scholarly journals Pulp revascularization: an alternative treatment to the apexification of immature teeth

2014 ◽  
Vol 62 (4) ◽  
pp. 401-410
Author(s):  
Maria Tereza Pedrosa ALBUQUERQUE ◽  
Juliana Yuri NAGATA ◽  
Adriana de Jesus SOARES ◽  
Alexandre Augusto ZAIA
Keyword(s):  
Calcium Hydroxide ◽  
Alternative Treatment ◽  
Treatment Protocols ◽  
Immature Teeth ◽  
Hygroscopic Properties ◽  
Proteolytic Activities ◽  
New Treatment ◽  
Treatment Alternatives ◽  
Pulp Revascularization

Pulp revascularization can be considered as a current alternative treatment to apexification, recommended for immature teeth cases, requiring endodontic treatment. Apexification involves long-term periodic exchanges of a calcium hydroxide paste into the root canal to induce the formation of a calcified barrier. Despite being the most classically therapy employed for these cases, the permanence of calcium hydroxide for long periods of time and also the successive changes may lead to a weakening of the root due to its hygroscopic properties and the proteolytic activities of calcium hydroxide, increasing the risk of fractures and contamination of the pulp space. Thus, a constant search for new treatment alternatives that provide the end of root development have been done to avoid the risk of future root fractures. So, revascularization has emerged as a new treatment option for cases of undeveloped teeth, that provides not only apical closure, as apexification, but also increase the dentin walls thickness. In the literature, there is an assortment of treatment protocols employing pulp revascularization procedure in attempt to attain the best way to achieve success. Assuming the diversity of protocols for revascularization treatment, it is important to go deep in the literature to collect, describe and discuss these protocols guiding new researches in this field and also conducting the clinicians. Therefore, this review aims to assess the literature on the different revascularization protocols.

scholarly journals Pulp Revascularization: A Literature Review

2017 ◽  
Vol 10 (1) ◽  
pp. 48-56 ◽  
Author(s):  
Pollyana Rodrigues de Souza Araújo ◽  
Luciano Barreto Silva ◽  
Alexandrino Pereira dos Santos Neto ◽  
José Alcides Almeida de Arruda ◽  
Pâmella Recco Álvares ◽  
...  
Keyword(s):  
Literature Review ◽  
Calcium Hydroxide ◽  
Traditional Treatment ◽  
Treatment Protocols ◽  
Immature Teeth ◽  
Hygroscopic Properties ◽  
Time Period ◽  
Long Time ◽  
Proteolytic Activities ◽  
Pulp Revascularization

Reestablishing blood flow and allowing the continuation of root development are some of the objectives of pulp revascularization. This procedure is currently indicated for teeth with incomplete root formation as an alternative to the traditional treatment of apecification, which consists of inserting calcium hydroxide paste into the root canal for a determined time period in order to induce the formation of a calcified barrier. Although it is considered as the most classically employed therapy, the permanence of the paste for long time periods may lead to the weakening of the root due to hygroscopic properties, as well as proteolytic activities of calcium hydroxide. Therefore, there has been a permanent search for alternatives which allow the full development of immature teeth. Revascularization has emerged as such an alternative, and a range of treatment protocols can be found in the scientific literature. The aim of this paper is to accomplish a literature review concerning this issue.

scholarly journals Pulp Revascularization of Immature Permanent Teeth: A Review of the Literature and a Proposal of a New Clinical Protocol

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Mélanie Namour ◽  
Stephanie Theys
Keyword(s):  
Treatment Method ◽  
Permanent Teeth ◽  
Clinical Protocol ◽  
Therapeutic Success ◽  
Immature Teeth ◽  
Triple Antibiotic Paste ◽  
New Treatment ◽  
Near Future ◽  
Pulp Revascularization ◽  
Stimulation Of

Tissue engineering is a growing field. In the near future, it will probably be possible to generate a complete vital tooth from a single stem cell. Pulp revascularization is dependent on the ability of residual pulp and apical and periodontal stem cells to differentiate. These cells have the ability to generate a highly vascularized and a conjunctive rich living tissue. This one is able to colonize the available pulp space. Revascularization is a new treatment method for immature necrotic permanent teeth. Up to now, apexification procedures were applied for these teeth, using calcium dihydroxide or MTA to produce an artificial apical barrier. However, the pulp revascularization allows the stimulation of the apical development and the root maturation of immature teeth. Two pulp revascularization techniques are used in the literature, one using calcium dihydroxide and the second using a triple antibiotic paste. Based on these two different pulp revascularization protocols, which obtain the desired therapeutic success, the literature will be reviewed and analyzed according to the relevance of their choice of materials. Based on the literature, we propose a new relevant protocol and a new mixture of antibiotics.

scholarly journals Treatment outcomes of pulp revascularization in traumatized immature teeth using calcium hydroxide and 2% chlorhexidine gel as intracanal medication

2020 ◽  
Vol 28 ◽  
Author(s):  
Andrea Cardoso PEREIRA ◽  
Matheus Lima de OLIVEIRA ◽  
Ana Carolina C. L. CERQUEIRA-NETO ◽  
Brenda P. F. A. GOMES ◽  
Caio Cezar Randi FERRAZ ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Calcium Hydroxide ◽  
Immature Teeth ◽  
Pulp Revascularization ◽  
Chlorhexidine Gel

scholarly journals Apexification with Calcium Hydroxide vs. Revascularization

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
H. Boufdil ◽  
M. Mtalsi ◽  
S. El Arabi ◽  
B. Bousfiha
Keyword(s):  
Calcium Hydroxide ◽  
Clinical Case ◽  
Therapeutic Option ◽  
Pediatric Dentistry ◽  
Therapeutic Options ◽  
Root Structure ◽  
Immature Teeth ◽  
Therapeutic Procedures ◽  
Real Challenge

Treatment of necrotic immature teeth has always been a real challenge for the clinician due to the open apex and weak root structure, which does not allow a conventional endodontic treatment. Several therapeutic options are possible to treat those teeth. Calcium hydroxide apexification is the oldest and most studied therapeutic option, but it has some disadvantages, including the long term of treatment, the possibility of reinfection, and the weakness of the wall. To solve these problems, several authors recommend the revascularization technique. This therapy allows the continuation of root edification with apical closure and thickening of the walls. The aim of our work is to compare the two therapeutic procedures, apexification with calcium hydroxide and revascularization, through a clinical case treated and followed up for 24 months at the pediatric dentistry department in Casablanca, Morocco.

Intentional Replantation of an Immature Incisor with a Transverse Root Fracture and Endo-Perio Condition: 4 Year Follow-Up

2017 ◽  
Vol 41 (3) ◽  
pp. 187-192
Author(s):  
Atsushi Oishi
Keyword(s):  
Calcium Hydroxide ◽  
Root Canal ◽  
Dental Trauma ◽  
Final Diagnosis ◽  
Radiographic Examination ◽  
Initial Examination ◽  
Root Canal Filling ◽  
Root Fracture ◽  
Immature Teeth

This case report describes the importance of continual examination for dental trauma and the efficacy of intentional replantation with retrograde root canal filling for a transverse root fracture in an immature incisor accompanied by subsequent periodontal-endodontic disease. In the treatment of traumatically fractured roots in immature incisors, continual examination is indispensable for the final diagnosis because roots in immature teeth are less calcified, resulting in less detailed radiological examinations. Thus, common dental trauma complications such as pulp necrosis may appear months after the initial examination. Endodontic treatment for transverse root fracture is mainly determined according to radiographic examination findings; for fractured immature roots, apexification with calcium hydroxide of the coronal fragment is generally applied. However, this method requires removal of considerable amounts of enamel and dentin to allow access to the cavity for preparation, which may increase the risk of future fractures. In contrast, intentional replantation with retrograde root canal filling does not require the removal or long-term application of calcium hydroxide. However, it requires careful extraction of the tooth, maintenance of root wetness during the extraoral procedure, rigid splinting, and oral hygiene control. Management of tooth mobility is also important in the post-replantation course.

scholarly journals Liposomal polychemotherapy improves adrenocortical carcinoma treatment in a preclinical rodent model

2014 ◽  
Vol 21 (3) ◽  
pp. 383-394 ◽  
Author(s):  
Constanze Hantel ◽  
Sara Jung ◽  
Thomas Mussack ◽  
Martin Reincke ◽  
Felix Beuschlein
Keyword(s):  
Adrenocortical Carcinoma ◽  
Liposomal Doxorubicin ◽  
Treatment Regimens ◽  
Stage Disease ◽  
Long Term Experiment ◽  
New Treatment ◽  
Treatment Alternatives

Owing to high relapse rates and early metastatic spread, prognosis in adrenocortical carcinoma (ACC) patients remains poor, highlighting the importance of developing new treatment alternatives for them. Recently, polychemotherapy regimens including etoposide, doxorubicin, and cisplatin together with mitotane (EDP-M) have been defined as the standard treatment for late-stage disease patients. Nevertheless, the administration of conventional cytostatic drugs is associated with severe and dose-limiting side effects. In an attempt to optimize existing clinical treatment regimens, in this study, we investigated the therapeutic efficacy of EDP-M in comparison with that of a paclitaxel-modified scheme (paclitaxel, doxorubicin, cisplatin plus mitotane (PDP-M)) in preclinicalin vitroandin vivomodels. In addition, based on an extraordinary uptake phenomenon of liposomes in ACC cells, we further evaluated liposomal variants of these protocols (etoposide, liposomal doxorubicin, liposomal cisplatin plus mitotane (LEDP-M) and nab-paclitaxel, liposomal doxorubicin, liposomal cisplatin plus mitotane (LPDP-M)).In vitro, PDP-M was more potent in the induction of apoptosis and inhibition of cell viability as well as cell proliferation than EDP-M. Following the administration of a single therapeutic cycle, we further demonstrated that LEDP-M and LPDP-M exerted significant antitumoral effectsin vivo, which were not as evident upon EDP-M and PDP-M treatments. These results were confirmed in a long-term experiment, in which the highest and sustained antitumoral effects were observed for LEDP-M. In summary, liposomal cytostatic substances could represent a promising option that deserves testing in appropriate clinical protocols for the treatment of ACC patients.

Long-Term Sustained Disease Control With Immunotherapy in Chemotherapy-Refractory Merkel Cell Carcinoma

2019 ◽  
pp. 8-11
Author(s):  
Deborah Yihler ◽  
Kathrin Vollmer ◽  
Antonio Cozzio
Keyword(s):  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Inadequate Response ◽  
Merkel Cell ◽  
First Line ◽  
Treatment Protocols ◽  
First Line Therapy ◽  
Significant Toxicity ◽  
Clinical Responses

ABSTRACT Merkel cell carcinoma (MCC) is a rare and difficult-to-treat cutaneous malignancy with a poor prognosis. Treatment protocols for localized MCC are well established. Until recently, metastatic MCC has generally been treated with chemotherapy, which was often associated with poor clinical responses and significant toxicity. In this report, the case of a patient with metastatic MCC who received avelumab, an immune checkpoint inhibitor, after an inadequate response to first-line radiotherapy and chemotherapy, is presented. Nine months after the initiation of the treatment with avelumab, the patient achieved a partial remission with no treatment-related adverse events. After a follow-up of 17 months, a systematically ongoing partial response was reported. In conclusion, this case study offers a clinical insight into the patient’s case and highlights the importance of immunotherapy as a first-line therapy for metastatic MCC.

Guideline for the management of long tunnelled external ventricular drains in chronic hydrocephalus

2021 ◽  
Vol 30 (7) ◽  
pp. 416-421
Author(s):  
Phillip Correia Copley ◽  
John Emelifeonwu ◽  
Pasquale Gallo ◽  
Drahoslav Sokol ◽  
Jothy Kandasamy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Care ◽  
Pilocytic Astrocytoma ◽  
Parental Education ◽  
Chronic Hydrocephalus ◽  
Treatment Protocols ◽  
New Approach ◽  
Viable Treatment

This article reports on the journey of a child with an inoperable hypothalamic-origin pilocytic astrocytoma causing hydrocephalus, which was refractory to treatment with shunts, and required a new approach. With multidisciplinary support, excellent nursing care and parental education, the child's hydrocephalus was managed long term in the community with bilateral long-tunnelled external ventricular drains (LTEVDs). This article describes the patient's journey and highlights the treatment protocols that were created to achieve this feat. Despite the difficulties in initially setting up these protocols, they proved successful and thus the team managing the patient proposed that LTEVDs are a viable treatment option for children with hydrocephalus in the context of inoperable tumours to help maximise quality of life.

scholarly journals Massachusetts’ Findings from Statewide Newborn Screening for Spinal Muscular Atrophy

2021 ◽  
Vol 7 (2) ◽  
pp. 26
Author(s):  
Jaime E. Hale ◽  
Basil T. Darras ◽  
Kathryn J. Swoboda ◽  
Elicia Estrella ◽  
Jin Yun Helen Chen ◽  
...  
Keyword(s):  
Spinal Muscular Atrophy ◽  
Newborn Screening ◽  
New England ◽  
Screening Program ◽  
Muscular Atrophy ◽  
Treatment Options ◽  
Newborn Screening Program ◽  
Treatment Protocols ◽  
Screening Algorithm ◽  
New Treatment

Massachusetts began newborn screening (NBS) for Spinal Muscular Atrophy (SMA) following the availability of new treatment options. The New England Newborn Screening Program developed, validated, and implemented a screening algorithm for the detection of SMA-affected infants who show absent SMN1 Exon 7 by Real-Time™ quantitative PCR (qPCR). We screened 179,467 neonates and identified 9 SMA-affected infants, all of whom were referred to a specialist by day of life 6 (average and median 4 days of life). Another ten SMN1 hybrids were observed but never referred. The nine referred infants who were confirmed to have SMA were entered into treatment protocols. Early data show that some SMA-affected children have remained asymptomatic and are meeting developmental milestones and some have mild to moderate delays. The Massachusetts experience demonstrates that SMA NBS is feasible, can be implemented on a population basis, and helps engage infants for early treatment to maximize benefit.

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