Javier Caviedes-Bucheli - Academia.edu (original) (raw)

Papers by Javier Caviedes-Bucheli

Research paper thumbnail of Dentin Growth after Direct Pulp Capping with the Different Fractions of Plasma Rich in Growth Factors (PRGF) vs. MTA: Experimental Study in Animal Model

Journal of Clinical Medicine

Background: This study aimed to evaluate the area of dentin growth in rabbit incisors after pulp ... more Background: This study aimed to evaluate the area of dentin growth in rabbit incisors after pulp capping with plasma rich in growth factors (PRGF) compared with mineral trioxide aggregate (MTA) by fluorescence. Methods: twenty-seven upper and lower incisors of rabbits were divided into 4 groups: poor PRGF (F1) (n = 9 teeth), rich PRGF (F2) (n = 8 teeth), ProRoot MTA (positive control, n = 5 teeth), and untreated (NC) (negative control, n = 5). Fluorochrome markers were injected 24 h before surgery and the day before euthanasia, 28 days after the vital pulp therapy (VPT). Two transverse cuts were performed to every tooth: the first cut (A), 1 mm incisal to the gingival margin, and the second cut (B), 5 mm apical to the first cut. The sections were assessed with histomorphometric evaluation by fluorescence microscopy, comparing the dentin area between fluorescence marks and the total mineralized area. Results: The higher percentage of dentin growth was observed in the F2 group (B = 63...

Research paper thumbnail of Association between cigarette smoking and the prevalence of post-endodontic periapical pathology: a systematic review and meta-analysis

Restorative Dentistry & Endodontics

Objectives: This systematic review and meta-analysis aimed to assess the association of cigarette... more Objectives: This systematic review and meta-analysis aimed to assess the association of cigarette smoking with the prevalence of post-endodontic apical periodontitis in humans. Materials and Methods: We searched through PubMed/Medline, Web of Science, and Scopus from inception to December 2020. Risk of bias was performed by using the Newcastle-Ottawa Scale for cross-sectional, cohort, and case-control studies. We performed the statistical analysis in Review Manager 5.3 (RevMan 5.3). Results: 6 studies met the inclusion criteria for qualitative and quantitative synthesis. Statistical analysis of these studies suggests that there were no differences in the prevalence of post endodontic apical periodontitis (AP) when comparing non-smokers vs smoker subjects regarding patients (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.31-1.49; I2 = 58%) and teeth (OR, 1.71; 95% CI, 0.99-2.93; I2 = 72%). Conclusions: Our findings suggest that there was no association between cigarette smoking and post-endodontic apical periodontitis, as we did not find statistical differences in the prevalence of post-endodontic AP when comparing non-smokers vs smoker subjects. Therefore, smoking should not be considered a risk factor associated with endodontic failure.

Research paper thumbnail of Publication Types: Research

The effect of glass ionomer and adhesive cements on substance P expression in human dental pulp

Research paper thumbnail of In Vitro Comparison of MTA and BC RRM-Fast Set Putty as Retrograde Filling Materials

Background: To compare, in vitro, the bioceramic materials (MTA and BC RRM-fast set putty) capaci... more Background: To compare, in vitro, the bioceramic materials (MTA and BC RRM-fast set putty) capacity to prevent microleakage of Enterococcus faecalis over time. Methods: An experimental design was made with forty extracted human teeth, coronally cut, and prepared to be placed in a leakage system under sterile conditions. They were randomly divided into an experimental group: thirty teeth (fifteen for retrograde filling material MTA and BC RRM-fast set putty, respectively) and a control group: ten teeth (five positive control, five negative control). The 3 mm root-ends were submerged in a brain-heart infusion broth with a red phenol indicator. The coronal access of each sample was inoculated with E. faecalis every seven days to maintain bacterial viability. The lower chamber was evaluated daily for 30 days to observe the turbidity of the culture medium and establish the presence and day of the filtration. Calculation of the colony-forming units (CFU) was performed for each leaked samp...

Research paper thumbnail of Regenerative endodontic procedure combined with apical surgery of a necrotic permanent incisor with extensive periapical lesion using plasma rich in growth factors (PRGF): A Case report with 6 years post-op evaluation using CBCT

Journal of Clinical and Experimental Dentistry, 2021

Background The aim of this case report is to describe the step-by step and outcomes of a treatmen... more Background The aim of this case report is to describe the step-by step and outcomes of a treatment approach which simultaneously combines a Regenerative Endodontic Procedure (REP) and apical surgery using PRGF as treatment of a post-traumatic necrotic permanent central incisor with extensive periapical lesion and undeveloped apex in a 16 years-old patient. Case description A 16 years-old patient with an extensive periapical lesion in the maxillary central incisor was treated with a combination of REP and periapical surgery in the same visit. A Bi- antibiotic paste (BAP) was used to priorly disinfect the canal, which was posteriorly sealed with MTA placed over a PRGF clot at the same time that the periapical lesion was surgically debrided, removed and grafted, The radiographic and CBCT follow-up results showed a complete healing of the radiolucent lesion, which was replaced with bone-like tissue in two years and well preserved until six years later. Practical implications A combined ...

Research paper thumbnail of Three-dimensional Analysis of the Root Canal Preparation with Reciproc Blue, WaveOne Gold and XP EndoShaper. A New Method in vivo

Background: Evaluation of changes in volume after root canal preparation. with single file rotary... more Background: Evaluation of changes in volume after root canal preparation. with single file rotary systems such as Reciproc-Blue, WaveOne-Gold and XP-EndoShaper, with a new in vivo study model using CBCT and 3D reconstructions on patients Methods: Thirty human lower premolars were randomly divided into three groups, in which the root canals were prepared using one of these single-file systems: Reciproc-Blue, WaveOne-Gold and XP-EndoShaper. Root canals were scanned before and after root canal preparation using CBCT, and a 3D reconstruction was performed with RHINOCEROS 5.0 software to assess the increase in canal volume for each group after instrumentation. The Anova test was used to determine statistically significant differences between the groups and Post-hoc Tukey's-test to compare the groups with each other. Results: The proposed 3D-reconstruction model allows to measure the variation of the volume within the root canal of the premolars studied. With this model, Reciproc-Blue...

Research paper thumbnail of Influence of the Pecking Motion Frequency on the Cyclic Fatigue Resistance of Endodontic Rotary Files

Journal of Clinical Medicine, 2019

Purpose: To analyze the influence of the pecking motion frequency on the cyclic fatigue resistanc... more Purpose: To analyze the influence of the pecking motion frequency on the cyclic fatigue resistance of endodontic rotary files. Material and Methods: Sixty PlexV 25.06 endodontic rotary files were selected and distributed into three groups: 30 movements/min (n = 20), 60 movements/min (n = 20), and 120 movements/min (n = 20). A dynamic cyclic fatigue device was designed using Computer Aided Design/ Computer Aided Engineering (CAD/CAE) technology and manufactured by 3D impressions to simulate the pecking motion performed by an operator. Failures of the endodontic rotary files were detected by a Light-Emitting Diode (LED)/Light-Dependent Resistor (LDR) system controlled by an Arduino-Driver complex and management software. Endodontic rotary files were tested on an artificial root canal manufactured by wire electrical discharge machining (EDM), with similar dimensions to those of the instrument under examination. Endodontic rotary files were used following the manufacturer’s recommendati...

Research paper thumbnail of Successful pulp revascularization of an autotransplantated mature premolar with fragile fracture apicoectomy and plasma rich in growth factors: a 3‐year follow‐up

International Endodontic Journal, 2019

Research paper thumbnail of Use of Platelet-rich Plasma in Endodontic Procedures in Adults: Regeneration or Repair? A Report of 3 Cases with 5 Years of Follow-up

Journal of Endodontics, 2017

Introduction: Regenerative endodontic procedures (REP) are a promising alternative for necrotic i... more Introduction: Regenerative endodontic procedures (REP) are a promising alternative for necrotic immature teeth in adolescents and children, but very little evidence is available on this alternative in long-lasting necrotic teeth with open apices in adults. REPs are designed to replace damaged structures of the pulpdentin complex, but no regeneration has been obtained in any of the cases described in necrotic immature permanent teeth with apical periodontitis with histologic results. The results are limited to periapical tissue repair with increasing root length, thickening of the root walls, and apical closure in young patients. In this series of cases, we report on the outcomes of the adjuvant use of autologous platelet-rich plasma (PRP) in endodontic therapy in adults by monitoring periapical tissue healing with periodic periapical radiographs and cone-beam computed tomographic scanning. Methods: Three teeth with apical periodontitis and open apices in 3 different patients from 21 to 35 years-old were evaluated. An REP was performed with the adjuvant use of PRP. Results: At controls, complete disappearance of the radiolucent lesions and the presence of calcified structures forming bridges occupying the pulp lumen were observed but not an ostensible thickening of root walls with a regeneration of pulp-dentin complex. Conclusions: The repair of periapical tissues with REPs of open apex teeth with apical periodontitis and in nonsurgical endodontic retreatment appears to be feasible in adults, but no regeneration was obtained in any of the present cases. The use of PRP may be a good choice as an autologous matrix because of its stability and induction; it contains growth factors and bioactive molecules like transforming growth factor beta, bone morphogenic proteins, insulinlike growth factors, and angiogenetic growth factors, which stimulate collagen production, angiogenesis, and cell differentiation. Anti-inflammatory and antibacterial properties have also been reported for this preparation, which are involved in all processes of repair.

Research paper thumbnail of Neuropeptides in Dental Pulp: The Silent Protagonists

Journal of Endodontics, 2008

Dental pulp is a soft mesenchymal tissue densely innervated by afferent (sensory) fibers, sympath... more Dental pulp is a soft mesenchymal tissue densely innervated by afferent (sensory) fibers, sympathetic fibers, and parasympathetic fibers. This complexity in pulp innervation has motivated numerous investigations regarding how these 3 major neuronal systems regulate pulp physiology and pathology. Most of this research is focused on neuropeptides and their role in regulating pulpal blood flow and the development of neurogenic inflammation. These neuropeptides include substance P, calcitonin gene-related peptide, neurokinin A, neuropeptide Y, and vasoactive intestinal polypeptide among others. The purpose of this article is to review recent advances in neuropeptide research on dental pulp, including their role in pulp physiology, their release in response to common dental procedures, and their plasticity in response to extensive pulp and dentin injuries. Special attention will be given to neuropeptide interactions with pulp and immune cells via receptors, including studies regarding receptor identification, characterization, mechanisms of action, and their effects in the development of neurogenic inflammation leading to pulp necrosis. Their role in the growth and expansion of periapical lesions will also be discussed. Because centrally released neuropeptides are involved in the development of dental pain, the pain mechanisms of the pulpodentin complex and the effectiveness of present and future pharmacologic therapies for the control of dental pain will be reviewed, including receptor antagonists currently under research. Finally, potential clinical therapies will be proposed, particularly aimed to manipulate neuropeptide expression or blocking their receptors, to modulate a variety of biologic mechanisms, which preliminary results have shown optimistic results.

Research paper thumbnail of The Effect of Cavity Preparation on Substance P Expression in Human Dental Pulp

Journal of Endodontics, 2005

Substance P (SP) plays an important role during neurogenic inflammation of dental pulp. The purpo... more Substance P (SP) plays an important role during neurogenic inflammation of dental pulp. The purpose of this study was to use a radioimmunoassay for determining the effect of cavity preparation on SP expression in healthy human dental pulp. Ten pulp samples were obtained from healthy premolars where extraction was indicated for orthodontic reasons. Deep cavity preparation (Ͻ1 mm remaining dentine thickness) was performed before extraction in five of these bicuspids. All samples were processed and 125 I-SP labeled; SP was quantified by competition assay. The results revealed SP expression in all human pulp samples. Mann-Whitney's U test revealed statistically significant higher expression in pulp from teeth where cavity preparation had been performed compared to control values (p Ͻ 0.05). These findings suggest that SP is released during common dental procedures (such as cavity preparation) and its expression may have an important clinical significance in terms of experiencing inflammation and pain.

Research paper thumbnail of Calcitonin gene-related peptide receptor expression in alternatively activated monocytes/macrophages during irreversible pulpitis

Journal of endodontics, 2008

The purpose of this study was to quantify the percentage and the mean fluorescence intensity of v... more The purpose of this study was to quantify the percentage and the mean fluorescence intensity of viable alternatively activated monocytes/macrophages (AAMø) CD163+ positive for calcitonin gene-related peptide receptor (CGRPr) within the total AAMø population in human dental pulp. Pulp tissue samples were collected from teeth with a clinical diagnosis of irreversible pulpitis (n = 13), pulps with induced inflammation (n = 13), and normal pulps (n = 13). All samples were labeled to identify positive cells for CGRPr and CD163 using a flow cytometry assay. Results demonstrated that a high percentage of total viable AAMø CD163+ expressed CGRPr on their membranes (72.12% in healthy pulp, 62.20% in irreversible pulpitis, and 58.01% in induced pulpitis). Significant differences were found between mean AAMø CD163+ fluorescence for CGRPr according to pulp condition, being greater in irreversible pulpitis. It can be concluded that AAMø CD163+ are expressed during normal and inflammatory process...

Research paper thumbnail of The Effect of Three Different Rotary Instrumentation Systems on Substance P and Calcitonin Gene-related Peptide Expression in Human Periodontal Ligament

Journal of Endodontics, 2010

Introduction: The purpose of this study was to quantify the effect of three different rotary root... more Introduction: The purpose of this study was to quantify the effect of three different rotary root canal preparation systems on substance P and calcitonin gene-related peptide expression in healthy human periodontal ligament. Methods: Fifty periodontal ligament samples were obtained from healthy premolars in which extraction was indicated for orthodontic reasons. Before extraction, 40 of these premolars were equally divided into four groups, and root canals were prepared using four different systems: the ProTaper Universal rotary system, the RaCe rotary system, the Mtwo rotary system, and the hand instrumentation technique. The remaining 10 healthy premolars that were extracted without treatment served as a negative control group. All periodontal ligament samples were processed, and SP and CGRP were measured by radioimmunoassay. Results: Greater SP and CGRP expression were found in the ProTaper Universal group followed by the hand instrumentation group, the RaCe, and the Mtwo groups. The lower SP and CGRP values were for the negative control group. The Kruskal-Wallis test showed statistically significant differences between groups (p < 0.0001). Post hoc Least Significant Difference (LSD) tests showed statistically significant differences in SP and CGRP expression between the negative control group and all the other groups except the Mtwo group. Hand instrumentation also showed statistically significant differences with all the other groups, except the ProTaper Universal group. Differences between the three rotary systems were also statistically significant. Conclusion: SP and CGRP expression in periodontal ligament increases when teeth are prepared with ProTaper Universal and RaCe rotary instrumentation systems as well as with hand instrumentation. Mtwo maintains SP and CGRP levels.

Research paper thumbnail of Expression of substance P, calcitonin gene-related peptide, β-endorphin and methionine-enkephalin in human dental pulp tissue after orthodontic intrusion: A pilot study

The Angle Orthodontist, 2013

ABSTRACTObjective:To determine the levels of two sensory neuropeptides (substance P [SP] and calc... more ABSTRACTObjective:To determine the levels of two sensory neuropeptides (substance P [SP] and calcitonin gene-related peptide [CGRP]) and two endogenous opioids (methionine-enkephalin [Met-Enk] and β-endorphin [β-End]) in dental pulp tissue samples subjected to controlled orthodontic intrusive forces.Materials and Methods:Sixteen healthy premolars were selected from eight patients who were undergoing extraction for orthodontic purposes. Eight were randomly used as controls, and the other eight were assigned to an experimental group (controlled orthodontic intrusive forces applied for 24 hours). After this period, teeth were extracted, and pulp samples were obtained. All samples were processed to quantify the expression levels of SP, CGRP, Met-Enk, and β-End using commercial radioimmunoassay kits.Results:All samples exhibited basal levels of both neuropeptides and endogenous opioids. After 24 hours of the intrusive stimulus, all patients reported a tolerable discomfort localized at th...

Research paper thumbnail of Effect of Experimentally Induced Occlusal Trauma on Substance P Expression in Human Dental Pulp and Periodontal Ligament

Journal of Endodontics, 2011

Introduction: The purpose of this study was to quantify the effect of occlusal trauma experimenta... more Introduction: The purpose of this study was to quantify the effect of occlusal trauma experimentally induced with occlusal interferences on substance P (SP) expression in healthy human dental pulp and periodontal ligament. Methods: Twenty-eight human dental pulp and periodontal ligament samples were obtained from healthy premolars in which extraction was indicated for orthodontic reasons. Before extraction, occlusal trauma was induced with experimental occlusal interferences in half of these premolars by placing a resin block over their occlusal surface and submitting patients to chew gum for 30 minutes. The remaining healthy premolars were extracted without occlusal trauma and served as a control group. All dental pulp and periodontal ligament samples were processed, and SP was measured by radioimmunoassay. Results: There was 45% and 120% greater SP expression in dental pulp and periodontal ligament, respectively, of teeth with experimentally induced occlusal trauma. Paired t test showed statistically significant differences for both human dental pulp and periodontal ligament (P = .02 and P < .001, respectively) of teeth submitted to occlusal trauma when compared with control group values. Conclusions: SP expression in human dental pulp and periodontal ligament increases when teeth are submitted to occlusal trauma experimentally induced with occlusal interferences.

Research paper thumbnail of The Effect of Different Vasoconstrictors and Local Anesthetic Solutions on Substance P Expression in Human Dental Pulp

Journal of Endodontics, 2009

The purpose of this study was to quantify the effect of the infiltration injection of different v... more The purpose of this study was to quantify the effect of the infiltration injection of different vasoconstrictor and anesthetic solutions on substance P (SP) expression in healthy human dental pulp. Thirty pulp samples were obtained from healthy upper premolars in which extraction was indicated for orthodontic reasons and were randomly assigned into three groups of 10 samples each: 2% lidocaine with 1:80,000 epinephrine (Lido group), 3% Prilocaine with 1:200000 felypressin (Prilo group); and 4% Prilocaine without vasoconstrictor (Prilo-no-VC group). All teeth were extracted 10 minutes after anesthetic application. Pulp samples were processed and SP was measured by radioimmunoassay. SP expression for the Lido, Prilo, and Prilono-VC groups were 616.49, 663.76, and 760.79 pmol/mg pulp tissue, respectively. Analysis of variance showed statistically significant differences between groups (p = 0.001). Tukey Honestly Significant Difference (HSD) post hoc tests showed significant statistical differences between the Prilo-no-VC group and the Lido group (p < 0.01) and between the Prilo-no-VC group and the Prilo group (p < 0.05). It can be concluded that infiltration injection of local anesthetics with vasoconstrictor attenuate SP expression in human dental pulp.

Research paper thumbnail of The Effect of Tooth Bleaching on Substance P Expression in Human Dental Pulp

Journal of Endodontics, 2008

The purpose of this study was to quantify the effect of tooth bleaching on substance P (SP) expre... more The purpose of this study was to quantify the effect of tooth bleaching on substance P (SP) expression in healthy human dental pulp. Forty pulp samples were obtained from healthy premolars in which extraction was indicated for orthodontic reasons. Thirty of these premolars were assigned into three different tooth-bleaching protocols: group 1 (n ϭ 10): Opalescence Xtra Boost (Ultradent Products, South Jordan, UT) (38% H 2 O 2) for 15 minutes; group 2 (n ϭ 10): Lase Peroxide (DMC, Brazil) (35% H 2 O 2) activated with infrared laser diode (Biolux; BioArt, Brazil) for 3 minutes, and group 3 (n ϭ 10): Zoom! Whitening System (Discuss Dental, Culver City, CA) (25% H 2 O 2) light activated for 20 minutes. The remaining 10 healthy premolars serve as a control group. Teeth were anesthetized immediately after bleaching and were extracted 10 minutes later. All pulp samples were processed and SP was measured by radioimmunoassay. Greater SP expression was found in the Zoom! Whitening System, followed by the Lase Peroxide group, Opalescence Xtra Boost, and the lower SP values were for the control group. Analysis of variance showed statistically significant differences between groups (p ϭ 0.0001). Tukey HSD post hoc tests showed significant differences in the light (p Ͻ 0.01) and laser (p Ͻ 0.05) activated bleaching systems when compared with control values. It can be concluded that lightand laser-activated tooth-bleaching systems increase SP expression in human dental pulp significantly higher than normal values.

Research paper thumbnail of Variation in the expression of insulin-like growth factor-1 in human pulp tissue according to the root-development stage

Journal of endodontics, 2007

Insulin-like growth factor-1 (IGF-1) plays an important role in cell proliferation and differenti... more Insulin-like growth factor-1 (IGF-1) plays an important role in cell proliferation and differentiation. It actively participates during odontogenesis and mineralization of dental hard tissues. The purpose of this study is to use a radioimmunoassay (RIA) to determine whether there are differences in the expression of IGF-1 in human pulp from teeth having incomplete or complete root development. Twenty-six pulp samples were obtained from freshly extracted human third molars, half of them from teeth with incomplete root development. All of the samples were processed and labeled using an IGF-1 RIA kit. Results showed IGF-1 presence in all human pulp samples with a statistically significant higher expression in pulps having complete root development. The present findings are consistent with the hypothesis that IGF-1 contributes toward forming and mineralizing dental tissues in teeth with incomplete root development as well as in pulp-repairing process in teeth with complete root developm...

Research paper thumbnail of The effect of glass ionomer and adhesive cements on substance P expression in human dental pulp

Medicina Oral Patología Oral y Cirugia Bucal, 2013

Objectives: The purpose of this study was to quantify the effect of glass ionomer and adhesive ce... more Objectives: The purpose of this study was to quantify the effect of glass ionomer and adhesive cements on SP expression in healthy human dental pulp. Study Design: Forty pulp samples were obtained from healthy premolars where extraction was indicated for orthodontic reasons. In thirty of these premolars a Class V cavity preparation was performed and teeth were equally divided in three groups: Experimental Group I: Glass Ionomer cement was placed in the cavity. Experimental Group II: Adhesive Cement was placed in the cavity. Positive control group: Class V cavities only. The remaining ten healthy premolars where extracted without treatment and served as a negative control group. All pulp samples were processed and SP was measured by radioimmunoassay. Results: Greater SP expression was found in the adhesive cement group, followed by the glass ionomer and the positive control groups. The lower SP values were for the negative control group. ANOVA showed statistically significant differences between groups (p<0.0001). Tukey HSD post hoc tests showed statistically significant differences in SP expression between negative control group and the 3 other groups (p<0.01). Differences between the cavity-only group and the two experimental groups were also statistically significant (p<0.05 and p<0.01 respectively). There is also a statistically significant difference between the two experimental groups (p<0.01). Conclusions: These findings suggest that adhesive cements provoke a greater SP expression when compared with glass ionomer.

Research paper thumbnail of The Effect of Orthodontic Forces on Calcitonin Gene-related Peptide Expression in Human Dental Pulp

Journal of Endodontics, 2011

Introduction: The purpose of this study was to quantify the effect of moderate and severe orthodo... more Introduction: The purpose of this study was to quantify the effect of moderate and severe orthodontic forces on calcitonin gene-related peptide (CGRP) expression in healthy human dental pulp. Methods: Thirty human dental pulp samples were obtained from healthy premolars in which extraction was indicated for orthodontic reasons. Before extraction, teeth were divided into 3 groups of 10 premolars each: (1) the control group: healthy premolars without application of orthodontic forces; (2) the moderate force group: a 56-g force was applied to the premolars for 24 hours; and (3) the severe force group: a 224-g force was applied to the premolars for 24 hours. All dental pulp samples were processed, and CGRP was measured by radioimmunoassay. Results: Greater CGRP expression was found in the severe force group followed by the moderate force group. The lower CGRP values were for the control group. The Kruskal-Wallis test showed statistically significant differences between groups (P < .0001). Least significant difference (LSD) post hoc tests showed statistically significant differences in CGRP expression between the control group and the severe force group (P < .0001) but not with the moderate force group (P = .06). Differences between the moderate and severe force groups were statistically significant (P < .0001). Conclusions: CGRP expression in human dental pulp increases when teeth are submitted to severe orthodontic forces.

Research paper thumbnail of Dentin Growth after Direct Pulp Capping with the Different Fractions of Plasma Rich in Growth Factors (PRGF) vs. MTA: Experimental Study in Animal Model

Journal of Clinical Medicine

Background: This study aimed to evaluate the area of dentin growth in rabbit incisors after pulp ... more Background: This study aimed to evaluate the area of dentin growth in rabbit incisors after pulp capping with plasma rich in growth factors (PRGF) compared with mineral trioxide aggregate (MTA) by fluorescence. Methods: twenty-seven upper and lower incisors of rabbits were divided into 4 groups: poor PRGF (F1) (n = 9 teeth), rich PRGF (F2) (n = 8 teeth), ProRoot MTA (positive control, n = 5 teeth), and untreated (NC) (negative control, n = 5). Fluorochrome markers were injected 24 h before surgery and the day before euthanasia, 28 days after the vital pulp therapy (VPT). Two transverse cuts were performed to every tooth: the first cut (A), 1 mm incisal to the gingival margin, and the second cut (B), 5 mm apical to the first cut. The sections were assessed with histomorphometric evaluation by fluorescence microscopy, comparing the dentin area between fluorescence marks and the total mineralized area. Results: The higher percentage of dentin growth was observed in the F2 group (B = 63...

Research paper thumbnail of Association between cigarette smoking and the prevalence of post-endodontic periapical pathology: a systematic review and meta-analysis

Restorative Dentistry & Endodontics

Objectives: This systematic review and meta-analysis aimed to assess the association of cigarette... more Objectives: This systematic review and meta-analysis aimed to assess the association of cigarette smoking with the prevalence of post-endodontic apical periodontitis in humans. Materials and Methods: We searched through PubMed/Medline, Web of Science, and Scopus from inception to December 2020. Risk of bias was performed by using the Newcastle-Ottawa Scale for cross-sectional, cohort, and case-control studies. We performed the statistical analysis in Review Manager 5.3 (RevMan 5.3). Results: 6 studies met the inclusion criteria for qualitative and quantitative synthesis. Statistical analysis of these studies suggests that there were no differences in the prevalence of post endodontic apical periodontitis (AP) when comparing non-smokers vs smoker subjects regarding patients (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.31-1.49; I2 = 58%) and teeth (OR, 1.71; 95% CI, 0.99-2.93; I2 = 72%). Conclusions: Our findings suggest that there was no association between cigarette smoking and post-endodontic apical periodontitis, as we did not find statistical differences in the prevalence of post-endodontic AP when comparing non-smokers vs smoker subjects. Therefore, smoking should not be considered a risk factor associated with endodontic failure.

Research paper thumbnail of Publication Types: Research

The effect of glass ionomer and adhesive cements on substance P expression in human dental pulp

Research paper thumbnail of In Vitro Comparison of MTA and BC RRM-Fast Set Putty as Retrograde Filling Materials

Background: To compare, in vitro, the bioceramic materials (MTA and BC RRM-fast set putty) capaci... more Background: To compare, in vitro, the bioceramic materials (MTA and BC RRM-fast set putty) capacity to prevent microleakage of Enterococcus faecalis over time. Methods: An experimental design was made with forty extracted human teeth, coronally cut, and prepared to be placed in a leakage system under sterile conditions. They were randomly divided into an experimental group: thirty teeth (fifteen for retrograde filling material MTA and BC RRM-fast set putty, respectively) and a control group: ten teeth (five positive control, five negative control). The 3 mm root-ends were submerged in a brain-heart infusion broth with a red phenol indicator. The coronal access of each sample was inoculated with E. faecalis every seven days to maintain bacterial viability. The lower chamber was evaluated daily for 30 days to observe the turbidity of the culture medium and establish the presence and day of the filtration. Calculation of the colony-forming units (CFU) was performed for each leaked samp...

Research paper thumbnail of Regenerative endodontic procedure combined with apical surgery of a necrotic permanent incisor with extensive periapical lesion using plasma rich in growth factors (PRGF): A Case report with 6 years post-op evaluation using CBCT

Journal of Clinical and Experimental Dentistry, 2021

Background The aim of this case report is to describe the step-by step and outcomes of a treatmen... more Background The aim of this case report is to describe the step-by step and outcomes of a treatment approach which simultaneously combines a Regenerative Endodontic Procedure (REP) and apical surgery using PRGF as treatment of a post-traumatic necrotic permanent central incisor with extensive periapical lesion and undeveloped apex in a 16 years-old patient. Case description A 16 years-old patient with an extensive periapical lesion in the maxillary central incisor was treated with a combination of REP and periapical surgery in the same visit. A Bi- antibiotic paste (BAP) was used to priorly disinfect the canal, which was posteriorly sealed with MTA placed over a PRGF clot at the same time that the periapical lesion was surgically debrided, removed and grafted, The radiographic and CBCT follow-up results showed a complete healing of the radiolucent lesion, which was replaced with bone-like tissue in two years and well preserved until six years later. Practical implications A combined ...

Research paper thumbnail of Three-dimensional Analysis of the Root Canal Preparation with Reciproc Blue, WaveOne Gold and XP EndoShaper. A New Method in vivo

Background: Evaluation of changes in volume after root canal preparation. with single file rotary... more Background: Evaluation of changes in volume after root canal preparation. with single file rotary systems such as Reciproc-Blue, WaveOne-Gold and XP-EndoShaper, with a new in vivo study model using CBCT and 3D reconstructions on patients Methods: Thirty human lower premolars were randomly divided into three groups, in which the root canals were prepared using one of these single-file systems: Reciproc-Blue, WaveOne-Gold and XP-EndoShaper. Root canals were scanned before and after root canal preparation using CBCT, and a 3D reconstruction was performed with RHINOCEROS 5.0 software to assess the increase in canal volume for each group after instrumentation. The Anova test was used to determine statistically significant differences between the groups and Post-hoc Tukey's-test to compare the groups with each other. Results: The proposed 3D-reconstruction model allows to measure the variation of the volume within the root canal of the premolars studied. With this model, Reciproc-Blue...

Research paper thumbnail of Influence of the Pecking Motion Frequency on the Cyclic Fatigue Resistance of Endodontic Rotary Files

Journal of Clinical Medicine, 2019

Purpose: To analyze the influence of the pecking motion frequency on the cyclic fatigue resistanc... more Purpose: To analyze the influence of the pecking motion frequency on the cyclic fatigue resistance of endodontic rotary files. Material and Methods: Sixty PlexV 25.06 endodontic rotary files were selected and distributed into three groups: 30 movements/min (n = 20), 60 movements/min (n = 20), and 120 movements/min (n = 20). A dynamic cyclic fatigue device was designed using Computer Aided Design/ Computer Aided Engineering (CAD/CAE) technology and manufactured by 3D impressions to simulate the pecking motion performed by an operator. Failures of the endodontic rotary files were detected by a Light-Emitting Diode (LED)/Light-Dependent Resistor (LDR) system controlled by an Arduino-Driver complex and management software. Endodontic rotary files were tested on an artificial root canal manufactured by wire electrical discharge machining (EDM), with similar dimensions to those of the instrument under examination. Endodontic rotary files were used following the manufacturer’s recommendati...

Research paper thumbnail of Successful pulp revascularization of an autotransplantated mature premolar with fragile fracture apicoectomy and plasma rich in growth factors: a 3‐year follow‐up

International Endodontic Journal, 2019

Research paper thumbnail of Use of Platelet-rich Plasma in Endodontic Procedures in Adults: Regeneration or Repair? A Report of 3 Cases with 5 Years of Follow-up

Journal of Endodontics, 2017

Introduction: Regenerative endodontic procedures (REP) are a promising alternative for necrotic i... more Introduction: Regenerative endodontic procedures (REP) are a promising alternative for necrotic immature teeth in adolescents and children, but very little evidence is available on this alternative in long-lasting necrotic teeth with open apices in adults. REPs are designed to replace damaged structures of the pulpdentin complex, but no regeneration has been obtained in any of the cases described in necrotic immature permanent teeth with apical periodontitis with histologic results. The results are limited to periapical tissue repair with increasing root length, thickening of the root walls, and apical closure in young patients. In this series of cases, we report on the outcomes of the adjuvant use of autologous platelet-rich plasma (PRP) in endodontic therapy in adults by monitoring periapical tissue healing with periodic periapical radiographs and cone-beam computed tomographic scanning. Methods: Three teeth with apical periodontitis and open apices in 3 different patients from 21 to 35 years-old were evaluated. An REP was performed with the adjuvant use of PRP. Results: At controls, complete disappearance of the radiolucent lesions and the presence of calcified structures forming bridges occupying the pulp lumen were observed but not an ostensible thickening of root walls with a regeneration of pulp-dentin complex. Conclusions: The repair of periapical tissues with REPs of open apex teeth with apical periodontitis and in nonsurgical endodontic retreatment appears to be feasible in adults, but no regeneration was obtained in any of the present cases. The use of PRP may be a good choice as an autologous matrix because of its stability and induction; it contains growth factors and bioactive molecules like transforming growth factor beta, bone morphogenic proteins, insulinlike growth factors, and angiogenetic growth factors, which stimulate collagen production, angiogenesis, and cell differentiation. Anti-inflammatory and antibacterial properties have also been reported for this preparation, which are involved in all processes of repair.

Research paper thumbnail of Neuropeptides in Dental Pulp: The Silent Protagonists

Journal of Endodontics, 2008

Dental pulp is a soft mesenchymal tissue densely innervated by afferent (sensory) fibers, sympath... more Dental pulp is a soft mesenchymal tissue densely innervated by afferent (sensory) fibers, sympathetic fibers, and parasympathetic fibers. This complexity in pulp innervation has motivated numerous investigations regarding how these 3 major neuronal systems regulate pulp physiology and pathology. Most of this research is focused on neuropeptides and their role in regulating pulpal blood flow and the development of neurogenic inflammation. These neuropeptides include substance P, calcitonin gene-related peptide, neurokinin A, neuropeptide Y, and vasoactive intestinal polypeptide among others. The purpose of this article is to review recent advances in neuropeptide research on dental pulp, including their role in pulp physiology, their release in response to common dental procedures, and their plasticity in response to extensive pulp and dentin injuries. Special attention will be given to neuropeptide interactions with pulp and immune cells via receptors, including studies regarding receptor identification, characterization, mechanisms of action, and their effects in the development of neurogenic inflammation leading to pulp necrosis. Their role in the growth and expansion of periapical lesions will also be discussed. Because centrally released neuropeptides are involved in the development of dental pain, the pain mechanisms of the pulpodentin complex and the effectiveness of present and future pharmacologic therapies for the control of dental pain will be reviewed, including receptor antagonists currently under research. Finally, potential clinical therapies will be proposed, particularly aimed to manipulate neuropeptide expression or blocking their receptors, to modulate a variety of biologic mechanisms, which preliminary results have shown optimistic results.

Research paper thumbnail of The Effect of Cavity Preparation on Substance P Expression in Human Dental Pulp

Journal of Endodontics, 2005

Substance P (SP) plays an important role during neurogenic inflammation of dental pulp. The purpo... more Substance P (SP) plays an important role during neurogenic inflammation of dental pulp. The purpose of this study was to use a radioimmunoassay for determining the effect of cavity preparation on SP expression in healthy human dental pulp. Ten pulp samples were obtained from healthy premolars where extraction was indicated for orthodontic reasons. Deep cavity preparation (Ͻ1 mm remaining dentine thickness) was performed before extraction in five of these bicuspids. All samples were processed and 125 I-SP labeled; SP was quantified by competition assay. The results revealed SP expression in all human pulp samples. Mann-Whitney's U test revealed statistically significant higher expression in pulp from teeth where cavity preparation had been performed compared to control values (p Ͻ 0.05). These findings suggest that SP is released during common dental procedures (such as cavity preparation) and its expression may have an important clinical significance in terms of experiencing inflammation and pain.

Research paper thumbnail of Calcitonin gene-related peptide receptor expression in alternatively activated monocytes/macrophages during irreversible pulpitis

Journal of endodontics, 2008

The purpose of this study was to quantify the percentage and the mean fluorescence intensity of v... more The purpose of this study was to quantify the percentage and the mean fluorescence intensity of viable alternatively activated monocytes/macrophages (AAMø) CD163+ positive for calcitonin gene-related peptide receptor (CGRPr) within the total AAMø population in human dental pulp. Pulp tissue samples were collected from teeth with a clinical diagnosis of irreversible pulpitis (n = 13), pulps with induced inflammation (n = 13), and normal pulps (n = 13). All samples were labeled to identify positive cells for CGRPr and CD163 using a flow cytometry assay. Results demonstrated that a high percentage of total viable AAMø CD163+ expressed CGRPr on their membranes (72.12% in healthy pulp, 62.20% in irreversible pulpitis, and 58.01% in induced pulpitis). Significant differences were found between mean AAMø CD163+ fluorescence for CGRPr according to pulp condition, being greater in irreversible pulpitis. It can be concluded that AAMø CD163+ are expressed during normal and inflammatory process...

Research paper thumbnail of The Effect of Three Different Rotary Instrumentation Systems on Substance P and Calcitonin Gene-related Peptide Expression in Human Periodontal Ligament

Journal of Endodontics, 2010

Introduction: The purpose of this study was to quantify the effect of three different rotary root... more Introduction: The purpose of this study was to quantify the effect of three different rotary root canal preparation systems on substance P and calcitonin gene-related peptide expression in healthy human periodontal ligament. Methods: Fifty periodontal ligament samples were obtained from healthy premolars in which extraction was indicated for orthodontic reasons. Before extraction, 40 of these premolars were equally divided into four groups, and root canals were prepared using four different systems: the ProTaper Universal rotary system, the RaCe rotary system, the Mtwo rotary system, and the hand instrumentation technique. The remaining 10 healthy premolars that were extracted without treatment served as a negative control group. All periodontal ligament samples were processed, and SP and CGRP were measured by radioimmunoassay. Results: Greater SP and CGRP expression were found in the ProTaper Universal group followed by the hand instrumentation group, the RaCe, and the Mtwo groups. The lower SP and CGRP values were for the negative control group. The Kruskal-Wallis test showed statistically significant differences between groups (p < 0.0001). Post hoc Least Significant Difference (LSD) tests showed statistically significant differences in SP and CGRP expression between the negative control group and all the other groups except the Mtwo group. Hand instrumentation also showed statistically significant differences with all the other groups, except the ProTaper Universal group. Differences between the three rotary systems were also statistically significant. Conclusion: SP and CGRP expression in periodontal ligament increases when teeth are prepared with ProTaper Universal and RaCe rotary instrumentation systems as well as with hand instrumentation. Mtwo maintains SP and CGRP levels.

Research paper thumbnail of Expression of substance P, calcitonin gene-related peptide, β-endorphin and methionine-enkephalin in human dental pulp tissue after orthodontic intrusion: A pilot study

The Angle Orthodontist, 2013

ABSTRACTObjective:To determine the levels of two sensory neuropeptides (substance P [SP] and calc... more ABSTRACTObjective:To determine the levels of two sensory neuropeptides (substance P [SP] and calcitonin gene-related peptide [CGRP]) and two endogenous opioids (methionine-enkephalin [Met-Enk] and β-endorphin [β-End]) in dental pulp tissue samples subjected to controlled orthodontic intrusive forces.Materials and Methods:Sixteen healthy premolars were selected from eight patients who were undergoing extraction for orthodontic purposes. Eight were randomly used as controls, and the other eight were assigned to an experimental group (controlled orthodontic intrusive forces applied for 24 hours). After this period, teeth were extracted, and pulp samples were obtained. All samples were processed to quantify the expression levels of SP, CGRP, Met-Enk, and β-End using commercial radioimmunoassay kits.Results:All samples exhibited basal levels of both neuropeptides and endogenous opioids. After 24 hours of the intrusive stimulus, all patients reported a tolerable discomfort localized at th...

Research paper thumbnail of Effect of Experimentally Induced Occlusal Trauma on Substance P Expression in Human Dental Pulp and Periodontal Ligament

Journal of Endodontics, 2011

Introduction: The purpose of this study was to quantify the effect of occlusal trauma experimenta... more Introduction: The purpose of this study was to quantify the effect of occlusal trauma experimentally induced with occlusal interferences on substance P (SP) expression in healthy human dental pulp and periodontal ligament. Methods: Twenty-eight human dental pulp and periodontal ligament samples were obtained from healthy premolars in which extraction was indicated for orthodontic reasons. Before extraction, occlusal trauma was induced with experimental occlusal interferences in half of these premolars by placing a resin block over their occlusal surface and submitting patients to chew gum for 30 minutes. The remaining healthy premolars were extracted without occlusal trauma and served as a control group. All dental pulp and periodontal ligament samples were processed, and SP was measured by radioimmunoassay. Results: There was 45% and 120% greater SP expression in dental pulp and periodontal ligament, respectively, of teeth with experimentally induced occlusal trauma. Paired t test showed statistically significant differences for both human dental pulp and periodontal ligament (P = .02 and P < .001, respectively) of teeth submitted to occlusal trauma when compared with control group values. Conclusions: SP expression in human dental pulp and periodontal ligament increases when teeth are submitted to occlusal trauma experimentally induced with occlusal interferences.

Research paper thumbnail of The Effect of Different Vasoconstrictors and Local Anesthetic Solutions on Substance P Expression in Human Dental Pulp

Journal of Endodontics, 2009

The purpose of this study was to quantify the effect of the infiltration injection of different v... more The purpose of this study was to quantify the effect of the infiltration injection of different vasoconstrictor and anesthetic solutions on substance P (SP) expression in healthy human dental pulp. Thirty pulp samples were obtained from healthy upper premolars in which extraction was indicated for orthodontic reasons and were randomly assigned into three groups of 10 samples each: 2% lidocaine with 1:80,000 epinephrine (Lido group), 3% Prilocaine with 1:200000 felypressin (Prilo group); and 4% Prilocaine without vasoconstrictor (Prilo-no-VC group). All teeth were extracted 10 minutes after anesthetic application. Pulp samples were processed and SP was measured by radioimmunoassay. SP expression for the Lido, Prilo, and Prilono-VC groups were 616.49, 663.76, and 760.79 pmol/mg pulp tissue, respectively. Analysis of variance showed statistically significant differences between groups (p = 0.001). Tukey Honestly Significant Difference (HSD) post hoc tests showed significant statistical differences between the Prilo-no-VC group and the Lido group (p < 0.01) and between the Prilo-no-VC group and the Prilo group (p < 0.05). It can be concluded that infiltration injection of local anesthetics with vasoconstrictor attenuate SP expression in human dental pulp.

Research paper thumbnail of The Effect of Tooth Bleaching on Substance P Expression in Human Dental Pulp

Journal of Endodontics, 2008

The purpose of this study was to quantify the effect of tooth bleaching on substance P (SP) expre... more The purpose of this study was to quantify the effect of tooth bleaching on substance P (SP) expression in healthy human dental pulp. Forty pulp samples were obtained from healthy premolars in which extraction was indicated for orthodontic reasons. Thirty of these premolars were assigned into three different tooth-bleaching protocols: group 1 (n ϭ 10): Opalescence Xtra Boost (Ultradent Products, South Jordan, UT) (38% H 2 O 2) for 15 minutes; group 2 (n ϭ 10): Lase Peroxide (DMC, Brazil) (35% H 2 O 2) activated with infrared laser diode (Biolux; BioArt, Brazil) for 3 minutes, and group 3 (n ϭ 10): Zoom! Whitening System (Discuss Dental, Culver City, CA) (25% H 2 O 2) light activated for 20 minutes. The remaining 10 healthy premolars serve as a control group. Teeth were anesthetized immediately after bleaching and were extracted 10 minutes later. All pulp samples were processed and SP was measured by radioimmunoassay. Greater SP expression was found in the Zoom! Whitening System, followed by the Lase Peroxide group, Opalescence Xtra Boost, and the lower SP values were for the control group. Analysis of variance showed statistically significant differences between groups (p ϭ 0.0001). Tukey HSD post hoc tests showed significant differences in the light (p Ͻ 0.01) and laser (p Ͻ 0.05) activated bleaching systems when compared with control values. It can be concluded that lightand laser-activated tooth-bleaching systems increase SP expression in human dental pulp significantly higher than normal values.

Research paper thumbnail of Variation in the expression of insulin-like growth factor-1 in human pulp tissue according to the root-development stage

Journal of endodontics, 2007

Insulin-like growth factor-1 (IGF-1) plays an important role in cell proliferation and differenti... more Insulin-like growth factor-1 (IGF-1) plays an important role in cell proliferation and differentiation. It actively participates during odontogenesis and mineralization of dental hard tissues. The purpose of this study is to use a radioimmunoassay (RIA) to determine whether there are differences in the expression of IGF-1 in human pulp from teeth having incomplete or complete root development. Twenty-six pulp samples were obtained from freshly extracted human third molars, half of them from teeth with incomplete root development. All of the samples were processed and labeled using an IGF-1 RIA kit. Results showed IGF-1 presence in all human pulp samples with a statistically significant higher expression in pulps having complete root development. The present findings are consistent with the hypothesis that IGF-1 contributes toward forming and mineralizing dental tissues in teeth with incomplete root development as well as in pulp-repairing process in teeth with complete root developm...

Research paper thumbnail of The effect of glass ionomer and adhesive cements on substance P expression in human dental pulp

Medicina Oral Patología Oral y Cirugia Bucal, 2013

Objectives: The purpose of this study was to quantify the effect of glass ionomer and adhesive ce... more Objectives: The purpose of this study was to quantify the effect of glass ionomer and adhesive cements on SP expression in healthy human dental pulp. Study Design: Forty pulp samples were obtained from healthy premolars where extraction was indicated for orthodontic reasons. In thirty of these premolars a Class V cavity preparation was performed and teeth were equally divided in three groups: Experimental Group I: Glass Ionomer cement was placed in the cavity. Experimental Group II: Adhesive Cement was placed in the cavity. Positive control group: Class V cavities only. The remaining ten healthy premolars where extracted without treatment and served as a negative control group. All pulp samples were processed and SP was measured by radioimmunoassay. Results: Greater SP expression was found in the adhesive cement group, followed by the glass ionomer and the positive control groups. The lower SP values were for the negative control group. ANOVA showed statistically significant differences between groups (p<0.0001). Tukey HSD post hoc tests showed statistically significant differences in SP expression between negative control group and the 3 other groups (p<0.01). Differences between the cavity-only group and the two experimental groups were also statistically significant (p<0.05 and p<0.01 respectively). There is also a statistically significant difference between the two experimental groups (p<0.01). Conclusions: These findings suggest that adhesive cements provoke a greater SP expression when compared with glass ionomer.

Research paper thumbnail of The Effect of Orthodontic Forces on Calcitonin Gene-related Peptide Expression in Human Dental Pulp

Journal of Endodontics, 2011

Introduction: The purpose of this study was to quantify the effect of moderate and severe orthodo... more Introduction: The purpose of this study was to quantify the effect of moderate and severe orthodontic forces on calcitonin gene-related peptide (CGRP) expression in healthy human dental pulp. Methods: Thirty human dental pulp samples were obtained from healthy premolars in which extraction was indicated for orthodontic reasons. Before extraction, teeth were divided into 3 groups of 10 premolars each: (1) the control group: healthy premolars without application of orthodontic forces; (2) the moderate force group: a 56-g force was applied to the premolars for 24 hours; and (3) the severe force group: a 224-g force was applied to the premolars for 24 hours. All dental pulp samples were processed, and CGRP was measured by radioimmunoassay. Results: Greater CGRP expression was found in the severe force group followed by the moderate force group. The lower CGRP values were for the control group. The Kruskal-Wallis test showed statistically significant differences between groups (P < .0001). Least significant difference (LSD) post hoc tests showed statistically significant differences in CGRP expression between the control group and the severe force group (P < .0001) but not with the moderate force group (P = .06). Differences between the moderate and severe force groups were statistically significant (P < .0001). Conclusions: CGRP expression in human dental pulp increases when teeth are submitted to severe orthodontic forces.