scholarly journals Regenerative Endodontics as the Future Treatment of Immature Permanent Teeth

2021 ◽  
Vol 11 (13) ◽  
pp. 6211
Author(s):  
Justyna Zbańska ◽  
Katarzyna Herman ◽  
Piotr Kuropka ◽  
Maciej Dobrzyński
Keyword(s):  
Root Apex ◽  
Endodontic Treatment ◽  
Permanent Teeth ◽  
X Rays ◽  
Important Indicator ◽  
Regenerative Endodontics ◽  
Management Protocol ◽  
Essential Components ◽  
The Future

The regenerative endodontic procedure (REP) is an alternative solution for endodontic treatment of permanent teeth with incomplete root apex development. It results in angiogenesis, reinnervation, and further root formation. Indications for REP include immature permanent teeth with necrotic pulp and inflammatory lesions of the periapical tissues. The main contraindications comprise significant destruction of the tooth tissues and a lack of patient cooperation. We distinguish the following stages of this procedure: disinfection of the canal, delivery of the REP components, closure of the cavity, and follow-up appointments. For effective canal disinfection, the use of both rinsing agents and intracanal medicaments is suggested. Sodium hypochlorite and triple antibiotic paste are used most commonly. Light-activated disinfection is proposed as an alternative method. The prerequisite for the regeneration process of the pulp is the supply of its essential components: stem cells, growth factors, and scaffolds to the canal lumen. Blood clotting, platelet-rich plasma, and platelet-rich fibrin are used for this purpose. For a proper course of REP, it is also necessary to close the tooth canal tightly. For this purpose, mineral trioxide aggregate (MTA), tricalcium silicate (Biodentine), or types of glass ionomer cement are employed. The patient should attend regularly scheduled follow-up appointments and each time undergo a thorough interview, physical and radiological examination. The most important indicator of a successful REP is the continued growth of the root in length and thickness and the closure of the root apex visible on X-rays. Many different proposals for a management protocol have been published; the following paper proposes the authors’ original scheme. Regenerative endodontics is the future of the endodontic treatment of immature permanent teeth; however, it still requires a lot of research to refine and standardize the treatment protocol. The application of tissue engineering methods seems to be promising, also for mature teeth treatment.

scholarly journals Use of Common Inflammatory Markers in the Long-Term Screening of Total Hip Arthroprosthesis Infections: Our Experience

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Gabriele Falzarano ◽  
Antonio Piscopo ◽  
Predrag Grubor ◽  
Giuseppe Rollo ◽  
Antonio Medici ◽  
...  
Keyword(s):  
Orthopedic Implants ◽  
Modern Medicine ◽  
X Rays ◽  
Septic Loosening ◽  
Total Hip ◽  
Reactive Protein ◽  
Essential Components ◽  
Prosthetic Implant

Orthopedic implants have become essential components of modern medicine. The risk of infection of total hip arthroplasty (THA) is 1.5%−2%. Are the C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) good markers for THA infection screenings? From February 2009 to December 2012 at our Department of Orthopedics and Traumatology, 1248 patients were treated with THA. No prosthesis was cemented. All patients received antibiotic prophylaxis. All patients were discharged approximately 7.4 days after surgery with this clinical and radiographic follow-up program at 15 days and 1, 3, 6, 12, 24, and 36 months after surgery. Blood samples to determine ESR, CRP, and PCT values were taken at 1 hour before surgery and 15 days and 1, 3, 6, 12, 24, and 36 months after surgery. During follow-ups there were 22 cases of THA infections; according the Widmer classification, infections are hematogenous ones in 16 cases, late chronic ones in 5 cases, and early postoperative ones in 1 case. In all cases the three markers were considered positive; in 6 cases there were no radiological signs of septic loosening. ESR, CRP, and PCT proved to have a greater diagnostic accuracy than X-rays in predicting late chronic and early postoperative infections. These markers are valuable support for the surgeon in monitoring the prosthetic implant lifespan.

scholarly journals Delayed Replantation of Avulsed Teeth: Two Case Reports

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Selcuk Savas ◽  
Ebru Kucukyilmaz ◽  
Merve Akcay ◽  
Serhat Koseoglu
Keyword(s):  
Case Report ◽  
Treatment Guidelines ◽  
Case Reports ◽  
Prophylactic Antibiotic ◽  
Endodontic Treatment ◽  
Permanent Teeth ◽  
Functional Position

This case report presents two cases of delayed replantation of avulsed maxillary central incisors after an extended dry extra-alveolar period. Eight-year-old boy and 10-year-old boy presented with avulsed maxillary central incisors due to trauma occurring 27 and 7 hours earlier, respectively. Treatment guidelines for avulsed mature/immature permanent teeth with prolonged extra-oral time were carried out for the teeth and the extra-oral endodontic treatment was completed. After having been repositioned, the teeth were stabilized for 4 weeks and prophylactic antibiotic was prescribed. Clinical and radiographic controls were done after 18 months for Case I and 12 months for Case II. During the follow-up periods the teeth reported in these cases have remained in a stable, functional position but revealed clinical initial replacement resorption and ankylosis.

scholarly journals Pulp therapy in immature traumatized incisor using tricalcium silicate cement – a case report

2020 ◽  
Vol 66 (2) ◽  
Author(s):  
Magdalena Gońda-Domin ◽  
Alicja Nowicka ◽  
Karolina Węsierska ◽  
Anna Jarząbek
Keyword(s):  
Present Report ◽  
Tricalcium Silicate ◽  
Endodontic Treatment ◽  
Permanent Teeth ◽  
Timely Manner ◽  
Traumatic Injuries ◽  
Tooth Structure ◽  
Sensitivity Tests ◽  
Irreversible Pulpitis

Introduction: Traumatic injuries to immature permanent teeth are one of the most recurrent and urgent emergency treatment cases in pediatric dental practice. In many instances, the protocol for responding to this kind of emergency is not correct, and is not performed in a timely manner. Delays in seeking treatment following a complicated crown fracture in young individuals can result in irreversible pulpitis or pulp necrosis. It can leave a wide-open apex and brittle dentinal walls that are unfavorable to manage with conventional endodontic treatment (apexification).Materials and methods: The present report describes the clinical case of a complicated crown fracture in young permanent central incisor, with 18 months of clinical and radiographic follow-up. The traumatized incisor was successfully treated using a coronal pulpotomy technique and tricalcium silicate cement – BiodentineTM.Results: The presented treatment approach provided elimination of the symptoms, an absence of pain episodes, and positive reactions to pulp sensitivity tests. The follow up radiological assessment revealed evidence of a dentin bridge formation and continuation of root maturation.Conclusions: Coronal pulpotomies using tricalcium silicate cement are quick and easy to perform, and unlike endodontic treatment, preserve the tooth structure for the reattached tooth fragment. The restorative technique, the reattachment of fractured tooth fragment, and tooth restoration with a composite resin, represents an aesthetic, functional approach, and is an excellent and easy restorative option for clinicians and young impatient patients.Keywords: BiodentineTM; complicated crown fracture; immature permanent teeth; pulpotomy.

scholarly journals A Prospective Study of Long-Term Regenerative Endodontics Outcomes of Necrotic Immature Permanent Teeth: An 8-Year Follow-Up

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1670
Author(s):  
Sawsan T. Abu Zeid ◽  
Ruaa A. Alamoudi ◽  
Osama S. Alothmani ◽  
Abeer A. Mokeem Saleh ◽  
Amna Y. Siddiqui
Keyword(s):  
Prospective Study ◽  
Mineral Trioxide Aggregate ◽  
Qualitative Evaluation ◽  
Permanent Teeth ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Regenerative Endodontics ◽  
Canal Diameter

For the management of necrotic immature teeth, regenerative endodontics offers the advantage of further root lengthening, thickening of dentin wall, and apical closure. This prospective study aimed to evaluate the long-term outcome of regenerative endodontics in immature necrotic permanent teeth. A total of 23 immature roots were medicated by triple antibiotic paste. After 21 days, bleeding was induced by over-instrumentation, and then mineral trioxide aggregate and coronal restoration were applied. Patients were scheduled for clinical and radiographic follow-up for 8 years. The radiographic changes of root dimensions were assessed using the ImageJ Plugin and statistically analyzed by Kruskal–Wallis test at a 95% confidence level. For qualitative evaluation, images were overlapped and analyzed using Photoshop software. All teeth were asymptomatic one month after the treatment. All teeth (n = 18) with preoperative periapical radiolucency showed complete resolution within 6–9 months. Recall rate at two, three, and eight years was 69.6%, 56.5%, and 34.8%, respectively. Continuous root development with a significant increase in root length and thickening of dentin wall accompanied by a significant decrease in apical canal diameter was seen at the end of the observation period (p < 0.001). In conclusion, the long-term outcome of regenerative endodontics revealed successful clinical and radiographic results with appropriate case selection.

scholarly journals Search for the violation of Pauli Exclusion Principle at LNGS

2018 ◽  
Vol 182 ◽  
pp. 02118 ◽  
Author(s):  
H. Shi ◽  
S. Bartalucci ◽  
M. Bazzi ◽  
S. Bertolucci ◽  
A.M. Bragadireanu ◽  
...  
Keyword(s):  
Ground State ◽  
Pauli Exclusion Principle ◽  
Exclusion Principle ◽  
X Rays ◽  
Future Perspectives ◽  
Atomic Transitions ◽  
The Future ◽  
Better Than

In the VIP (VIolation of Pauli exclusion principle) and its follow-up VIP- 2 experiments at the Laboratori Nazionali del Gran Sasso, we test the validity of the Pauli Exclusion Principle, by searching for x-rays from copper atomic transitions from a 2p orbit electron to the ground state which is already occupied by two electrons. Such transitions are prohibited by the Pauli Exclusion Principle. The physics run of the VIP-2 experiment started in late 2016 and will collect data for three years. From the first data taking period of two months we have obtained a new limit better than the VIP result from three years of running. In this article we present the published first physics result from the VIP-2 experiment and discuss about the future perspectives.

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 Nonsurgical endodontic management of dens invaginatus: a report of two cases

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 2039
Author(s):  
Amjad Abu Hasna ◽  
Daniela Maria de Toledo Ungaro ◽  
Allana Agnes Pereira de Melo ◽  
Karen Cristina Kazue Yui ◽  
Eduardo Galera da Silva ◽  
...  
Keyword(s):  
Case Series ◽  
Root Apex ◽  
Endodontic Treatment ◽  
Type Ii ◽  
Treatment Results ◽  
Periapical Lesions ◽  
Complex Anatomy ◽  
Invasive Management ◽  
Dens Invaginatus

Dens invaginatus is a malformation affecting mainly the superior lateral incisors. It is defined as an infolding of the crown hard tissues, including the enamel and dentin, and can extend up to the root apex. Root canal treatment of this abnormality is considered difficult due to the complex anatomy presented by these teeth. This case series presents nonsurgical endodontic treatment in two cases of dens invaginatus (type II and III) in maxillary lateral incisors. This nonsurgical or conventional endodontic treatment results in healing of the periapical lesions associated with both cases, with no need for extra intervention e.g. surgical or invasive management. The manual instrumentation associated with sodium hypochlorite and calcium hydroxide were able to completely heal the lesions.  Radiographic exams were carried out to control and asses the healing. Nonsurgical treatment was successful in both cases with adequate repair after a 6-year follow-up with radiographic and tomographic assessments.

scholarly journals EFICÁCIA DA REVASCULARIZAÇÃO NA FORMAÇÃO DO ÁPICE RADICULAR EM PACIENTES COM RIZOGÊNESE INCOMPLETA: UMA REVISÃO INTEGRATIVA

2021 ◽  
Vol 4 (7) ◽  
pp. 1-10
Author(s):  
Verônica Caroline Brito REIA ◽  
Pedro MOLITOR ◽  
Fernanda Furtado PIRAS ◽  
Marcelo Ueti de CAMARGO ◽  
Miriam Graziele MAGRO
Keyword(s):  
Root Formation ◽  
Web Of Science ◽  
Root Apex ◽  
Permanent Teeth ◽  
Electronic Database ◽  
Periapical Lesion ◽  
X Ray ◽  
Searching Strategy ◽  
Tooth Apex

Objetivos: Verificar a eficácia da revascularização para induzir a continuidade de formação do ápice radicular em pacientes com rizogênese incompleta. Metodologia: A estratégia de busca foi aplicada nas bases de dados eletrônicas PubMed, Embase, Web of Science e LILACS, sendo selecionados quatro artigos publicados entre 2011 e 2021. Resultados: Um total de 27 pacientes diagnosticados com necrose pulpar foi incluído, de ambos os sexos. Os testes de percussão, térmico e elétrico no exame clínico foram realizados em 4 pacientes. Todos os pacientes fizeram radiografia periapical para análise inicial. O tratamento endodôntico foi realizado com indução do sangramento apical do canal radicular para revascularização em todos os estudos. No acompanhamento de até 4 anos, observou-se, radiograficamente, aumento do comprimento e espessura radicular, diminuição e posterior desaparecimento da radioluscência periapical, estreitamento do ápice radicular, desenvolvimento radicular e redução da lesão periapical. Conclusão: A revascularização permite que, mesmo após o estímulo para indução de sangramento, a região periapical continue a formação radicular por mais tempo quando comparada a outros materiais endodônticos.   THE EFFECTIVENESS OF REVASCULARIZATION ON ROOT APEX FORMATION IN PATIENTS WITH IMMATURE PERMANENT TEETH: AN INTEGRATIVE REVIEW   ABSTRACT Objectives: To verify the effectiveness of revascularization to induce further root apex formation in patients with immature permanent teeth. Method: A searching strategy was performed at PubMed, Embase, Web of Science, and LILACS electronic database, four articles issued between 2011 and 2021 were screened. Results:  A total of 27 patients diagnosed with pulp necrosis were included, both genders. Percussion, electric, and thermal pulp testing were performed for clinical examination in those 4 patients. All the patients had a periapical x-ray taken for initial analysis. The endodontic treatment was performed with the apex-induced bleeding into the root canal for the revascularization in all the studies. At a 4-year follow-up it was observed, radiographically, an increase in root length and thickness, and afterward the periapical radiolucency disappearance, the root apex narrowing, root growing, and the periapical lesion reduction. Conclusion: Revascularization enables, even after the stimulus for bleeding induction, the periapical region to further continue the root formation when compared to other endodontic materials.     Descriptors: Endodontics. Pulp Necrosis. Tooth Apex.

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.

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