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Effect of MTAD on postoperative discomfort: a randomized clinical trial.
Endod. 2005 Mar;31(3):171-6.
Torabinejad M, Shabahang S, Bahjri K.
The purpose of this study was to compare levels of postoperative discomfort
after cleaning and shaping of root canals using two protocols for removal of smear layer.
Seventy-three consecutive patients requiring root canal treatment were included. At random,
canals were cleaned and shaped with one of the following protocols. In group 1,
5.25% sodium hypochlorite was used as the root canal irrigant. The smear layer
was removed by placing 17% EDTA in the canal(s) for 1 min followed by a 5-ml
rinse with 5.25% NaOCl. In group 2, canals were irrigated with 1.3% NaOCl; the
smear layer was removed by placing MTAD in the canal(s) for 5 min. Access
cavities were closed with a sterile cotton pellet and Cavit. The patients
recorded degree of discomfort at various time intervals after cleaning and
shaping on a visual analogue scale for 1 wk. No significant statistical difference
was found in the degree of discomfort between the two groups (p = 0.58).
Contemporary endodontic surgery. (PDF)
J Calif Dent Assoc. 2004 Jun;32(6):485-92.
Rubinstein R, Torabinejad M.
During the past decade, endodontics has seen a dramatic shift in the application of
periradicular surgery and the role it plays in endodontic treatment. With the introduction
of enhanced magnification, periradicular ultrasonics and other associative technologies,
teeth that might otherwise be extracted now have a chance for retention.
This article describes the role of these advances in contemporary endodontic surgery.
Repair of root perforations using mineral trioxide aggregate: a long-term study.
J Endod. 2004 Feb;30(2):80-3.
Main C, Mirzayan N, Shabahang S, Torabinejad M.
Root perforations adversely affect the prognosis of teeth. Inadequacy of the
repair materials has been a contributing factor to the poor outcome of repair procedures.
Mineral trioxide aggregate (MTA) is a relatively new material that is being successfully
used to repair perforations. The purpose of this study was to evaluate the success rate
of root perforation repairs using MTA. A list of all of the perforation repairs
completed with MTA at an endodontic residency program was obtained. Sixteen cases
were included that met the criteria for this study. Pretreatment, immediate posttreatment,
and at least 1 year follow-up radiographs were evaluated in a double-blind manner
to determine the presence or absence of any pathologic changes adjacent to the
perforation site. The results showed that all 16 cases demonstrated normal tissue
architecture adjacent to the repair site at the recall visit. Teeth with existing
lesions showed resolution of the lesion, and teeth without preoperative lesions
continued to demonstrate absence of lesion formation at the follow-up visit.
Based on the results of this study, MTA provides an effective seal of root
perforations and shows promise in improving
the prognosis of perforated teeth that would otherwise be compromised.
The effect of calcium sulfate on hard-tissue healing after periradicular surgery.
J Endod. 2004 Jan;30(1):17-20.
Apaydin ES, Torabinejad M.
The purpose of this study was to determine the effect of calcium sulfate (CS)
on cementum deposition and osseous healing after periradicular surgery.
The root canals of 24 mandibular premolars in four 2-yr-old beagle dogs were
endodontically treated, followed 2 weeks later by periradicular surgery. Mineral
trioxide aggregate (MTA) was used as root-end-filling material. The right or left
side was assigned at random to receive CS alpha-hemihydrate or no material in the
osteotomy sites before closure. The animals were killed after 4 months. Hard-tissue
healing was analyzed histomorphometrically. All samples displayed evidence of
cementum deposition adjacent to the root-end fillings and bone regeneration in
the osteotomy sites. The data was analyzed using the Mann-Whitney U test, comparing
the scores for cementum and osseous healing of the two groups at significance level
of alpha = 0.05. The results indicated that placement of CS in osteotomy sites
after periradicular surgery does not significantly affect periradicular healing.
Identification of hard tissue after experimental pulp capping using dentin sialoprotein (DSP) as a marker.
J Endod. 2003 Oct;29(10):646-50.
Andelin WE, Shabahang S, Wright K, Torabinejad M.
The purpose of this study was to identify the hard tissue formed early
in experimental pulp exposures capped with mineral trioxide aggregate (MTA) or
bone morphogenetic protein (BMP)-7 using dentin sialoprotein (DSP) as a marker.
The pulps of 35 maxillary first, second, and third molar teeth from 10 male rats were
experimentally exposed. The pulps were capped with MTA alone as a pulp-capping agent
and final restoration or with BMP-7 followed by restoration with MTA. Five teeth
with class I occlusal preparations, no exposure, and no restoration served as positive
controls. Five teeth that received pulp exposures and no restoration served as negative
controls. Five untreated third molars served as additional controls. The animals
were killed at 2 weeks. The specimens were prepared and evaluated histologically
and with immunohistochemistry using polyclonal antibodies raised against rat DSP.
Pulps capped with MTA formed hard tissue that demonstrated significantly more
immunostaining for DSP compared with BMP-7 (p = 0.0031). MTA-capped pulps also
showed significantly more complete bridge formation compared with BMP-7 (p = 0.0008).
Pulps capped with BMP-7 demonstrated a hard tissue that was bone-like in appearance
and devoid of DSP staining.
Effect of teeth with periradicular lesions on adjacent dental implants.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003 Sep;96(3):321-6.
Shabahang S, Bohsali K, Boyne PJ, Caplanis N, Lozada J, Torabinejad M.
OBJECTIVES: It is generally accepted that dental implants should not be placed in infected sites.
However, the effect of periradicular infections of natural teeth on adjacent osseointegrated
implants is less understood. The purpose of this study was to evaluate effects of
periradicular lesions on osseointegration of existing implants.Study design Forty
titanium solid root-form implants were placed close to premolars in dogs. After healing
following implant placement, the adjacent premolars were treated in 1 of 4 ways: group A,
no treatment of the adjacent premolar; group B, induction of a periradicular lesion
followed by nonsurgical root canal therapy of the premolar; group C, induction of a
periradicular lesion followed by nonsurgical root canal therapy of the premolar and
surgical detoxification of the implant surface; and group D, induction of periradicular
lesion and no treatment of the tooth. After 7(1/2) months, block sections were prepared
and the percentage of osseointegration was analyzed histomorphometrically.
RESULTS: The average integration for implants in groups A-B was 54%, 74%, 56%,
and 68%, respectively. One-way analysis of variance demonstrated no difference
between the 4 groups ( P =.518). CONCLUSIONS: The results of this study indicate
that teeth with periradicular lesions do
not adversely affect adjacent titanium solid root-form implants.
Leakage evaluation of root end filling materials using endotoxin.
J Endod. 2002 Jan;28(1):5-7.
Tang HM, Torabinejad M, Kettering JD.
Mineral trioxide aggregate (MTA) has been shown to possess excellent sealing ability
when tested with dye, bacteria, and a fluid filtration technique. Endotoxin, a component
of the cell wall of Gram-negative bacteria, has been proposed to play a role in the
pathogenesis of periradicular lesions. This study used a modified Limulus Amebocyte
Lysate test for the presence of endotoxin as a tracer and compared the sealing ability
of Super-EBA, IRM, amalgam, and MTA. The results showed that MTA permitted less
endotoxin leakage than IRM and amalgam at 1, 2, 6, and 12 wk (p < 0.05),
and leaked less than Super-EBA at 2 and 12 wk (p < 0.05).
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