The interrelationship between periodontal and endodontic disease has aroused much speculation, confusion, and controversy. Pulpal and periodontal problems are responsible for more than 50% of tooth mortality today. Diagnosis is often difficult since these diseases have been studied primarily as separate entities. The toxic substances of the pulp may initiate periodontal defects through canal ramifications and patent dentinal tubules, thus impairing wound healing in regenerative procedures. Although no studies exist addressing the direct effect of pulpal infection on the outcome of guided tissue regeneration (GTR) procedures, several studies do indicate that pulpal status may play a significant role toward the end results of GTR. This review article discusses the potential influence of endodontic treatment on the long-term outcomes of GTR. Potential pathways between the pulp and periodontal ligament, which may be responsible for the failure of the regeneration of new periodontal attachment apparatus, are explored. Examination and review of the clinical and research findings in the literature relating to perio-endo lesions are made to demonstrate that a negative influence may exist between GTR outcomes and the status of the pulp.

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The objective of the present research was to investigate the thermal injury in the brain after minimally invasive electrosurgery using instruments with copper-doped diamond-like carbon (DLC-Cu) surface coating. The surface morphologies of DLC-Cu thin films were characterized using scanning electron microscopy and atomic force microscopy. Three-dimensional brain models were reconstructed using magnetic resonance imaging to simulate the electrosurgical operation. In adult rats, a monopolar electrosurgical instrument coated with the DLC-Cu thin film was used to generate lesions in the brain. Animals were sacrificed for evaluations on postoperative days 0, 2, 7, and 28. Data indicated that the temperature decreased significantly when minimally invasive electrosurgical instruments with nanostructure DLC-Cu thin films were used and continued to decrease with increasing film thickness. On the other hand, the DLC-Cu-treated device created a relatively small thermal injury area and lateral thermal effect in the brain tissues. These results indicated that the DLC-Cu thin film minimized excessive thermal injury and uniformly distributed the temperature in the brain. Taken together, our study results suggest that the DLC-Cu film on copper electrode substrates is an effective means for improving the performance of electrosurgical instruments.

The objective of the present study was to investigate the thermal injury and tissue sticking in the liver after a minimally invasive electrosurgery with a chromium nitride (CrN) surface modifications. The surface morphologies and the hydrophobic properties of CrN thin films were characterized using scanning electron microscopy (SEM), atomic force microscopy (AFM) and contact angle goniometer. Three-dimensional (3D) liver models were reconstructed using magnetic resonance imaging to simulate the electrosurgical procedure. In animal model, needle type monopolar electrosurgery equipped with CrN thin films were used to create lesions in the liver of adult rats. Animals were sacrificed for evaluations at 0, 1, 2, and 4 weeks postoperatively. Data indicated that the temperature decreased significantly when minimally electrosurgery with nanostructured CrN thin films were used, and that it continued to decrease with increasing film thickness. In an animal model, thermography revealed that the surgical temperature was significantly lower in the minimally invasive electrosurgery with CrN thin film compared to untreated electrosurgery. In addition, adherence analysis showed that the smallest amount adherence tissue on the CrN electrode. Moreover, CrN electrosurgery created a relatively small thermal injury area and lateral thermal effect. The present study reveals that the novel nanostructured thin film on electrode substrates is an effective means of improving the performance of reducing excessive thermal injury, decreasing adherence tissue, and uniformly distributing temperature in the liver. However, further tests in the clinical trial must be evaluated to confirm the effect and safety of promising findings in the electrosurgery.