scholarly journals Unpredictable Outcomes of a Regenerative Endodontic Treatment

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Zahra Mohammadi ◽  
Hadi Assadian ◽  
Behnam Bolhari ◽  
Mohammadreza Sharifian ◽  
Mehrfam Khoshkhounejad ◽  
...  
Keyword(s):  
Bacterial Contamination ◽  
Root Apex ◽  
Sinus Tract ◽  
Endodontic Treatment ◽  
Central Incisor ◽  
Immature Teeth ◽  
Valuable Treatment ◽  
Radiolucent Lesion ◽  
Regenerative Endodontic Treatment

Regenerative endodontic treatment (RET) is a valuable treatment for necrotic immature teeth with many advantages such as increasing root length and thickness of root wall. The success of RETs is based on healthy stem cells, suitable scaffolds, and growth factors and takes place when bacterial contamination is well controlled. The aim of this article is to address controversy in a case with multiple success criteria. This paper reports a 9-year-old boy with a complicated crown fracture of the maxillary left central incisor about three years prior to referral with a diagnosis of intrusive luxation with spontaneous reeruption. The tooth had an underdeveloped root and a well-defined periapical radiolucent lesion around the root apex. RET was considered according to the stage of root development. Upon the three-week recall session, the clinical examination indicated that the patient was asymptomatic in the affected site. However, the patient returned two weeks later with a sinus tract pertaining to the apex of tooth #9. Therefore, debridement of the root canal space was repeated and the RET redone. On the second trial, the patient was symptom-free, but no more evidence of root maturation was observed on 18-month follow-up. The tooth was asymptomatic (without swelling, drainage, and pain) during this time, and esthetics was provided for the patient.

scholarly journals 12-Year Follow-Up of Regenerative Endodontic Treatment of Immature Permanent Upper Incisors with Acute Abscess

2020 ◽  
Vol 31 (6) ◽  
pp. 680-684
Author(s):  
Claudio Maniglia-Ferreira ◽  
Eduardo Diogo Gurgel Filho ◽  
Fabio de Almeida Gomes ◽  
Sthefanny Amaral Reis ◽  
Fernanda Geraldo Pappen
Keyword(s):  
Clinical Success ◽  
Glass Ionomer Cement ◽  
Mineral Trioxide Aggregate ◽  
Endodontic Treatment ◽  
Treatment Access ◽  
Root Canals ◽  
Immature Teeth ◽  
The Right ◽  
Regenerative Endodontic Treatment

Abstract This case report discusses the endodontic treatment of a 7-year-old girl who suffered trauma (intrusion) to the immature upper central incisors secondary to a fall from a bicycle. Thirty days after the accident the patient was brought by her mother for clinical and radiographic assessment with a chief complaint of swelling and tenderness to percussion and palpation. Acute apical abscess associated with immature teeth were diagnosed. A decision was made to perform regenerative endodontic treatment. Access cavities were made and the root canals were disinfected by irrigation with 2.5% sodium hypochlorite. Final irrigation was performed with 17% EDTA. Due to pain and presence of secretions, 2% chlorhexidine gel was applied as an intracanal medicament. Seven days later, at the second visit, the root canals were once again disinfected and the canals of the right and left permanent upper central incisors were filled with double antibiotic paste (metronidazole/ciprofloxacin) and calcium hydroxide paste, respectively. Zinc oxide was mixed in both pastes. At the third visit, after 21 more days, the pastes were removed and the periapical areas were stimulated with a #80 K-file to encourage clot formation within the pulp cavities. A mineral trioxide aggregate (MTA) paste cervical plug was placed and the teeth were restored with glass ionomer cement. Radiographs and CBCT scans demonstrated complete root formations. The patient has been followed for 12 years, with evidence of clinical success throughout.

scholarly journals Management of Dens Invaginatus in a Maxillar Lateral Incisor with Open Apex and Persistent Sinus Tract: a Case Report

2018 ◽  
Vol 22 (2) ◽  
pp. 111-114
Author(s):  
Funda Fundaoğlu Küçükekenci ◽  
Ahmet Serkan Küçükekenci
Keyword(s):  
Case Report ◽  
Root Apex ◽  
Sinus Tract ◽  
Endodontic Treatment ◽  
Radiographic Examination ◽  
Root Canals ◽  
Surgical Methods ◽  
Main Canal ◽  
Dens Invaginatus

SummaryBackground/Aim: Dens invaginatus is a developmental anomaly of teeth. The endodontic treatment of these teeth may be difficult because of adversity in accessing the root canals and also complicated variations of internal structure. In this case, the report is presented the nonsurgical management and follow-up of a tooth with class II dens invaginatus with an open apex and sinus tract.Case Report: In the radiographic examination, there are two root canals; a primary (main) canal and an invaginated canal. The main canal wide-open at the portal of exit and associated with a large chronic periapical lesion extending to the apex of the maxillary left central incisor. An invaginated canal was not reaching the apex. In a clinical examination, a sinus tract was detected in the labial gingiva. After apexification with using MTA was applied, the endodontic treatment was completed. In 12 month recall, a gray discoloration was detected and internal bleaching with 35% hydrogen peroxide was applied. Finally, the tooth was restored using composite resin. 12 months follow-up radiographs revealed resolution of periapical radiolucency, trabecular bone formation, and closure of the root apex with the totally asymptomatic tooth.Conclusions: The case report shows that tooth with DI that has wide apex and sinus tract can be treated with non-surgical methods, such as immature tooth without anomalies.

scholarly journals Radiographic characteristics in the periapical healing post endodontic treatment in patients of the Autonomous University of Yucatan, School of Dentistry

Nova Scientia ◽  
2018 ◽  
Vol 10 (21) ◽  
pp. 379-390
Author(s):  
Oscar David Jurado Patrón ◽  
Andrés Vargas López ◽  
Elma María Vega Lizama ◽  
Gabriel Alvarado Cárdenas ◽  
María Eugenia López Villanueva ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Sinus Tract ◽  
Complete Healing ◽  
Endodontic Treatment ◽  
Periapical Lesions ◽  
Periapical Healing ◽  
School Of Dentistry ◽  
One Year ◽  
Causes Of Failure

Introduction: The radiographic control of the root canal treatment can evaluate the healing of the periapical lesions. The objective of this study was to determinate the characteristics of the radiographic healing that was observed after one year, during follow-up sessions; so, the healing of the lesions according to the periapical pathology at the beginning of the treatment and the causes of failure of the endodontic treatments were recorded.Method: This is a prospective, observational, descriptive and longitudinal study, carried out in patients who attended control one year after endodontic treatment through the Periapical Index (PAI).Results: A total of 395 teeth of patients who underwent endodontic treatment one year prior to data collection, 87 presented radiogaphically observable periapical lesions; of these, 40 (45.97%) attended the control at one year. The frequency of cases in which some degree of radiographic healing was observed one year after treatment was 97.46%. The pathology with more cases of complete healing was periodontitis with sinus tract. In general, 84.61% of the cases decreased two levels in their PAI after one year. The 100% of the cases of failure presented vertical root fractures.Conclusion: The frequency of periapical healing after endodontic treatment is high. The main cause for the failure of the treatments documented in this study was the lack of coronal restoration that caused vertical fractures.

scholarly journals Late endodontic treatment of a tooth with extrusive dislocation and invasive cervical resorption: a clinical case report

2021 ◽  
Vol 10 (12) ◽  
pp. e139101220061
Author(s):  
Ana Paula Fernandes Ribeiro ◽  
Julia Guerra de Andrade ◽  
Heitor César Maia ◽  
Caroline Loureiro ◽  
Gladiston Willian Lobo Rodrigues ◽  
...  
Keyword(s):  
Root Canal ◽  
Clinical Case ◽  
Glass Ionomer Cement ◽  
Sinus Tract ◽  
Endodontic Treatment ◽  
Radiographic Examination ◽  
Periapical Lesion ◽  
Root Canal Filling ◽  
Recurrent Sinus

This study aims to report the clinical case of a 16 years-old male patient, who attended a private office reporting that at an accident suffered at the age of 10 years-old, which caused extrusive dislocation in both teeth 11 and 21. At that time, the teeth were repositioned, without an adequate follow-up. Upon physical and radiographic examination, the following features were observed: presence of recurrent sinus tract on the vestibular surface, area of ​​external cervical resorption, and a periapical lesion on tooth 21. Endodontic treatments (necropulpectomy) were performed on teeth 11 and 21, with the placement of a root canal dressing of calcium hydroxide and subsequent root canal filling. In addition, soft tissue flap folding was performed to treat the resorption area and to seal it with glass ionomer cement. A 7 months follow-up radiograph shows stabilization in the process of the tooth resorption and remission of the periapical lesion. In conclusion, the endodontic treatment with intracanal medication, and the sealing of the resorption area were successful to preserve the traumatized tooth. In addition, it is noteworthy that following up with the patient after the trauma episode is essential to monitor the pulp vitality of the tooth involved.

scholarly journals Treatment Management With Long Term Follow-Up In Late-Admitted Traumatized Permanent Incisors: Case Series

2021 ◽  
Author(s):  
Ceren Çimen ◽  
Burcu Nihan Yüksel ◽  
Nurhan Özalp
Keyword(s):  
Root Canal ◽  
Case Series ◽  
Endodontic Treatment ◽  
Anterior Teeth ◽  
Long Term Follow Up ◽  
Traumatic Dental Injuries ◽  
Dental Injuries ◽  
Regenerative Endodontic Treatment

Traumatic dental injuries are particularly common in school-age children and often occur in the anterior region. Process management of cases is possible with alternative treatments according to the root development levels. This case series is aimed to present the treatment and 2-year follow-up of permanent anterior teeth with traumatic dental injuries. Case 1: An 8-year-old patient, who had a bicycle accident 20 days earlier, was diagnosed with extrusion of #31. Due to late admission to the clinic, no repositioning procedure was applied to the tooth. Regenerative endodontic treatment was performed. During the radiological follow-up, the apex was closed in the 12th month; however, it was observed that obliteration started in the root canal at the 24th month. The case is still being followed up at regular intervals. Case 2: A 13-year-old patient, who had a traffic accident 3 days prior, was diagnosed with subluxation in #11, and a root fracture was detected in the apical third of #21. In #21, root canal treatment was applied to the coronal part of the fragments. After the diagnosis of pulp necrosis in #11 in the 2nd month of the follow-up period, root canal filling was applied. During the follow-up period, no pathology was detected and no granulation tissue was formed between the fragments in #21. In traumatic dental injuries, long-term follow-up, well-timed endodontic treatments, and material selection play an important role in success. With regenerative endodontic treatment, successful results can be obtained even in treatments applied in late-admitted patients.

scholarly journals Decompression of a Large Periapical Lesion: A Case Report of 4-Year Follow-Up

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Claudio Maniglia-Ferreira ◽  
Fabio de Almeida Gomes ◽  
Marcelo de Morais Vitoriano ◽  
Francisco de Assis Silva Lima
Keyword(s):  
Case Report ◽  
Endodontic Treatment ◽  
Radiographic Examination ◽  
Periapical Lesion ◽  
Periodontal Tissues ◽  
Periapical Granuloma ◽  
Extensive Lesion ◽  
Radiolucent Lesion ◽  
Root Canal System

This case report described the endodontic treatment and decompression of an extensive lesion in the anterior region of the mandible, detected during clinical and radiographic examination, in a patient with a complaint of slight tenderness to palpation in the area of mandibular right lateral incisor and canine. These teeth had been accessed without proper clinical evaluation, and their pulp tissues were exposed. The periodontal tissues were healthy, with no signs of inflammation or fistula. On radiographic examination, a radiolucent lesion with well-defined borders was seen extending from the distal root of mandibular left second premolar to the mesial root of mandibular right second premolar. Central and lateral mandibular left incisors were unresponsive to thermal pulp testing and exhibited coronal discoloration, consistent with a diagnosis of pulp necrosis. Due to persistent discharge from the root canal system during endodontic procedures despite application of intracanal medicament (calcium hydroxide paste), the decision was made to biopsy and decompress the lesion and conclude endodontic treatment. Histopathologic examination revealed a periapical granuloma. After endodontic treatment of the involved teeth, at 4-year clinical and radiographic follow-up, the affected region was almost completely repaired.

Regenerative Endodontic Treatment versus Apical Plug in Immature Teeth: Three-Year Follow-Up

2016 ◽  
Vol 40 (5) ◽  
pp. 356-360 ◽  
Author(s):  
Saeed Asgary ◽  
Mahta Fazlyab ◽  
Ali Nosrat
Keyword(s):  
Endodontic Treatment ◽  
Treatment Protocols ◽  
Anterior Maxilla ◽  
Periapical Lesions ◽  
Cem Cement ◽  
Immature Teeth ◽  
Tooth Discoloration ◽  
History Of ◽  
The Right ◽  
Regenerative Endodontic Treatment

This report compares and evaluates the treatment outcomes of regenerative endodontic treatment and apical plug as two accepted treatment protocols in a pair of necrotic immature maxillary central incisors of a 12-year old female. The patient was referred complaining of a dull pain and swelling in her upper lip area. She had a history of trauma to the anterior maxilla two years earlier. Both teeth were clinically diagnosed with pulp necrosis and periapical radiographs revealed that separate periapical radiolucent lesions surrounded the immature apices of both teeth. The left and right incisors were treated with apical plug and regenerative endodontic treatment, respectively, using calcium-enriched mixture (CEM) cement. The patient was followed-up for three years. During this period, both teeth were clinically asymptomatic and showed complete radiographic healing of the periapical lesions. The right central incisor showed root development. No tooth discoloration was evident. Apexification by apical plug placement and pulp regeneration are both reliable treatments for immature non-vital teeth. In order to choose the right treatment the advantages of either technique should be weighed against its drawbacks. CEM cement can be successfully applied for both purposes. This biomaterial causes less discoloration of the tooth.

scholarly journals Regression of large periapical lesion using calcium hydroxide therapy: a six-year follow-up case report

2015 ◽  
Vol 18 (1) ◽  
pp. 17 ◽  
Author(s):  
Cari Maristela Pieper ◽  
Eliseu Aldrighi Münchow ◽  
Evandro Piva
Keyword(s):  
Case Report ◽  
Calcium Hydroxide ◽  
Root Canal ◽  
Endodontic Treatment ◽  
Maximum Diameter ◽  
Radiographic Analysis ◽  
Periapical Lesion ◽  
Tooth Number ◽  
Radiolucent Lesion

<span>Periradicular lesions occur in non-vital teeth as the result of a chronic aggression by the presence of microorganisms into the root canal, which may appear as a radiolucent lesion in the radiographic exam; treatment varies according to surgical or nonsurgical methods. This case report describes the regression of a periradicular lesion using a nonsurgical endodontic treatment in association with intracanal calcium hydroxide-based medicament. After patient examination and radiographic analysis, a 13 mm (in maximum diameter) radiolucent lesion was observed in tooth number 12. The endodontic treatment was done and Calen-CMCP (S.S. White Artigos Dentários Ltda., Rio de Janeiro, RJ, Brazil) was placed into the root canal, which was changed after every two weeks during two months. It was observed a progressive centrifugal regression of the lesion after every renewing of the medicament. In addition, after six-year follow-up the tooth was still free of re-infection and bone tissue was completely regenerated. In conclusion, calcium hydroxide therapy can conservatively stimulate the regression of large periradicular lesions.</span>

scholarly journals Regenerative Endodontic Treatment of an Infected Immature Dens Invaginatus with the Aid of Cone-Beam Computed Tomography

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Işıl Kaya-Büyükbayram ◽  
Şerife Özalp ◽  
Emre Aytugar ◽  
Seda Aydemir
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Endodontic Treatment ◽  
Cone Beam ◽  
Radiographic Examination ◽  
Periapical Lesion ◽  
Type Iii ◽  
Regenerative Endodontic Treatment ◽  
Dens Invaginatus

Dens invaginatus is a developmental anomaly that results in an enamel-lined cavity intruding into the crown or root before the mineralization phase. This report presents regenerative endodontic treatment of a necrotic immature tooth with Oehler’s type III dens invaginatus of a nine-year-old female patient. A diagnosis of dens invaginatus (Oehler’s type III) and a large periapical lesion was established with the aid of cone-beam computed tomography (CBCT). In the presented case contrary to the classic revascularization protocol, mechanical instrumentation was performed which apparently did not interfere with the regeneration process. After mechanical instrumentation of the invaginated canal by manual K-files, the invaginated canal space was disinfected by triple antibiotic paste followed by blood clot induction from the periapical tissues and the placement of mineral trioxide aggregate. At one-year follow-up, the tooth remained clinically asymptomatic. Radiographic examination revealed complete healing of the periapical lesion. At the 20-month follow-up, the radiographic examination also showed that the open apex was closed and the walls of the root canal were thickened.

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