Ramy Emara - Academia.edu (original) (raw)

Papers by Ramy Emara

Research paper thumbnail of Utjecaj osteogeničnih dodataka agregatu mineralnog trioksida na razinu genske ekspresije odontoblastičnih markera nakon zatvaranja pulpe u pasa

This study investigates the effect of addition of dexamethasone, vitamin D3, or chitosan to miner... more This study investigates the effect of addition of dexamethasone, vitamin D3, or chitosan to mineral trioxide aggregate (MTA) on the gene expression level of dentin sialophosphoprotein (DSPP) and matrix extracellular phosphoglycoprotein (MEPE) after pulp capping in dogs. Pulp exposure was performed in sixty dogs’ teeth. The teeth were classified into 3 equal groups according to the evaluation period. Group 1:7 days, group 2: 21 days and group 3: 60 days. Each group was further subdivided according to the pulp capping material used, into subgroup A: MTA + dexamethasone, subgroup B: MTA + dexamethasone + vitamin D3, subgroup C: MTA + chitosan and subgroup D: MTA. According to the group, the pulps of the capped teeth were removed for analysis of the relative mRNA expression level of DSPP and MEPE using PCR. Statistical analysis of all data was performed. In subgroup A, significant expression was observed of DSPP (P≤0.05) in group 2 up to 18.8 relative fold change while in subgroup B a s...

Research paper thumbnail of Maintaining pulpal vitality: Cost-effectiveness analysis on carious tissue removal and direct pulp capping

Journal of Dentistry, 2020

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Research paper thumbnail of The influence of addition of osteogenic supplements to mineral trioxide aggregate on the gene expression level of odontoblastic markers following pulp capping in dog

Veterinarski Arhiv, 2016

SEidA, R. A. EMARA: The influence of addition of osteogenic supplements to mineral trioxide aggre... more SEidA, R. A. EMARA: The influence of addition of osteogenic supplements to mineral trioxide aggregate on the gene expression level of odontoblastic markers following pulp capping in dog. Vet. arhiv 86, 685-697, 2016.

Research paper thumbnail of Effects of calcium silicate cements on dental pulp cells: A systematic review

Journal of Dentistry, 2018

The aim of this study was to evaluate the biocompatibility, odontogenic, angiogenic and inflammat... more The aim of this study was to evaluate the biocompatibility, odontogenic, angiogenic and inflammatory effects of commercially available calcium silicate cements (CSCs) on dental pulp cells. Data: In vitro, animal and human in vivo studies reporting on biocompatibility, odontogenic, angiogenic and inflammatory effects of CSCs on dental pulp cells were screened using a systematic review, and a descriptive analysis performed. Sources: We searched Medline via PubMed, Google Scholar and Scopus, followed by hand search and crossreferencing. Study selection: From 7007 identified studies; 38 were included. At least one MTA-type product was evaluated in each study, with ProRooT MTA being the most frequently assessed, followed by Biodentine and iRoot BP Plus. Nearly all CSCs exhibited a high biocompatibility and induced odontogenic and angiogenic effects. There was great heterogeneity in methodology and findings. In vivo, effects differed between materials; also, differences between human or animal pulp cell effects were noted. In vitro, the dilution of the cement, the period of exposure to the CSC and the specific effect measure influenced the outcomes. No CSC was clearly superior to alternatives. Conclusions: All commercially available CSCs are biocompatible, exhibit comparable and favorable effects on odontogenic differentiation of dental pulp cells in vitro and can efficiently enhance dentin bridge formation of high quality with minimal inflammation. No specific CSC can be recommended. Clinical significance: Most CSCs are highly biocompatible, promoting pulp healing at minimal pulp inflammation. While the variation in methodology limits comparisons across studies, it seems that nearly all CSCs show favorable effects on dental pulp cell. We are unable to recommend one specific material over the others. However, a synthesis of this research seems warranted: (1) Most studies

Research paper thumbnail of Effects of mineral trioxide aggregate, calcium hydroxide, biodentine and Emdogain on osteogenesis, Odontogenesis, angiogenesis and cell viability of dental pulp stem cells

BMC Oral Health, 2019

Background: Vital pulp therapy preserves and maintains the integrity and the health of dental pul... more Background: Vital pulp therapy preserves and maintains the integrity and the health of dental pulp tissue that has been injured by trauma, caries or restorative procedures. The enhancement of cells viability and formation of reparative dentine and new blood vessels are vital determinants of the success of direct pulp capping. Therefore, the aims of this study was to evaluate and compare the in vitro osteogenic, odontogenic and angiogenic effects of mineral trioxide aggregate (MTA), calcium hydroxide [Ca(OH) 2 ], Biodentine and Emdogain on dental pulp stem cells (DPSCs) and examine the effects of the tested materials on cell viability. Methods: DPSCs were treated with MTA, Ca(OH) 2 , Biodentine or Emdogain. Untreated cells were used as control. The cell viability was measured by MTT assay on day 3. Real-Time PCR with SYBR green was used to quantify the gene expression levels of osteogenic markers (alkaline phosphatase and osteopontin), odontogenic marker (dentin sialophosphoprotein) and angiogenic factor (vascular endothelial growth factor) on day 7 and day 14. Results: All capping materials showed variable cytotoxicity against DPSCs (77% for Emdogain, 53% for MTA, 26% for Biodentine and 16% for Ca(OH) 2 compared to control (P value < 0.0001). Osteopontin (OPN) and dentin sialophosphoprotein (DSPP) gene expression was increased by all four materials. However, alkaline phosphatase (ALP) was upregulated by all materials except Emdogain. Vascular endothelial growth factor (VEGF) expression was upregulated by all four tested materials except Ca(OH) 2. Conclusions: Our results suggest MTA, Biodentine and Emdogain exhibit similar attributes and may score better than Ca(OH) 2. Emdogain could be a promising alternative to MTA and Biodentine in enhancing pulp repair capacity following dental pulp injury. However, further future research is required to assess the clinical outcomes and compare it with the in vitro findings.

Research paper thumbnail of Deep Learning for the Radiographic Detection of Apical Lesions

Journal of Endodontics, 2019

Introduction: We applied deep convolutional neural networks (CNNs) to detect apical lesions (ALs)... more Introduction: We applied deep convolutional neural networks (CNNs) to detect apical lesions (ALs) on panoramic dental radiographs. Methods: Based on a synthesized data set of 2001 tooth segments from panoramic radiographs, a custom-made 7-layer deep neural network, parameterized by a total number of 4,299,651 weights, was trained and validated via 10 times repeated group shuffling. Hyperparameters were tuned using a grid search. Our reference test was the majority vote of 6 independent examiners who detected ALs on an ordinal scale (0, no AL; 1, widened periodontal ligament, uncertain AL; 2, clearly detectable lesion, certain AL). Metrics were the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and positive/negative predictive values. Subgroup analysis for tooth types was performed, and different margins of agreement of the reference test were applied (base case: 2; sensitivity analysis: 6). Results: The mean (standard deviation) tooth level prevalence of both uncertain and certain ALs was 0.16 (0.03) in the base case. The AUC of the CNN was 0.85 (0.04). Sensitivity and specificity were 0.65 (0.12) and 0.87 (0.04,) respectively. The resulting positive predictive value was 0.49 (0.10), and the negative predictive value was 0.93 (0.03). In molars, sensitivity was significantly higher than in other tooth types, whereas specificity was lower. When only certain ALs were assessed, the AUC was 0.89 (0.04). Increasing the margin of agreement to 6 significantly increased the AUC to 0.95 (0.02), mainly because the sensitivity increased to 0.74 (0.19). Conclusions: A moderately deep CNN trained on a limited amount of image data showed satisfying discriminatory ability to detect ALs on panoramic radiographs.

Research paper thumbnail of Utjecaj osteogeničnih dodataka agregatu mineralnog trioksida na razinu genske ekspresije odontoblastičnih markera nakon zatvaranja pulpe u pasa

This study investigates the effect of addition of dexamethasone, vitamin D3, or chitosan to miner... more This study investigates the effect of addition of dexamethasone, vitamin D3, or chitosan to mineral trioxide aggregate (MTA) on the gene expression level of dentin sialophosphoprotein (DSPP) and matrix extracellular phosphoglycoprotein (MEPE) after pulp capping in dogs. Pulp exposure was performed in sixty dogs’ teeth. The teeth were classified into 3 equal groups according to the evaluation period. Group 1:7 days, group 2: 21 days and group 3: 60 days. Each group was further subdivided according to the pulp capping material used, into subgroup A: MTA + dexamethasone, subgroup B: MTA + dexamethasone + vitamin D3, subgroup C: MTA + chitosan and subgroup D: MTA. According to the group, the pulps of the capped teeth were removed for analysis of the relative mRNA expression level of DSPP and MEPE using PCR. Statistical analysis of all data was performed. In subgroup A, significant expression was observed of DSPP (P≤0.05) in group 2 up to 18.8 relative fold change while in subgroup B a s...

Research paper thumbnail of Maintaining pulpal vitality: Cost-effectiveness analysis on carious tissue removal and direct pulp capping

Journal of Dentistry, 2020

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Research paper thumbnail of The influence of addition of osteogenic supplements to mineral trioxide aggregate on the gene expression level of odontoblastic markers following pulp capping in dog

Veterinarski Arhiv, 2016

SEidA, R. A. EMARA: The influence of addition of osteogenic supplements to mineral trioxide aggre... more SEidA, R. A. EMARA: The influence of addition of osteogenic supplements to mineral trioxide aggregate on the gene expression level of odontoblastic markers following pulp capping in dog. Vet. arhiv 86, 685-697, 2016.

Research paper thumbnail of Effects of calcium silicate cements on dental pulp cells: A systematic review

Journal of Dentistry, 2018

The aim of this study was to evaluate the biocompatibility, odontogenic, angiogenic and inflammat... more The aim of this study was to evaluate the biocompatibility, odontogenic, angiogenic and inflammatory effects of commercially available calcium silicate cements (CSCs) on dental pulp cells. Data: In vitro, animal and human in vivo studies reporting on biocompatibility, odontogenic, angiogenic and inflammatory effects of CSCs on dental pulp cells were screened using a systematic review, and a descriptive analysis performed. Sources: We searched Medline via PubMed, Google Scholar and Scopus, followed by hand search and crossreferencing. Study selection: From 7007 identified studies; 38 were included. At least one MTA-type product was evaluated in each study, with ProRooT MTA being the most frequently assessed, followed by Biodentine and iRoot BP Plus. Nearly all CSCs exhibited a high biocompatibility and induced odontogenic and angiogenic effects. There was great heterogeneity in methodology and findings. In vivo, effects differed between materials; also, differences between human or animal pulp cell effects were noted. In vitro, the dilution of the cement, the period of exposure to the CSC and the specific effect measure influenced the outcomes. No CSC was clearly superior to alternatives. Conclusions: All commercially available CSCs are biocompatible, exhibit comparable and favorable effects on odontogenic differentiation of dental pulp cells in vitro and can efficiently enhance dentin bridge formation of high quality with minimal inflammation. No specific CSC can be recommended. Clinical significance: Most CSCs are highly biocompatible, promoting pulp healing at minimal pulp inflammation. While the variation in methodology limits comparisons across studies, it seems that nearly all CSCs show favorable effects on dental pulp cell. We are unable to recommend one specific material over the others. However, a synthesis of this research seems warranted: (1) Most studies

Research paper thumbnail of Effects of mineral trioxide aggregate, calcium hydroxide, biodentine and Emdogain on osteogenesis, Odontogenesis, angiogenesis and cell viability of dental pulp stem cells

BMC Oral Health, 2019

Background: Vital pulp therapy preserves and maintains the integrity and the health of dental pul... more Background: Vital pulp therapy preserves and maintains the integrity and the health of dental pulp tissue that has been injured by trauma, caries or restorative procedures. The enhancement of cells viability and formation of reparative dentine and new blood vessels are vital determinants of the success of direct pulp capping. Therefore, the aims of this study was to evaluate and compare the in vitro osteogenic, odontogenic and angiogenic effects of mineral trioxide aggregate (MTA), calcium hydroxide [Ca(OH) 2 ], Biodentine and Emdogain on dental pulp stem cells (DPSCs) and examine the effects of the tested materials on cell viability. Methods: DPSCs were treated with MTA, Ca(OH) 2 , Biodentine or Emdogain. Untreated cells were used as control. The cell viability was measured by MTT assay on day 3. Real-Time PCR with SYBR green was used to quantify the gene expression levels of osteogenic markers (alkaline phosphatase and osteopontin), odontogenic marker (dentin sialophosphoprotein) and angiogenic factor (vascular endothelial growth factor) on day 7 and day 14. Results: All capping materials showed variable cytotoxicity against DPSCs (77% for Emdogain, 53% for MTA, 26% for Biodentine and 16% for Ca(OH) 2 compared to control (P value < 0.0001). Osteopontin (OPN) and dentin sialophosphoprotein (DSPP) gene expression was increased by all four materials. However, alkaline phosphatase (ALP) was upregulated by all materials except Emdogain. Vascular endothelial growth factor (VEGF) expression was upregulated by all four tested materials except Ca(OH) 2. Conclusions: Our results suggest MTA, Biodentine and Emdogain exhibit similar attributes and may score better than Ca(OH) 2. Emdogain could be a promising alternative to MTA and Biodentine in enhancing pulp repair capacity following dental pulp injury. However, further future research is required to assess the clinical outcomes and compare it with the in vitro findings.

Research paper thumbnail of Deep Learning for the Radiographic Detection of Apical Lesions

Journal of Endodontics, 2019

Introduction: We applied deep convolutional neural networks (CNNs) to detect apical lesions (ALs)... more Introduction: We applied deep convolutional neural networks (CNNs) to detect apical lesions (ALs) on panoramic dental radiographs. Methods: Based on a synthesized data set of 2001 tooth segments from panoramic radiographs, a custom-made 7-layer deep neural network, parameterized by a total number of 4,299,651 weights, was trained and validated via 10 times repeated group shuffling. Hyperparameters were tuned using a grid search. Our reference test was the majority vote of 6 independent examiners who detected ALs on an ordinal scale (0, no AL; 1, widened periodontal ligament, uncertain AL; 2, clearly detectable lesion, certain AL). Metrics were the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and positive/negative predictive values. Subgroup analysis for tooth types was performed, and different margins of agreement of the reference test were applied (base case: 2; sensitivity analysis: 6). Results: The mean (standard deviation) tooth level prevalence of both uncertain and certain ALs was 0.16 (0.03) in the base case. The AUC of the CNN was 0.85 (0.04). Sensitivity and specificity were 0.65 (0.12) and 0.87 (0.04,) respectively. The resulting positive predictive value was 0.49 (0.10), and the negative predictive value was 0.93 (0.03). In molars, sensitivity was significantly higher than in other tooth types, whereas specificity was lower. When only certain ALs were assessed, the AUC was 0.89 (0.04). Increasing the margin of agreement to 6 significantly increased the AUC to 0.95 (0.02), mainly because the sensitivity increased to 0.74 (0.19). Conclusions: A moderately deep CNN trained on a limited amount of image data showed satisfying discriminatory ability to detect ALs on panoramic radiographs.