This study aims to determine and compare the dental pulp and gingival blood flow in patients referred for oropharyngeal radiotherapy (RT) at three different time points: before the start, immediately after, and six months following the completion of RT. The aim is also to evaluate the dependence of the pulp and gingival blood flow on the radiation dose. A prospective study included 10 patients referred for intensity-modulated RT (IMRT) in the oropharyngeal region, with at least one intact tooth surrounded by a healthy gingiva. The dose received by each selected tooth and adjacent gingiva was determined according to the map of treatment planning and computer systems. The blood flow measurements were performed using the laser Doppler flowmetry (LDF) method. Comparing vascular flows at three different time points, the median blood flow in the dental pulp showed no statistically significant difference (p=0.325), contrary to gingiva (p=0.011). Immediately after RT completion, the gingival flow significantly increased compared to its starting point (p=0.012). The pulp flow correlated negatively with the radiation dose, whereas a strong correlation was noted 6 months following the RT completion. RT caused a significant acute gingival blood flow increase, followed by a long-term (over six months) tendency to return to the starting levels. The dental pulp blood flow is differently affected by higher radiation doses (over 50Gy) in comparison to lower doses (below 50Gy). During RT planning, considering the possibility of protecting the teeth localized near the Gross Tumor Volume as a sensitive organ is recommended.
Background/Aim: Radiopacity enables radiographic visualization, which is significant in diagnostic procedures and assessment of the quality of endodontic filling. It is important to compare newly developed endodontic sealers with materials that are already in clinical use in order to promote evidence-based dentistry. The aim of our study was to evaluate radiopacity of different calcium silicate-based sealers in comparison with control, epoxy resin-based sealer. The null hypothesis was that there were no statistically significant differences in radiopacity of the tested sealers. Material and Methods: Premixed (TotalFill BC Sealer, EndoSequence BC Sealer, Ceraseal, Bio-C Sealer), two-component (BioRoot RCS, MTA Fillapex, Bioceramic Root Canal Sealer, GuttaFlow Bioseal) calcium silicate-based sealers and AH Plus, as a control, were used. Specimens were radiographed using a Radiovisiography (RVG-4) CCD (charge-coupled devices)-based digital sensor. Results: Ceraseal had the highest, while Bioceramic Root Canal Sealer had the lowest radiopacity. Bioceramic Root Canal Sealer and MTA Fillapex had radiopacity significantly lower than all other sealers. Radiopacity level of AH Plus, was similar to premixed and significantly higher than radiopacities of all two-component endodontic sealers. Conclusions: Calcium silicate-based sealers radiopacity ranged from slightly above minimal required value (3mm), to a value higher than control sealer. Premixed endodontic sealers showed similar radiopacity as AH Plus which suggests that their clinical performance, in terms of visibility on dental radiograms, should be similar
Introduction. Adequate radiopacity of endodontic sealers allows radiographic visualization, assessment of root canal filling quality and its clinical follow-up after obturation. The aim of our study was to evaluate the radiopacity of Bio-Root RCS, MTA Fillapex, Bioceramic Root Canal Sealer, GuttaFlow Bioseal in comparison to AH Plus sealer, as a gold standard in clinical practice. Material and methods. Sealer specimens, 2 mm thick and 5 mm in diameter, were radiographed with an aluminum stepwedge using digital imaging system. Radiographic densities of the specimens were shown as mean greyscale values (Adobe Photoshop CS4 software) and expressed as mmAl/mm of the material. ANOVA with a post hoc Tukey test was used, significance was set at 0.05. Results. Differences in radiopacity between tested endodontic sealers were statistically significant except the difference between BioRoot RCS and GuttaFlow Bioseal. Conclusion. Radiopacities of all evaluated calcium silicate-based sealers were higher than minimal values recommended by standards. AH Plus sealer had the highest radiopacity, while calcium silicate-based sealers showed lower values, from BioRoot RCS, followed by GuttaFlow Bioseal, to MTA Fillapex, in descending order, and Bioceramic Root Canal Sealer with the lowest values.