Management of necrotic immature permanent maxillary incisors using a modified technique of revascularisation

2021 ◽  
Vol 14 (3) ◽  
pp. e240203
Author(s):  
Arun Mayya ◽  
Shruti Bhandary ◽  
Advith Kolakemar ◽  
Ann Mary George
Keyword(s):  
Platelet Rich Plasma ◽  
Blood Clot ◽  
Treatment Options ◽  
Permanent Teeth ◽  
Treatment Modalities ◽  
Successful Outcome ◽  
Modified Technique ◽  
Platelet Rich Fibrin ◽  
Periapical Lesions ◽  
Over Time

The management of necrotic immature permanent teeth has always been a challenge to endodontists. Various treatment modalities have been tried and tested for achieving a successful outcome. Revascularisation is one among these treatment options, which is gaining widespread attention among endodontists. The growing body of evidence demonstrating the success of revascularisation has led to different variations of this treatment option. Clinicians have over time used different scaffolds such as blood clot, collagen, platelet-rich fibrin (PRF) and platelet-rich plasma for revascularisation. This case report outlines the management of immature maxillary central incisors with pulp necrosis and large periapical lesions in a 19-year-old female patient with a modified technique of revascularisation by combining PRF and blood clot. At the end of 12 months, the patient was completely asymptomatic along with regression of the periapical lesions.

scholarly journals Platelet-Rich Fibrin Used in Regenerative Endodontics and Dentistry: Current Uses, Limitations, and Future Recommendations for Application

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Sohaib Arshad ◽  
Fatima Tehreem ◽  
Muhammad Rehab khan ◽  
Fatima Ahmed ◽  
Anand Marya ◽  
...  
Keyword(s):  
Bone Growth ◽  
Cell Attachment ◽  
Platelet Rich Plasma ◽  
Blood Clot ◽  
Permanent Teeth ◽  
Clinical Practices ◽  
Platelet Rich Fibrin ◽  
Regenerative Endodontics

Regenerative endodontics has introduced numerous procedures such as pulp implantation, revascularization, and postnatal stem cell therapy. Revascularization has been successfully implemented clinically nowadays, thus providing dentists with outrageous results. Platelet-rich fibrin (PRF) used either alone or along with bone graft promotes bone growth and vascularization. This matrix promotes migration, cell attachment, and proliferation of osteoblast that leads to bone formation. PRF consists of a packed fibrin complex consisting of leukocytes, cytokines, and glycoproteins such as thrombospondin. The usage of PRF has reported high success rates in surgical cases such as sinus lift procedures, healing of extraction sockets, and management of periapical abscesses. Compared to platelet-rich plasma, PRF is more economical, easy to prepare, and feasible to use in daily clinical practices. Revascularization compromised the induction of a blood clot into the root canal space, which emerged as a clinical triumph. This further led to platelet concentrates as an autologous scaffold on which revascularization could occur. The applications of PRF in regenerative endodontics are numerous, such as an agent for repairing iatrogenic perforation of the pulpal floor and for the revascularization of immature permanent teeth with necrotic pulps. It acts as a matrix for tissue ingrowth. Evidence of progressive thickening of dentinal walls, root lengthening, regression in the periapical lesion, and apical closure was reported. Further studies are needed to clarify the precise mechanism of action of PRF for dental pulp regeneration both in vitro and in vivo. The current review aims at the present uses of PRF in regenerative endodontics dentistry and its application with future recommendations and limitations.

scholarly journals Case Report: Dilemma To Save Or Not To Save A Tooth

2017 ◽  
Vol 16 (2) ◽  
Author(s):  
Yee Woo Yap ◽  
Azillah Mohd Ali
Keyword(s):  
Case Report ◽  
Root Formation ◽  
Dentigerous Cyst ◽  
Permanent Teeth ◽  
Treatment Modalities ◽  
Successful Outcome ◽  
Odontogenic Cysts ◽  
Standard Assessment ◽  
Good Healing

Introduction: Dentigerous cyst is the most common odontogenic cysts that are associated with the crowns of permanent teeth. Treatment modalities normally include enucleation or marsupialization of the cyst. However, currently there are no standard assessment criteria to dictate which kind of treatment for certain cases. The purpose of this report is to describe the successful outcome of conservative surgical management of a large dentigerous cyst associated with an unerupted right maxillary permanent canine in an 8-year-old boy. The cyst was enucleated partially but leaving the cystic lining surrounding the unerupted canine in order to preserve the tooth. 3-year follow up revealed good healing with significant root formation and tooth eruption.

scholarly journals Regenerating the Pulp–Dentine Complex Using Autologous Platelet Concentrates: A Critical Appraisal of the Current Histological Evidence

2020 ◽  
Author(s):  
Amna Riaz ◽  
Furqan A. Shah
Keyword(s):  
De Novo ◽  
Platelet Rich Plasma ◽  
Blood Clot ◽  
Permanent Teeth ◽  
Morphological Evidence ◽  
Wall Thickening ◽  
Platelet Concentrates ◽  
Pulp Tissue ◽  
True Nature ◽  
Autologous Platelet

Background: Autologous platelet concentrates such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) have gained overwhelming popularity in regenerative endodontics. Clinical evidence reveals the lack of a particular advantage of using PRP or PRF over an evoked blood clot in promoting canal wall thickening and/or continued root development in immature necrotic teeth. Moreover, despite stimulating tissue repair and repopulating the root canals of immature and mature permanent teeth, the new vital tissue may not possess the functional activity of the native pulp tissue. Methods: To better understand the origin, nature, and long-term fate of the tissue types found within the pulp space, we critically examine all available histo-/morphological evidence for pulp–dentine complex regeneration using PRP and/or PRF, alone or together with an evoked blood clot, specialised or unspecialised primary cells, and other biomaterials. Results: Histological data from clinical studies is scant. Reportedly, the inner dentinal surface supports cementum-like tissue formation, but this interface likely deviates in structure and function from the native cementodentinal junction. Presence of bone-like tissue within the pulp space is intriguing since de novo osteogenesis requires closely coordinated recruitment and differentiation of osteoprogenitor cells. Compared to untreated necrotic teeth, an evoked blood clot (with/without PRF) improves fracture resistance. Tooth regeneration using PRF and dental bud cells is unreliable and the constituent neoformed tissues are poorly organised. Conclusion: PRP/PRF fail to demonstrate a significant advantage over an induced blood clot, alone. The true nature of neoformed tissues remains poorly characterised while their response to subsequent insult/injury is unexplored.

scholarly journals REVASCULARISATION OF AN IMMATURE PERMANENT TOOTH USING PLATELET RICH FIBRIN AND BIODENTIN AS A MATRIX - A CASE REPORT

2019 ◽  
Vol 3 (7) ◽  
Author(s):  
Dr. Anil K Tomer ◽  
Dr. Panna Mangat ◽  
Dr. Akankshita Behera ◽  
Dr. Savneet Kour ◽  
Dr. Artika Gupta ◽  
...  
Keyword(s):  
Ethylenediaminetetraacetic Acid ◽  
Treatment Options ◽  
Permanent Tooth ◽  
Permanent Teeth ◽  
Periapical Lesion ◽  
Platelet Rich Fibrin ◽  
Growth Status ◽  
Triple Antibiotic Paste ◽  
Regenerative Approach ◽  
Dentin Formation

Any injury to the pulp during its development lead to cessation of dentin formation and root growth. Status of the pulp and root development are the decisive factors in the treatment approach. Various treatment options include surgery with rood end sealing,  apexification using calcium hydroxide ,placement of apical plug and regenerative endodontic procedures to induce apexogenesis. This study describes the treatment of an immature permanent tooth which was treated with regenerative approach using 3% NaOCl and 17%  ethylenediaminetetraacetic acid as irrigants,and then medicated with triple antibiotic paste, after that platelet rich fibrin (PRF) and Biodentine were place in the canal. On follow up at 3 ,6,12 months healing of periapical lesion, dentinal thickening, and apical closure were evident. So, PRF can be used for the treatment of immature permanent teeth with periapical lesion, as part of a regenerative endodontic procedures. Keywords: Platelet rich fibrin (PRF), Biodentine, open apex, revascularisation

Mitigation of traumatic blepharoptosis with “central levator tuck”: A novel approach in upper eyelid repair

2020 ◽  
pp. 112067212094628
Author(s):  
Aditi Mehta ◽  
Umang Thakur ◽  
Manu Saini ◽  
Sushant Adiga ◽  
Sartaj Singh Grewal ◽  
...  
Keyword(s):  
Surgical Repair ◽  
Successful Outcome ◽  
Muscle Action ◽  
Orbital Fractures ◽  
Modified Technique ◽  
Upper Eyelid ◽  
Novel Approach ◽  
Post Traumatic ◽  
Scar Therapy ◽  
Over Time

Purpose: Complex upper eyelid lacerations can present to the emergency department after a myriad of trauma. The goal of the surgical repair is anatomical and functional recovery along with symmetrical cosmesis. Despite meticulous surgery, post traumatic blepharoptosis may develop. We describe an additional step during upper eyelid laceration repair to help mitigate the development of traumatic blepharoptosis. Methods: Patients with traumatic eyelid laceration without head injury, globe injury or associated orbital fractures, who were planned for a primary upper eyelid repair were included. Intraoperatively, wound margins and tissues were identified to establish anatomical continuity. After the LPS muscle was reinserted onto the tarsus, a single, central suture LPS plication – the “ central levator tuck” was performed. This helped in improving the muscle action as well as strengthening its reattachment onto tarsus. Results: Four cases underwent laceration repair with this modified technique. The nature of eyelid injury, surgical technique, and the outcome at 6 months is described. Three patients had a successful outcome, whereas one patient developed early scarring which reduced with scar therapy over time. Conclusion: We describe a simple and effective “central levator tuck” technique for traumatic eyelid laceration repair with optimal functional and cosmetic outcome while reducing the development of blepharoptosis in four patients.

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