expressed a desire to have dental treatment to enhance her teeth visual appeal. After completing root canal preparation, the root canal was sterilised using calcium hydroxide. During the second appointment, there was visible inflammation of the gums near the tip of the tooth. The problem was addressed by apicoectomy procedure. The 1-week assessment demonstrated favourable soft tissue regeneration. The 1-week postoperative evaluation demonstrated satisfactory healing of the soft tissues. Apical resorption and calcium hydroxide extrusion-induced inflammation in teeth can be effectively treated with apicoectomy. An apicoectomy is a surgical operation that involves removing the infected portion of the tooth root and promoting the healing of the inflammatory and necrotic tissue in the area around the root tip to achieve the best possible healing outcome. [ABSTRACT FROM AUTHOR]

Synthetic oligodeoxynucleotides (ODNs) containing unmethylated cytosine–phosphate–guanine (CpG) motifs (CpG-ODNs) are ligand molecules for Toll-like receptor 9 (TLR9), which is expressed by odontoblasts in vitro and dental pulp cells. This study determined the effects of CpG-ODNs on pulpal immunomodulatory response and repair following injury. Briefly, the upper right first molars of three-week-old mice were extracted, immersed in Type A (D35) or B (K3) CpG-ODN solutions (0.1 or 0.8 mM) for 30 min, and then replanted. Pulpal healing and immunomodulatory activity were assessed by hematoxylin–eosin and AZAN staining, as well as immunohistochemistry. One week following the operation, inflammatory reactions occurred in all of the experimental groups; however, re-revascularization and newly formed hard tissue deposition were observed in the pulp chamber of all groups at week 2. A positive trend in the expression of immune cell markers was observed toward the CpG-ODN groups at 0.1 mM. Our data suggest that synthetic CpG-ODN solutions at low concentrations may evoke a long-lasting macrophage–TLR9-mediated pro-inflammatory, rather than anti-inflammatory, response in the dental pulp to modulate the repair process and hard tissue formation. Further studies are needed to determine the effects of current immunomodulatory agents in vitro and in vivo and develop treatment strategies for dental tissue regeneration.

Aim: Limiting the incidence of resorption associated with delayed replantation of avulsed teeth is critical for long‐term tooth survival. In this study, we assessed whether icariin, a natural product with anti‐osteoclastic properties, could reduce root resorption in a rat model of tooth replantation. Methodology: Cytocompatibility of icariin (10, 20, 40 and 80 μM) was evaluated by CCK‐8 proliferation assay in vitro, and an osteoclastogenesis assay was performed to evaluate the effect of icariin on the differentiation of rat bone marrow macrophages and human peripheral blood monocytes into tartrate‐resistant acid phosphatase‐stained (TRAP+) multinucleated giant cells (MNGCs). Differentiation of human periodontal ligament stem cells (hPDLSCs) treated with icariin (10 μM) was also evaluated at 5, 10 and 21 days of osteogenic induction. The first maxillary molars of five‐week‐old male Sprague–Dawley rats were extracted, denuded of PDL, then treated either with neutralized collagen solution (Carrier control) or icariin in collagen (3 μg/μL) before replantation into their sockets. The animals were euthanized 2 weeks post‐surgery for micro‐computed tomography (micro‐CT) imaging and histological analyses. Results: Icariin was cytocompatible and significantly reduced the differentiation of TRAP+ MNGCs in a dose‐dependent manner compared to the control. Moreover, icariin enhanced alkaline phosphatase activity, expression of osteogenic marker genes and proteins, and calcium deposition in hPDLSCs. Micro‐CT imaging of the replanted samples demonstrated a significantly higher volume of remaining roots in the icariin‐treated group than in the control group. Histological analysis revealed a marked number of resorptive lacunae with TRAP activity in the control group, whereas icariin‐treated samples showed signs of functional healing and reduced osteoclastic activity. Conclusions: Icariin was biocompatible and demonstrated potent anti‐osteoclastic and pro‐osteogenic properties that reduced resorption and promoted functional healing of denuded roots in a rat maxillary first molar model of replantation. These findings indicate that root surface treatment with icariin may be a clinically relevant and practical method for improving the retention and survival of teeth with compromised PDL after delayed replantation following traumatic avulsion. [ABSTRACT FROM AUTHOR]

Objective: To report a novel digital workflow to replace an anterior maxillary tooth lost due to trauma with an implant multilayer restoration by using the patient's extracted tooth as a final crown restoration using computer‐aided design/computer‐aided manufacturing (CAD/CAM) technology. Clinical Considerations: Instead of using the patient's natural tooth as an immediate provisional restoration to achieve predictable results in terms of esthetics and soft tissue structure, a novel digital strategy was performed to obtain a natural final crown restoration by using the patient's tooth associated with a lithium disilicate customized implant abutment. Conclusions: The perspective of using this strategic approach for implant restorative dental treatments in patients with traumatic root fractures in the anterior region has great potential as it helps to maintain the emergence profile of the natural dentition and esthetics. Clinical Significance: Optimal esthetic outcomes are challenging in implant dentistry regarding soft tissue structure and morphology factors. Using natural teeth from surgery to deliver the final restoration might be beneficial when an anterior tooth is lost due to trauma. [ABSTRACT FROM AUTHOR]