Janet Kirilova

Material and Method: Twenty-four patients with a diagnosis of reversible pulpitis or asymptomatic irreversible pulpitis were treated. The treated teeth were 16 molars, seven premolars, and one incisor. The chosen treatment method was direct pulp capping. All patients signed informed consent. Results: Depending on the diagnosis, success is reported for the application of direct pulp capping in patients diagnosed with reversible pulpitis at 90.9% success (10/11), and in patients diagnosed with asymptomatic irreversible pulpitis: 76.9% success (10/13). Size of the pulp exposure. A decreasing success rate is observed with increasing exposure size: <1 mm: 100% (11/11); 1–1.5 mm: 75% (3/4); 1.5–2.5 mm: 66.7% (6/9). Conclusion: Detailed assessment of the pulpal communication and adjacent dentine is critical for selecting the appropriate treatment. Examination under magnification enables objective evaluation of tissue changes. The autologous platelet concentrates A-PRF+ combined with a calcium-silicate cement performed well, particularly in small communications with clean, sound peripheral dentine. When hemostasis is difficult or necrosis is suspected, pulpotomy or pulpectomy is preferable.

Introduction: Preservation of dental pulp vitality through direct pulp capping with platelet-rich fibrin (PRF), an autologous platelet concentrate (APC), has been demonstrated in clinical studies and case follow-up reports. Aim: The aim of the present article was to present the clinical outcomes of vital pulp therapy using direct pulp capping with two different autologous platelet concentrate-derived membranes, namely A-PRF+ and a combination of H-PRF and e-PRF, in teeth diagnosed with reversible pulpitis and pulp exposure < 2.5 mm. Materials and Methods: In Case 1, an A-PRF+ membrane was prepared using a centrifugation protocol in a vertical centrifuge. In Case 2, H-PRF and e-PRF membranes were prepared using centrifugation protocols in a horizontal centrifuge. In both cases, teeth diagnosed with reversible pulpitis and pulp exposure (<2.5 mm) were treated. Disinfection of the lesion was with ozone gas for 18 s, following direct pulp capping with a PRF membrane. Clinical and radiographic follow-up examinations, including cone-beam computed tomography (CBCT), were performed for up to 12 months after treatment. Results: Both cases demonstrated successful preservation of pulp vitality, confirmed by electric pulp testing (EPT), and formation of reparative dentin, as assessed by CBCT, with measured thicknesses of 0.57 mm and 0.63 mm. Conclusions: The use of autologous platelet concentrate-derived membranes, including A-PRF+ and a combination of H-PRF and e-PRF, for direct pulp capping in teeth with reversible pulpitis and pulp exposure < 2.5 mm was associated with maintenance of pulp vitality throughout the 12-month follow-up period and with dentin bridge formation.

Background: Autologous platelet concentrates, including platelet-rich fibrin (PRF) matrices, have been proposed as biologically active scaffolds for vital pulp therapy. Evidence on the clinical use of different solid PRF matrices for direct pulp capping remains limited. Objective: The aim of this study is to describe and monitor two clinical cases of reversible pulpitis treated with direct pulp capping using two PRF membranes prepared by different centrifugation approaches, namely advanced platelet-rich fibrin plus (A-PRF+) and horizontal platelet-rich fibrin plus (H-PRF). Methods: In Case 1, A-PRF+ was prepared using a fixed-angle centrifugation protocol; in Case 2, H-PRF was prepared using a horizontal centrifugation protocol. In both cases, deep carious lesions with small carious pulp exposures (<1.5 mm) were managed by caries removal, ozone-assisted dentin disinfection, and direct pulp capping with the respective PRF membrane, followed by temporary calcium-silicate cement definitive coronal restoration. Clinical and radiographic follow-up, including cone-beam computed tomography, was performed for up to 12 months. Results: In Case 1 (A-PRF+), reparative dentin bridge formation was confirmed at 90 days, with a thickness of 0.2 mm. In Case 2 (H-PRF), reparative dentin was observed within 46 days, with a thickness of 0.28 mm. In both cases, pulp vitality was maintained, and no clinical symptoms or periapical changes were detected during the 12-month follow-up. Conclusions: These two cases suggest that direct pulp capping using PRF membranes (A-PRF+ or H-PRF), combined with ozone-assisted dentin disinfection and adequate coronal sealing, may be associated with maintained pulp vitality and hard-tissue repair after carious pulp exposure diagnosed as reversible pulpitis. Due to the descriptive two-case design and major confounding factors (including age and lesion characteristics), no comparative conclusions can be drawn. Prospective controlled clinical studies with standardized protocols are warranted.

Background: This study aims to evaluate the effect of different types of platelet concentrates (autologous blood biomaterials) on the migration potential of human dental pulp stem (hDPSCs). Materials and Methods: Our team created a model of human dental pulp stem cells (hDPSCs). Various types of AB biomaterials were produced from blood samples from volunteers using the protocols presented: A-PRF+, Gel A-PRF+, and Solid PRF. The scratch wound healing assay was used to examine the closure of the experimental wounds on day 1 and day 14. The wound areas were quantified using Image J software. Statistical analysis was performed with the Kruskal–Wallis and Mann–Whitney U tests, as the data did not follow a normal distribution, which was confirmed by the Shapiro–Wilk test (p < 0.05). Results: The results demonstrate significantly faster closure of the experimental wounds on day 14 of the studied biomaterials AB: A-PRF+, Gel A-PRF+, and Solid PRF compared to the control group of cells. Gel A-PRF+ exhibited the most pronounced stimulatory effect on cell migration (p = 0.0036 vs. control), followed by Solid PRF and A-PRF+. Conclusions: The results indicate that autologous blood platelet concentrates stimulate the migration of hDPSCs in vitro. Gel A-PRF+ demonstrated the strongest effect, underscoring its potential clinical relevance for applications in tissue engineering.

This study aims to monitor the results of treating reversible pulpitis using direct pulp capping with biomaterial autologous blood A-PRF+ after 12 months. Materials and Methods. Twenty-nine patients with a diagnosis of reversible pulpitis were treated through direct pulp capping with biomaterial autologous blood (biomaterial AB) A-PRF+. The protocol for the biomaterial AB A-PRF+ is provided. Results of the treatment are analyzed statistically.Results. We found a 72.41% success rate for direct pulp capping with biomaterial AB, and this were the cases with pulp comunication up to < 1.5mm. A uniform pink or slightly reddish colour of the pulp is considered as favorable. A pulp comunications between 1.5 mm and 2.5 mm were related with unsuccessful outcome using the same procedure. Red colouration and darkening areas of the surrounding dentin are unfavourable. The location of the pulp wound below the dentin level, and the presence of dentin fragments inside the pulp wound for direct pulp capping are also unfavourable. Conclusions. According these results the derermination of pulp communication type and the condition of the surrounding dentin are crucial for the successful outcome after direct pulp capping with biomaterial AB A-PRF+.

This study assessed and compared the shear bond strength of self-adhesive and self-etching resin cements for indirect aesthetic restorations to dentin. Four different materials, lithium disilicate ceramics, zirconia ceramics, polymethyl methacrylate (PMMA) composites, and hybrid materials, were used for indirect restorations cemented to dentin. The null hypothesis was that there would be no differences in shear bond strength between the investigated materials. Eighty extracted human molars were used. Eighty dentin specimens with a flat surface were prepared and randomly distributed in groups of 10 (n = 10). From each material (Cerasmart 270, Initial LiSi Blok, Katana ZR Noritake, and Crowntec Next Dent), 20 blocks were made and cemented to the dentin samples. Half of the blocks from each material were cemented to dentin using self-etching resin cement (Panavia V5), and the other half using self-adhesive resin cement (i-CEM). After the specimens were prepared, a laboratory test was conducted to evaluate the shear bond strength. The fracture type was determined using a light microscope, and SEM confirmed the results. The results were statistically analysed. All materials cemented with self-etching cements (Panavia V5) showed statistically higher shear strength values than those cemented with self-adhesive resin cement (i-CEM). In the specimen groups where self-adhesive cement (i-CEM) was used, Cerasmart 270 bonded statistically better. A statistical difference was found between all groups of materials cemented with self-etching cement. The Initial LiSi Block showed the strongest bond, followed by Katana Zr Noritake, Crowntec NextDent, and Cerasmart 270. Adhesion fracture to dentin was observed for all groups cemented with i-CEM. This study highlights the superior performance of self-etching cements in terms of shear bond strength. 10-Methacryloyloxydecyl dihydrogen phosphate (10-MDP), a functional monomer, was found to enhance adhesion strength significantly. However, using self-adhesive cements was associated with a weaker bond to dentin, highlighting the importance of the right cementing agent in restorative dentistry.

This study aimed to evaluate the micro-tensile bond strength (µTBS) of two types of composites for indirect restoration, luted to enamel and dentin with self-adhesive cement. Moreover, it aimed to evaluate the impact of thermocycling on bond strength. Sixteen flat enamel and dentin surfaces of human molars were cemented to equal flat specimens of the laboratory composite Signum ceramis and the CAD/CAM block Cerasmart. Half of the specimens of the group underwent thermocycling. After that, the samples were cut into 80 beams for µTBS analysis. The data were analyzed using Levene’s test and the independent sample t-test. The micro-tensile bond strength tests revealed that thermocycling significantly reduced the adhesive bond. Dentin bonds better to conventional laboratory composites. Enamel bonds are better than composite blocks for milling.

This study aims to evaluate the micro-tensile bond strength of two types of composites for indirect restoration luted to enamel and dentin by self-adhesive cement. Sixteen flat enamel and dentin surfaces of human molar were cemented to equal flat specimens from laboratory composite Signum ceramics and CAD/CAM block Cerasmart. Half of the specimens of the group were thermocycling. After that, the samples were prepared for µTBS. From the micro-tensile bond strength tests, we found that thermocycling significantly reduced the adhesive bond. Dentin bonds better to conventional laboratory composites. Enamel bonds are better than composite blocks for milling.

Contemporary indirect restorative materials vary in their physical and mechanical properties, necessitating additional research. This investigation aims to compare the mechanical properties (such as fatigue and compressive strength) of indirect dental restorative materials. In an in vitro study, the mechanical behaviour of monolithic onlay restorations made from a lithium disilicate glass–ceramic (Group A), a ceramic-infiltrated composite (Group B), a polymer-based composite resin (Group C), and zirconia (Group D), bonded to a prepared tooth model, was evaluated after ageing and mechanical cycling. The average value of compressive strength (stage of cracking) in each group was as follows: Group A, 871 N; Group B, 728 N; Group C, 2655 N; and Group D, 2005 N. Moreover, the results of the compressive strength test (stage of destruction) in each group were as follows: Group A, 2516.5 N; Group B, 2266 N; Group C, 5670 N; and Group D, 3543 N. An analysis of variance (ANOVA) followed by Tukey’s (HSD) post hoc test was conducted to assess pairwise comparisons among group means. Statistical analysis revealed significant differences between Groups C and D and the others, highlighting the potential of these materials in clinical applications. Based on the average values, it can be concluded that the 3D-printed ceramic-infiltrated composite onlays exhibited the highest compressive resistance values among the materials evaluated. The lithium disilicate glass–ceramic and the ceramic-infiltrated composite are brittle materials, which should be considered when covering teeth with high occlusal stress.

Knowledge about the proximity of important anatomical structures is crucial for all surgical interventions, including those in the lower jaw region. One of these important structures is the mental foramen, which transmits the mental nerve, whose branches provide sensory innervation to the chin, lower lip, and gingiva. The mental foramen variations can influence the effectiveness of the mental nerve anesthesia and can also be related to complications during surgical procedures such as implant placement, apicoectomy, vestibuloplasty, etc. We present a very rare case of agenesis of left mental foramen coexisting with two right mental foramina incidentally found in a patient examined by cone-beam computed tomography.