Treatment of a Hypertaurodontic Maxillary Second Molar in a Patient with 10 Taurodonts: A Case Report

Introduction

Taurodontism is an aberration in tooth morphology characterized by vertically enlarged pulp chambers, apical displacement of pulp floors, and short roots. So far in the literature, no more than 8 taurodonts have been reported in 1 patient. The aim of this case report was to describe the endodontic management of a hypertaurodont maxillary second molar and to present a rare case with 10 taurodonts in a black man with a biometric analysis using cone-beam computed tomographic imaging.

Methods

An 18 year-old black man was referred to the postgraduate endodontic clinic for emergency treatment. The patient's medical history was noncontributory. Tooth #2 had lingering pain in response to the cold test and was positive to both percussion and palpation. Radiographic examination showed the characteristics of taurodontism and periapical radiolucency around the root apices of tooth #2. Tooth #2 was diagnosed with symptomatic irreversible pulpitis and symptomatic apical periodontitis. The tooth was endodontically treated in 2 appointments. A panoramic radiograph showed multiple taurodontism. At the follow-up, a cone-beam computed tomographic scan was taken to further evaluate and diagnose taurodontism. Ten molars showed taurodontism including 7 hypertaurodonts, 2 mesotaurodonts, and a hypotaurodont. High variations of root canal anatomy were observed among taurodonts including maxillary and mandibular hypertaurodonts with C-shape canals.

Conclusions

The present case describes 10 taurodonts in a patient with no specific syndromes and endodontic treatment of a hypertaurodont maxillary second molar. Cone-beam computed tomographic imaging may be useful in the evaluation and management of the anatomic complexity of roots and root canals of taurodonts.     

Histologic Examinations of Teeth Treated with 2 Scaffolds: A Pilot Animal Investigation

Introduction

A growing body of evidence is building a case for the possibility of tissue regeneration within the root canal of necrotic teeth, allowing for continued root development. However, it remains unknown what type of tissue is produced after regenerative endodontics. The purpose of this study was to use blood clots and platelet-rich plasma (PRP) as scaffolds in regenerative endodontics under ideal conditions in a ferret model to examine the tissues generated within the root canals.

Methods

The pulps of 21 canine teeth from 7 young ferrets were extirpated using broaches without filing the canal walls. Bleeding was stimulated from the periapical tissues, and a blood clot was induced in the canal space to the level of the cementoenamel junction in 12 teeth. PRP was prepared and placed in the canals to the level of the cementoenamel junction in 9 teeth. The coronal access was sealed with mineral trioxide aggregate. Seven canines were not operated on and served as controls. Three months later, block sections including each canine and its surrounding tissues were removed for histologic evaluation. The tissues found in the canals of experimental teeth were compared with those in the control teeth.

Results

Almost all of the experimental teeth showed the presence of intracanal bonelike tissue. No evidence of dentinal wall thickening or apical narrowing was noted in the experimental teeth.

Conclusions

In this experimental model, the use of either PRP or blood clots during regenerative endodontics leads to the formation of intracanal bonelike tissue without continual root maturation.     

Determination of the Location of the Mental Foramen: A Critical Review

Introduction

The mental foramen (MF) is an important landmark to consider during surgical endodontic procedures. The purpose of this review article was to discuss the variety of techniques that have been developed to determine the location of the MF, to make recommendations for the current best technique available, and to discuss upcoming technologies.

Methods

Articles that have addressed the location of the MF were evaluated for information pertinent to include in this review.

Results

Different technologies have been used to help operators determine the clinical location of the MF. Most of the techniques have shortcomings such as magnification, radiation, and cost. Cone-beam computed tomographic imaging is the best current available imaging technology to determine the accurate location of the MF, but it has shortcomings such as radiation, cost, and not being real time, which means the data must be interpreted at a later time than when the information was computed.

Conclusions

In the future, magnetic resonance imaging and ultrasound technologies seem to provide promising noninvasive imaging techniques.     

The Effect of SIRT6 on the Odontoblastic Potential of Human Dental Pulp Cells

Introduction

The aim of this study was to investigate whether SIRT6 is expressed in human dental pulp as well as the effect of SIRT6 on proliferation and odontoblastic differentiation of human dental pulp cells (HDPCs).

Methods

Immunohistochemical and immunocytochemical assays were used to detect the expression of SIRT6 in human dental pulp tissue and HDPCs. To determine the effect of SIRT6 on odontoblast differentiation, HDPCs with loss (HDPCs SIRT6 knockdown) and gain (HDPCs SIRT6 overexpression) of SIRT6 function were developed, and their proliferation ability was examined. Odontogenic differentiation of HDPCs was determined by alkaline phosphatase (ALP) activity, ALP-positive cell staining, alizarin red staining, and von Kossa staining. Mineralization-related genes, including ALP, dentin sialophosphoprotein (DSPP), and dentin matrix acidic phosphoprotein 1, were determined by real-time quantitative polymerase chain reaction. Western blot analysis was performed to detect the expression of DSPP protein.

Results

SIRT6 was found in the dental pulp tissue and HDPCs. SIRT6 knockdown decreased ALP activity in HDPCs; calcium nodule formation ability; and the expression of mineralization-related genes such as ALP, DSPP, and DMP1, whereas these were increased with the overexpression of SIRT6.

Conclusions

SIRT6 is expressed in human dental pulp and participates in the odontoblast differentiation of HDPCs.