scholarly journals Immature to Mature - A Predictable Outcome of Two Immature Incisors with 36 Months Follow-Up!

2021 ◽  
Vol 10 (18) ◽  
pp. 1356-1360
Author(s):  
Neeta Surendra Padmawar ◽  
Viddyasagar Prabhakar Mopagar ◽  
Vinay Hanumantrao Vadvadgi ◽  
Sourabh Ramesh Joshi ◽  
Meghna J. Padubidri
Keyword(s):  
Root Development ◽  
Platelet Rich Plasma ◽  
Young Patients ◽  
Treatment Strategies ◽  
Signs And Symptoms ◽  
High Rate ◽  
Permanent Teeth ◽  
Histological Evaluation ◽  
Apical Region ◽  
Regenerative Endodontics

Management of non-vital immature anterior permanent teeth in children remains a challenge in paediatric dentistry and endodontics. Once the tooth becomes non-vital, root development ceases, rendering the tooth weak, and unable to withstand physiological forces of mastication. This results in a high rate of root fracture with poor prognosis in the medium to long term. Despite being endodontically treated, over 50 % of such teeth will be lost in the first 10 years following trauma. Traditional endodontic treatment does not contribute to any quantitative or qualitative increase in root dimensions resulting in life-long oral disability. The advancement in the science of Endodontics - Regenerative Endodontics has revolutionized current treatment strategies in treating the immature non-vital permanent tooth which has overcome the drawbacks of traditional treatment approaches. This report provides an insight view on successful maturogenesis of immature non-vital permanent incisors by induction of intracanal bleeding along with complications endured during the process. Regenerative endodontics is defined as “biologically based procedures designed to replace damaged structures, including dentin and root structures, as well as cells of the pulp - dentin complex”.1 Continued root development and reestablishment of pulp - dentine complex can be achieved by these procedures. Two major concepts in the regenerative endodontics are guided tissue regeneration (GTR) and tissue engineering. The base of these procedures is stem cells which can differentiate into the desired tissue component, growth factors or other tissue - inducing mediators and scaffold.2 Regenerative endodontic procedure (REP) includes induction of intracanal bleeding, placement of platelet rich fibrin (PRF), and platelet rich plasma (PRP). The goals of these procedures were elimination of signs and symptoms, continued root development, apical healing, and positive response to vitality testing. But preparation of PRP and PRF requires withdrawal of blood and sight of syringe can add emotional stress to young patients. Revascularization may be defined as the invagination of undifferentiated periodontal cells from the apical region in immature teeth.3,4 The nature of tissue formed after revascularization is not certain and can be confirmed by histological evaluation. Presence of blood supply is reliable. Revascularization considers only one facet - nature of newly formed tissue thus making term revascularization inaccurate and thus many authors disagreed with this term.5

scholarly journals In–Vivo Clinical Evaluation of Regenerative Endodontics in Immature Necrotic Permanent Teeth With Open Apex

2015 ◽  
Vol 03 (01) ◽  
pp. 026-033
Author(s):  
Prem Lata ◽  
Ajay Chhabra ◽  
Varun Jindal ◽  
Arun Thakur ◽  
Keyword(s):  
Platelet Rich Plasma ◽  
Signs And Symptoms ◽  
Permanent Teeth ◽  
Wall Thickening ◽  
Radiographic Findings ◽  
Regenerative Endodontics ◽  
Anterior Teeth ◽  
Group I ◽  
Significant Difference

Abstract Introduction: This study was conducted to evaluate clinical and radiographic findings induced by revascularization with and without platelet-rich plasma (PRP). Methods: Twenty patients with nonvital, immature anterior teeth were randomly categorized into 2 groups. Subsequent to minimal instrumentation of the root canal, disinfection was achieved with ledermix paste and followed by revascularization with and without PRP in groups 1 and 2, respectively. The cases were followed up clinically and radiographically at 6- and 12-month intervals. Results: Clinically, all cases were asymptomatic with complete resolution of signs and symptoms (except four cases which were considered as dropout). Radiographically, there was no significant difference in periapical healing, apical closure, and dentinal wall thickening in group I in comparison with group II. However, root lengthening was comparable for both of the procedures. Conclusions: Revascularization is a conservative and an effective method for inducing maturogenesis in nonvital, immature teeth. Supplementations with PRP can potentially improve the desired biological outcome of this regenerative procedure.

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.

Regenerative Endodontics

2017 ◽  
Vol 34 (3) ◽  
pp. 161-178 ◽  
Author(s):  
Kristina Feigin ◽  
Bonnie Shope
Keyword(s):  
Patient Selection ◽  
Root Development ◽  
Animal Studies ◽  
Case Reports ◽  
Permanent Teeth ◽  
Regenerative Endodontics ◽  
Successful Case ◽  
Infected Root ◽  
Canal Systems ◽  
Infected Root Canal

Regenerative endodontics has been defined as “biologically based procedure designed to replace damaged structures, including dentin and root structures, as well as cells of the pulp–dentin complex.” This is an exciting and rapidly evolving field of human endodontics for the treatment of immature permanent teeth with infected root canal systems. These procedures have shown to be able not only to resolve pain and apical periodontitis but continued root development, thus increasing the thickness and strength of the previously thin and fracture-prone roots. In the last decade, over 80 case reports, numerous animal studies, and series of regenerative endodontic cases have been published. However, even with multiple successful case reports, there are still some remaining questions regarding terminology, patient selection, and procedural details. Regenerative endodontics provides the hope of converting a nonvital tooth into vital one once again.

scholarly journals Histological Evaluation of the Effect of Platelet-rich Plasma on Pulp Regeneration in Nonvital Open Apex Teeth: An Animal Study

2017 ◽  
Vol 18 (11) ◽  
pp. 1045-1050 ◽  
Author(s):  
Maryam Forghani ◽  
Hamid Jafarzadeh ◽  
Jamileh Ghoddusi ◽  
Amir Maghsudlu ◽  
Amirhossein Jafarian
Keyword(s):  
Animal Study ◽  
Platelet Rich Plasma ◽  
Mineral Trioxide Aggregate ◽  
Nerve Tissue ◽  
Permanent Teeth ◽  
Histological Evaluation ◽  
Chi Square ◽  
Pulp Regeneration ◽  
Suitable Material ◽  
Significant Difference

ABSTRACT Aim Platelet-rich plasma (PRP), which is a concentration of growth factors found in platelets, may be a suitable material for pulp regeneration. The aim of this animal study was a histological evaluation of PRP on pulp regeneration in nonvital teeth with immature apices. Materials and methods A total of 40 premolar dogs’ teeth were chosen for this study. After general anesthesia, the teeth were exposed, and subsequently, pulps were removed and the cavities were opened to the oral cavity. After 2 weeks, root canals were irrigated and disinfected with sodium hypochlorite with noninstrumentation technique, and triple antibiotic paste was placed inside the canals. Cavities were sealed with a temporary restoration. About 4 weeks later, canals were irrigated again and the teeth were randomly divided into three groups. Bleeding was evoked with overinstrumentation, then experimental materials for each group [PRP, mineral trioxide aggregate (MTA), and parafilm respectively] were placed over the bleeding, and orifices were sealed with MTA and glass ionomer. After 3 months, dogs were sacrificed and the teeth were separated from the jaws and sections prepared for histological evaluation. Results Regeneration was shown in 44.7% of the samples. About 47.3% of the samples in the MTA group and 42.1% of the samples in the PRP group showed regeneration; however, no regeneration was observed in the parafilm group. Chi-square test showed no significant difference between groups I and II. The soft regenerative tissue included pulp-like tissue and vessels. Mineralized regenerative tissue included cementumlike, periodontal ligament-like, and bone-like tissues. No normal pulp and nerve tissue were observed. Conclusion Both PRP and MTA may be ideal scaffolds to accelerate the regeneration process. Clinical significance Pulp repair in immature permanent teeth with weak roots has a better outcome than replacement of the pulp with gutta-percha or biomaterials. How to cite this article Ghoddusi J, Maghsudlu A, Jafarzadeh H, Jafarian A, Forghani M. Histological Evaluation of the Effect of Platelet-rich Plasma on Pulp Regeneration in Nonvital Open Apex Teeth: An Animal Study. J Contemp Dent Pract 2017;18(11):1045-1050.

scholarly journals Aortic valve neocuspidization with in-body tissue-engineered autologous membranes: preliminary results in a long-term goat model

2021 ◽  
Author(s):  
Takayuki Kawashima ◽  
Tadashi Umeno ◽  
Takeshi Terazawa ◽  
Tomoyuki Wada ◽  
Takashi Shuto ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Young Patients ◽  
High Rate ◽  
Body Tissue ◽  
Histological Evaluation ◽  
Long Term Outcome ◽  
Severe Aortic Regurgitation ◽  
Autologous Pericardium

Abstract OBJECTIVES Aortic valve neocuspidization has shown satisfactory clinical outcomes; however, autologous pericardium durability is a concern for young patients. This study applied an autologous collagenous membrane (Biosheet®), produced by in-body tissue architecture, to aortic valve neocuspidization and investigated its long-term outcome in a goat model. METHODS Moulds were embedded subcutaneously in 6 goats. After 2 months, Biosheets formed in the moulds. We performed aortic valve neocuspidization using a portion of the sheets with a thickness of 0.20–0.35 mm, measured by optical coherence tomography. Animals were subjected to echocardiography and histological evaluation at 6 months (n = 3) and 12 months (n = 3). As a control, the glutaraldehyde-treated autologous pericardium was used in 4 goats that were similarly evaluated at 12 months. RESULTS All animals survived the scheduled period. At 6 months, Biosheets maintained valve function and showed a regeneration response: fusion to the annulus, cell infiltration to the leaflets and appearance of elastic fibres at the ventricular side. After 12 months, the regenerative structure had changed little without regression, and there was negligible calcification in the 1/9 leaflets. However, all cases had one leaflet tear, resulting in moderate-to-severe aortic regurgitation. In the pericardium group, three-fourths of the animals experienced moderate-to-severe aortic regurgitation with a high rate of calcification (9/12 leaflets). CONCLUSIONS Biosheets may have regeneration potential and anti-calcification properties in contrast to autologous pericardium. However, in order to obtain reliable outcome, further improvements are required to strictly control and optimize its thickness, density and homogeneity.

scholarly journals Regenerative Endodontics – Looking Inward

2020 ◽  
pp. 83-98
Author(s):  
Shivani Mallishery ◽  
Tanvi Shah
Keyword(s):  
Tissue Engineering ◽  
Root Development ◽  
Dental Pulp ◽  
Ex Vivo ◽  
Clinical Success ◽  
Permanent Teeth ◽  
Pulp Tissue ◽  
Regenerative Endodontics ◽  
Regenerative Dentistry

Regenerative endodontics has become a revolutionizing tissue engineering concept in the treatment of immature permanent teeth for over two decades. It has been described as a ‘paradigm shift’ in the treatment of immature teeth, since it fosters continued root maturation. An immature necrotic permanent tooth is usually a result of trauma or infection due to which the tooth becomes non-vital before completing root development. In such cases, the root walls are left thin and weak with an open apex. Traditional apexification procedures may resolve pathology but have not been able to prove tooth survival due to absence of continued root development and risk of root fracture. A successful regenerative endodontic procedure (REP) results in resolution of signs and symptoms of pathology, radiographic signs of healing, proof of continued root development as well as presence of pulp vitality due to the regeneration of pulp tissue in the root canal. Various stem cells, growth factors, scaffolds and suitable environment form the tetrad of elements necessary to induce regeneration of dental pulp. While there has been some success in isolating dental pulp cells with in-vitro experiments, it has been proven to be rather difficult to implement the same in a practical perspective ex vivo. Although there has been clinical success related to REP, histologically they seem to undergo guided endodontic repair rather than true regeneration of physiologic pulp tissue. This review provides an overview of components of tissue engineering, clinical protocol and predictable outcomes for REP and recent advances in regenerative dentistry.

Signs and symptoms of craniomandibular dysfunction in a population of Spanish children

2018 ◽  
Vol 16 (1) ◽  
pp. 24
Author(s):  
Maria Esperanza Sánchez-Sánchez
Keyword(s):  
Signs And Symptoms ◽  
Permanent Teeth ◽  
Tooth Sensitivity ◽  
Craniomandibular Dysfunction ◽  
Teeth Grinding ◽  
Specific Questionnaire ◽  
Other Hand ◽  
Opening And Closing

The craniomandibular dysfunction (CMD) is a pathology that can appear at early ages. In a sample of 36 childrenresiding in Madrid (Spain), of both sexes, with ages between 7 and 13 years, the prevalence of signs and symptomsof CMD was analyzed. For that purpose, we did a dental and muscular examination, together with temporomandibularjoints, functional and occlusal examination, and completed with a specific questionnaire. The results revealedthat 100% showed some sign or sympthom of CMD. 77,8% of the pacients presented 3 or more CMD signs.The most prevalent were painful muscle palpation (94,4%), together with sliding anteriorly (91,7%), painful jointpalpation (69,4%), wear facets in permanent teeth (41,7%) and altered opening and closing trayectory (38,9%). Onthe other hand, only 38,9% showed any CMD symptom. The most prevalent symptoms were night teeth grinding(27,8%), followed by tooth sensitivity (19,4%) and fullness in the ears (16,7%). We conclude that in our sample,25% presented mild CMD (less that 3 signs or symptoms), 58,3% presented moderate CMD (from 3 to 6 signs orsymptoms) and 16,7% showed severe CMD (more than 6 symptoms). Nevertheless, it’s important to remark thatnone of these pacients came seeking treatment for his CMD and these symptoms were refered only when beingasked. Hence the importance of a comprehensive clinic history to precociously diagnose this pathology and havethe ability to prevent its progression.

Treatment of Anderson-Fabry Disease

2020 ◽  
Vol 26 (40) ◽  
pp. 5089-5099 ◽  
Author(s):  
Irene Simonetta ◽  
Antonino Tuttolomondo ◽  
Mario Daidone ◽  
Salvatore Miceli ◽  
Antonio Pinto
Keyword(s):  
Fabry Disease ◽  
Treatment Strategies ◽  
Signs And Symptoms ◽  
Current Treatment ◽  
Viral Gene ◽  
Pharmacological Chaperone ◽  
Enzyme Replacement ◽  
Cell Based Therapy ◽  
Organ Manifestations ◽  
Alpha Galactosidase

: Fabry disease is an X-linked disorder of glycosphingolipid metabolism that results in progressive accumulation of neutral glycosphingolipids, predominantly globotriaosylsphingosine (Gb3) in lysosomes, as well as other cellular compartments of several tissues, causing multi-organ manifestations (acroparesthesias, hypohidrosis, angiokeratomas, signs and symptoms of cardiac, renal, cerebrovascular involvement). Pathogenic mutations lead to a deficiency of the lysosomal enzyme alpha-galactosidase A (GLA). In the presence of high clinical suspicion, a careful physical examination and specific laboratory tests are required. Finally, the diagnosis of Fabry’s disease is confirmed by the demonstration of the absence of or reduced alpha-galactosidase A enzyme activity in hemizygous men and gene typing in heterozygous females. Measurement of the biomarkers Gb3 and Lyso Gb3 in biological specimens may facilitate diagnosis. The current treatment of Anderson-Fabry disease is represented by enzyme replacement therapy (ERT) and oral pharmacological chaperone. Future treatments are based on new strategic approaches such as stem cell-based therapy, pharmacological approaches chaperones, mRNA therapy, and viral gene therapy. : This review outlines the current therapeutic approaches and emerging treatment strategies for Anderson-Fabry disease.

Motor Recovery after Chronic Spinal Cord Transection in Rats: A Proof-of-Concept Study Evaluating a Combined Strategy

2019 ◽  
Vol 18 (1) ◽  
pp. 52-62 ◽  
Author(s):  
Antonio Ibarra ◽  
Erika Mendieta-Arbesú ◽  
Paola Suarez-Meade ◽  
Elisa García-Vences ◽  
Susana Martiñón ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Treatment Strategies ◽  
Chronic Phase ◽  
Motor Recovery ◽  
Neural Regeneration ◽  
Histological Evaluation ◽  
Control Group ◽  
Proof Of Concept ◽  
Sprague Dawley ◽  
Concept Study

Background: The chronic phase of Spinal Cord (SC) injury is characterized by the presence of a hostile microenvironment that causes low activity and a progressive decline in neurological function; this phase is non-compatible with regeneration. Several treatment strategies have been investigated in chronic SC injury with no satisfactory results. OBJECTIVE- In this proof-of-concept study, we designed a combination therapy (Comb Tx) consisting of surgical glial scar removal plus scar inhibition, accompanied with implantation of mesenchymal stem cells (MSC), and immunization with neural-derived peptides (INDP). Methods: This study was divided into three subsets, all in which Sprague Dawley rats were subjected to a complete SC transection. Sixty days after injury, animals were randomly allocated into two groups for therapeutic intervention: control group and animals receiving the Comb-Tx. Sixty-three days after treatment we carried out experiments analyzing motor recovery, presence of somatosensory evoked potentials, neural regeneration-related genes, and histological evaluation of serotoninergic fibers. Results: Comb-Tx induced a significant locomotor and electrophysiological recovery. An increase in the expression of regeneration-associated genes and the percentage of 5-HT+ fibers was noted at the caudal stump of the SC of animals receiving the Comb-Tx. There was a significant correlation of locomotor recovery with positive electrophysiological activity, expression of GAP43, and percentage of 5-HT+ fibers. Conclusion: Comb-Tx promotes motor and electrophysiological recovery in the chronic phase of SC injury subsequent to a complete transection. Likewise, it is capable of inducing the permissive microenvironment to promote axonal regeneration.

scholarly journals Possible tics diagnosed as stereotypies in patients with severe autism spectrum disorder: a video-based evaluation

2020 ◽  
Author(s):  
Cristiano Termine ◽  
Enzo Grossi ◽  
Valentina Anelli ◽  
Ledina Derhemi ◽  
Andrea E. Cavanna
Keyword(s):  
Autism Spectrum Disorder ◽  
Rating Scale ◽  
Young Patients ◽  
Autism Spectrum ◽  
Repetitive Behaviors ◽  
Spectrum Disorder ◽  
High Rate ◽  
Video Recordings ◽  
Significant Difference ◽  
Severe Autism

Abstract Background The association of stereotypies and tics is not rare in children with severe autism spectrum disorder (ASD). The differential diagnosis between stereotypies and tics in this patient population can be difficult; however, it could be clinically relevant because of treatment implications. Methods A total of 108 video recordings of repetitive behaviors in young patients with stereotypies in the context of ASD were reviewed by a movement disorders expert and a trainee, in order to assess the prevalence of possible co-morbid tics. The Modified Rush Videotape Rating Scale (MRVS) was used to rate tic frequency and severity. Results Out of 27 patients with stereotypies (24 males; mean age 14 years), 18 (67%) reported possible tics. The most frequently observed tics were eye blinking, shoulder shrugging, neck bending, staring, and throat clearing. The mean MRVS score was 5, indicating mild tic severity. The only significant difference between patients with tics and patients without tics was the total number of stereotypies, which was higher in the subgroup of patients without tics (p = 0.01). Conclusions Expert review of video-recordings of repetitive behaviors in young patients with ASD and stereotypies suggests the possibility of a relatively high rate of co-morbid tics. These findings need to be integrated with a comprehensive clinical assessment focusing on the diagnostic re-evaluation of heterogeneous motor manifestations.

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