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العنوان
Effect of New Formulation of Nano Calcium Phosphate Based gel on Regeneration of Periapical Lesions after Endodontic Treatment and Periapical Surgery in Dogs /
المؤلف
El Ashry, Basma Farouk M.
هيئة الاعداد
مشرف / بسمه فاروق محمد العشرى
مشرف / سلمى حسن العشرى
مشرف / وفاء اسماعيل عبد الفتاح
مشرف / محمد عياد عبد الحميد
مشرف / مدحت طه عبد الفتاح
تاريخ النشر
2017.
عدد الصفحات
176 p. :
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
Dentistry (miscellaneous)
تاريخ الإجازة
1/1/2017
مكان الإجازة
جامعة عين شمس - كلية طب الأسنان - علاج الجذور
الفهرس
Only 14 pages are availabe for public view

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Abstract

The aim of this study was to synthesize and characterize nano Calcium phosphate based gel as a bone graft material: 1) to be used in periapical surgery in the treatment of periapical abscesses, granulomas and cysts, and 2) to be injected through the prepared root canal to reach the periapical area, thus eliminating the need for the aggressive surgical treatment approaches. Furthermore, Klipdent-PL and nano Calcium phosphate based gel were compared in vivo on periradicular regeneration of endodontically treated teeth in dogs in terms of radiographical and histological examination.
Materials and Methods:
β-TCP nanoparticles were prepared based on natural synthesis method. The crystalline structure of NPs was verified by XRD analysis. The appropriate quality of the synthesized material and the ideal synthesis process were confirmed. Also, the average size of the nano β-TCP crystals within CS composite was evaluated using TEM as 8-17 nm.
Six adult mongrel dogs were used in this study. The experimented teeth were randomly assigned into three groups (n=63) in which the bony lesions were filled surgically with Klipdent-PL or nano calcium phosphate based gel compared to the non surgically filled with nano calcium phosphate based gel. The control group (n=35) were divided into two positive groups (infected with apical periodontitis without any treatment intervention (infected) or prepared endodontic treated teeth with apical periodontitis (obturated) and negative group (intact teeth). Each experimental group and the positive control obturated group were subdivided into three subgroups according to observational periods (1, 2, 3 months). The access cavity was done, the dental pulps were removed and the root canals were exposed to the oral cavity for 7 days to allow microbial contamination. Access openings were then sealed. Radiographs of all teeth under investigation were done after 45 days, so radiographic images showed periapical radiolucency indicating that there is a periapical periodontitis.
All previously infected teeth in the experimental groups and positive control group were reaccessed. The teeth were instrumented and obturated. Only in the new formulation non surgical group, the prepared new hydrogel was then injected through the root apex to allow the passage of such formulation to fill the periapical lesion non surgically.
The surgical phase was carried out one week after obturation. The buccal plate of bone opposite to the 4 premolars was removed. Granulation tissue was curetted from the periapical region of each root, and groups were treated by Klipdent-PL or the new formulation.
The animals were sacrificed and block sections were obtained. Histological evaluation of the results was achieved through histomorphological events according to the following criteria: apical cementum surface, bone tissue resorption, apical PDL thickness, intensity of inflammatory reaction and osseous repair. Analysis and interpretation of the histopathological results was performed.
Results:
Results revealed at one month, only the Klipdent Pl group showed increased active bone resorption areas with a significant difference with other tested groups. While new formulation (non-surgical and surgical) groups showed no active bone resorption. Only the new formulation (surgical) group showed more active new bone formation compared to Klipdent PL. At two months, all the experimental groups showed absence of bone tissue resorption. Also new formulation (surgical) group showed the highest score for active new bone formation followed by Klipdent PL then new formulation (non surgical) groups. At three months, there was no statistically significance difference between all tested groups with little bone resorption. New formulation (surgical) group showed active new bone formation with no statistically significant difference with new formulation (non surgical) groups and Klipdent PL. While positive (obturated) group didn’t show any new bone formation.
At one month, new formulation (non surgical) showed the lowest mean count of inflammatory cells for one month followed by new formulation (surgical). Klipdent Pl, and positive (obturated) groups showed an intermediate mean values for inflammatory cell count. Also at two months, new formulation (non surgical) showed lower mean count of inflammatory cells then positive obturated group then new formulation (surgical) with no significant difference with each other. Although they were significant different with Klipdent-PL and positive (infected) groups which showed higher mean count of inflammatory cells. At three months, new formulation (non surgical and surgical) showed lower mean count of inflammatory cells then positive obturated group with no significant difference with each other. Although they were significant different with Klipdent-PL and positive (infected) groups which showed higher mean count of inflammatory cells.
The present study demonstrates that the developed nano β-TCP/CS hydrogel could be a clinically applicable bone substitute, because its implantation enhanced bone regeneration more than that of Klipdent which is commercially used as a bone substitute in clinics.