scholarly journals Regenerative Endodontic Procedures Using Contemporary Endodontic Materials

Materials ◽  
2019 ◽  
Vol 12 (6) ◽  
pp. 908 ◽  
Author(s):  
Simone Staffoli ◽  
Gianluca Plotino ◽  
Barbara Nunez Torrijos ◽  
Nicola Grande ◽  
Maurizio Bossù ◽  
...  
Keyword(s):  
Root Development ◽  
Scientific Literature ◽  
Blood Clot ◽  
Mineral Trioxide Aggregate ◽  
Permanent Teeth ◽  
Root Structure ◽  
Clinical Procedures ◽  
Periodontal Breakdown ◽  
Long Term Prognosis

Calcium hydroxide apexification and Mineral Trioxide Aggregate (MTA) apexification are classical treatments for necrotic immature permanent teeth. The first tend to fail for lack of compliance given the high number of sessions needed; the second has technical difficulties such as material manipulation and overfilling. With both techniques, the root development is interrupted leaving the tooth with a fragile root structure, a poor crown-to-root ratio, periodontal breakdown, and high risk of fracture, compromising long-term prognosis of the tooth. New scientific literature has described a procedure that allows complete root development of these specific teeth. This regenerative endodontic procedure (REP) proposes the use of a combination of antimicrobials and irrigants, no canal walls instrumentation, induced apical bleeding to form a blood clot and a tight seal into the root canal to promote healing. MTA is the most used material to perform this seal, but updated guidelines advise the use of other bioactive endodontic cements that incorporate calcium and silicate in their compositions. They share most of their characteristics with MTA but claim to have fewer drawbacks with regards to manipulation and aesthetics. The purpose of the present article is to review pertinent literature and to describe the clinical procedures protocol with its variations, and their clinical application.

scholarly journals Roles of Dental Mesenchymal Stem Cells in the Management of Immature Necrotic Permanent Teeth

2021 ◽  
Vol 9 ◽  
Author(s):  
Dixin Cui ◽  
Sihan Yu ◽  
Xin Zhou ◽  
Ying Liu ◽  
Lu Gan ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Root Development ◽  
Animal Studies ◽  
Permanent Teeth ◽  
Large Animal ◽  
Periapical Lesion ◽  
Traditional Treatment ◽  
Long Term Prognosis

Dental caries and trauma always lead to pulp necrosis and subsequent root development arrest of young permanent teeth. The traditional treatment, apexification, with the absence of further root formation, results in abnormal root morphology and compromises long-term prognosis. Regeneration endodontics procedures (REPs) have been developed and considered as an alternative strategy for management of immature permanent teeth with pulpal necrosis, including cell-free and cell-based REPs. Cell-free REPs, including revascularization and cell homing with molecules recruiting endogenous mesenchymal stem cells (MSCs), have been widely applied in clinical treatment, showing optimistic periapical lesion healing and continued root development. However, the regenerated pulp–dentin complex is still absent in these cases. Dental MSCs, as one of the essentials of tissue engineering, are vital seed cells in regenerative medicine. Dental MSC–based REPs have presented promising potential with pulp–dentin regeneration in large animal studies and clinical trials via cell transplantation. In the present review, we summarize current understanding of the biological basis of clinical treatments for immature necrotic permanent teeth and the roles of dental MSCs during this process and update the progress of MSC-based REPs in the administration of immature necrotic permanent teeth.

scholarly journals Regenerative endodontic procedures: a review of the literature and a case report of an immature central incisor

2017 ◽  
Vol 31 (2) ◽  
pp. 65-72 ◽  
Author(s):  
Marc Llaquet ◽  
Montse Mercadé ◽  
Gianluca Plotino
Keyword(s):  
Case Report ◽  
Root Growth ◽  
Blood Clot ◽  
Setting Time ◽  
Mineral Trioxide Aggregate ◽  
Complete Healing ◽  
Permanent Teeth ◽  
Central Incisor ◽  
Current Case ◽  
Tooth Discoloration

Background: Trauma of developing teeth may lead to pulpal necrosis with subsequent arrestment of root development, making them more susceptible to fracture. Regenerative endodontic procedures induce maturogenesis in necrotic immature permanent teeth in order to promote continuation of root growth. Mineral trioxide aggregate (MTA) is widely used as a blood clot protecting material, although it presents a potential drawback of discoloration. Biodentine is a tricalcium silicate cement with adequate bioactive properties that solve the problem of discoloration. Case report: The current case report demonstrates a maturogenesis of an upper central incisor with chronic apical abscess. Calcium hydroxide was used as intracanal medicament for a week. After a blood clot was formed, Biodentine was placed over it. Periapical healing and root growth were evident at 6 months follow-up. Cone Beam Computed Tomography (CBCT) confirmed apical closure and complete healing at 1 year. Key-learning points: Apical closure of necrotic immature permanent teeth is possible by means of regenerative endodontic procedure.Regenerative endodontic procedure with Biodentine has some advantages over that performed with MTA: No tooth discoloration, hort setting time, asy manipulation. CBCT is the best technique to evaluate root canal growth (length and wide).

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.

APEXIFICATION REVISITED

2021 ◽  
pp. 68-71
Author(s):  
Jaziya Z ◽  
Suchithra M S ◽  
Rita Zarina A ◽  
Fathima. S
Keyword(s):  
Calcium Hydroxide ◽  
Mineral Trioxide Aggregate ◽  
Permanent Teeth ◽  
Survival Prognosis ◽  
Crown Root ◽  
The Past ◽  
Regenerative Endodontics ◽  
Open Apices ◽  
Thin Walled

Pulpal necrosis in permanent teeth with immature roots leads to development of roots which are very short, thin walled and an inadequate crown-root ratio, which overshadows their survival prognosis. Traditionally, the apexication procedure has consisted of multiple and long-term applications of calcium hydroxide to create an apical barrier to aid the obturation. Recently, articial apical barriers such as those made with mineral trioxide aggregate (MTA) have been used in teeth with necrotic pulps and open apices. More recently, procedures referred to as regenerative endodontics have received much attention as an option for these teeth. This paper reviews the past, present and recent concepts used for apexication.

Dental Pulp Revascularization of Necrotic Permanent Teeth with Immature Apices

2016 ◽  
Vol 40 (5) ◽  
pp. 361-366 ◽  
Author(s):  
Eman A El Ashiry ◽  
Najat M Farsi ◽  
Sawsan T Abuzeid ◽  
Mohamed M El Ashiry ◽  
Hammam A Bahammam
Keyword(s):  
Root Canal ◽  
Blood Clot ◽  
Mineral Trioxide Aggregate ◽  
Pediatric Dentistry ◽  
Sinus Tract ◽  
Apical Periodontitis ◽  
Permanent Teeth ◽  
Revascularization Procedure ◽  
Underlying Mechanisms ◽  
Pulp Revascularization

Objectives: The treatment of immature necrotic teeth with apical periodontitis presents challenges in endodontic and pediatric dentistry. Revascularization is a recent treatment for such cases as an alternative to conventional apexification. The purpose is to examine the effect of a pulpal revascularization procedure on immature necrotic teeth with apical periodontitis. Study design: Twenty patients were enrolled for pulp revascularization procedure by root canal disinfection using a triple antibiotic mixture for 1–2 weeks, followed by creating a blood clot, sealing the root canal orifice using white mineral trioxide aggregate and a coronal seal of composite resin. Patients were recalled periodically for up to 24 months. Results: During follow-up, all patients were asymptomatic. Three cases of chronic apical periodontitis showed clinical disappearance of the sinus tract 2 weeks after treatment. Radiography revealed progressive periapical radiolucency resolution within the first 12 months. Within 12–24 months, the treated teeth showed progressive increases in dentinal wall thickness, root length and continued root development. Conclusions: Clinical and radiographic evidence showed successful revascularization treatments of immature necrotic permanent teeth with apical periodontitis. More studies are necessary to understand the underlying mechanisms and to perform histopathology of the pulp space contents after revascularization procedures.

Management of traumatised maxillary central incisor with immature open apex using mineral trioxide aggregate and tailor made gutta percha: a case report

2017 ◽  
Vol 5 (3) ◽  
pp. 1151
Author(s):  
Suvarna Patil ◽  
Upendra Hoshing ◽  
Sharanappa Kambale ◽  
Sharanappa Kambale ◽  
Ruchika Gupta ◽  
...  
Keyword(s):  
Case Report ◽  
Root Development ◽  
Treatment Time ◽  
Mineral Trioxide Aggregate ◽  
Permanent Teeth ◽  
Central Incisor ◽  
Successful Management ◽  
Maxillary Central Incisor ◽  
Gutta Percha ◽  
Alternative Material

Root development and apex closure after the eruption of teeth takes a minimum of 3-4 years. If trauma to the pulp occurs during this period, it becomes a challenge for the clinician to treat the pulpal injury. Apexification is the treatment of choice for necrotic teeth with immature apex. Apexification done with calcium hydroxide encounters certain difficulties like very long treatment time, possibility of tooth fracture and incomplete calcification of the bridge. Mineral trioxide aggregate (MTA) was introduced as an alternative material to traditional materials for the apexification of immature permanent teeth. This case report presents successful management of a case with open apex using MTA followed by Tailor made gutta-percha.

scholarly journals Revascularization of immature non-vital permanent teeth - literature review and a case study

Folia Medica ◽  
2013 ◽  
Vol 55 (3-4) ◽  
pp. 11-16
Author(s):  
Yordan D. Tarpomanov ◽  
Maria P. Kukleva
Keyword(s):  
Literature Review ◽  
Root Development ◽  
Blood Clot ◽  
Permanent Tooth ◽  
Permanent Teeth ◽  
Modern Concept ◽  
Clinical Protocols ◽  
Radiological Data ◽  
One Year

ABSTRACT Apical periodontitis in permanent children’s teeth with incomplete root development is a challenge for endodontists to treat. It is important that highly efficient therapeutic methods and biologically valuable therapies be developed to prevent the loss of these teeth. The AIM of the study was to review modern literature on revascularization of non-vital permanent teeth with incomplete root development, and to present a clinical case. The literature review herein reflects the modern concept of revascularization of non-vital permanent teeth with incomplete root development. Clinical protocols are presented on cases with and without the formation of a blood clot. The case study reports the treatment of an immature non-vital permanent tooth using the technique of revascularization that utilises formation of a blood clot and use of a two-component antibiotic paste for disinfection. One year after treatment the clinical and radiological data showed absence of subjective complaints, thickening of the root walls, apical closure and no periapical pathology of the revascularized tooth. Literature data and the favorable outcome of our case allow us to further research the revascularization of immature non-vital permanent teeth.

Revascularızatıon/Regeneratıon Performed in Immature Molars: Case Reports

2013 ◽  
Vol 37 (3) ◽  
pp. 231-234 ◽  
Author(s):  
IS Sönmez ◽  
A Akbay Oba ◽  
M Erkmen Almaz
Keyword(s):  
Root Development ◽  
Case Reports ◽  
Blood Clot ◽  
Mineral Trioxide Aggregate ◽  
Apical Periodontitis ◽  
Permanent Molar ◽  
Molar Teeth ◽  
Mp Method

These 3 case reports the outcome of revascularization treatment in necrotic immature molars. During treatment, a tri antibiotic mix was used to disinfect the pulp for 2 weeks. Then a blood clot was created in the canal, over which mineral trioxide aggregate was placed. After 24 months, the immature molars showed continuation of root development. The patients were asymptomatic, no sinus tracts were evident and apical periodontitis was resolved. Results from these cases show that revascularization/regeneration using 3Mix-MP method could be effective for managing immature permanent molar teeth with pulpal necrosis.

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