scholarly journals Revascularization versus apical barrier technique with mineral trioxide aggregate plug: A systematic review

2018 ◽  
Vol 32 (1) ◽  
pp. 9-16 ◽  
Author(s):  
Luiz Alexandre Chisini ◽  
Guillermo Grazioli ◽  
Alejandro Francia ◽  
Alissa Schmidt San Martin ◽  
Flavio Fernando Demarco ◽  
...  

Aim: To compare the clinical and radiographic outcomes observed in Necrotic Immature Permanent Teeth (NIPT) after revascularization or apexification with MTA-apical plug. Methodology: PubMed/MEDLINE, Web of science and Scopus were the databases used, up to July 30th, 2017, for article research. Independent reviewers read the titles and abstracts of all reports that met inclusion/exclusion criteria: prospective or retrospective clinical studies comparing the revascularization of root canal and apexification. Clinical success of therapies, deposition and thickening of lateral dentinal walls (root width) and the continuation of root development (root length) were investigated. Bias risk of included studies was assessed using the Cochrane risk of bias. Results: From 1642 records, five papers fulfilled all inclusion criteria. Overall, 91 teeth were submitted to revascularization and 64 teeth to apexification with MTA. The mean follow-up was 23.2 months in revascularization and 21.8 in apexification. Clinical success rate was of 87.9% in the revascularization group and 90.6% in the apexification group. An increase on lateral dentinal walls thickening was observed in most revascularization cases (13%) while MTA as apical plug suggest a mild resorption of the root (1.3%). High bias risk was observed on included studies. Conclusions: Apexification with MTA-apical plug provides similar clinical success to revascularization. However, radiographic measurements showed an improvement in thickening of lateral dentinal walls in most of the revascularization cases in addition to a higher dental development. However, these results should be interpreted with caution.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Selvakumar Kritika ◽  
V. Sujatha ◽  
N. Srinivasan ◽  
Senthil Kumar Renganathan ◽  
Sekar Mahalaxmi

AbstractRegenerative endodontic procedures have gained momentum as a treatment modality of young immature permanent teeth. Literature reports reveal that platelet-rich fibrin (PRF) stimulates growth factors and induces regeneration. This study was undertaken to assess the regenerative potential of non-vital immature permanent maxillary central incisors using PRF with a follow-up for 2 yrs. 19 patients in the age group of 9–25 yrs with immature, non-vital permanent maxillary central incisors (n = 23) with/without signs and/or symptoms of periapical pathosis and open apex were included in this study. In the first appointment, access opening, canal disinfection and triple antibiotic paste placement were done. In the subsequent visit, PRF was prepared and placed inside the canal. Access was sealed with Mineral trioxide aggregate plug and composite. The patient was reviewed up to 24 mths. The mean difference was statistically analyzed using Friedman test followed by Dunn post hoc test and adjusted by Bonferroni correction (p < 0.05). As per AAE guidelines, the primary and secondary goals were achieved. A significant (p < 0.001) gradual increase in the root length, thickness of dentinal walls and decrease in apical diameter were observed. Within the limitations of this study, PRF placement was clinically and radiographically effective in inducing regeneration of non-vital immature permanent teeth.


2013 ◽  
Vol 24 (1) ◽  
pp. 8-11
Author(s):  
Md Nurul Afsar Badrul ◽  
Kamal Ahmed ◽  
Sufia Rahman

Since its introduction in 1977, Percutaneous Coronary  Interventions (PCI) is an important tool in the treatment of  coronary artery disease (CAD). It is a retrospective analysis  of data of 100 cases (132 vessels). The mean age was 50.9  years (range 30-70) with 90 (90%) male and 10 (10%) female.  Indication of PCI includes acute and old MI, Chronic stable  angina and unstable angina were 48 (48%), 33 (33%) and  19(19%) respectively. Procedure done in total 132 vessels  among 100 patients. most of the cases were single vessels  disease (SVD) {68 (68%} followed by double vessel disease  (DVD) {30(30%)} , triple vessel disease (TVD) {02 (02%)}  and chronic total occlusion (CTO) {02 (02%)}.Cobalt  chromium was commonly used stent (117 (88.6%) followed by  drug illuting stent (DES) 12 (9.1%) and bare metal stent  (BMS) 3 (2.3%). Among the site of the stent insertion left  anterior descending (LAD) 62 (47%), right coronary lesion  (RCA) 37 (28), left circumplex artery (LCX) 33  (25%).Maximum stent length was 35 mm, minimum 10mm.  Maximum stent diameter was 3.5 mm whereas minimum  diameter 2.5 mm. The mean pretreatment reference diameter  was 2.55 ± 0.20 mm and post treatment diameter 2.70 ± 0.45  mm. Angiographic, procedural and clinical success rate were  100%, 98% and 98% respectively. Major adverse  cardiovascular event (MACE) {periprocedural MI} occurred  in 2 (02 %) cases. Minor cardiovascular complications  revealed vascular haematoma 2 (02%), bleeding from access  site in 1 (01%), transient ventricular fibrillation (VF) in 3  (03%) cases. There was no hospital death, emergency CABG  before discharge from hospital. Angiographic, procedural and  clinical success rate were excellent with a little MACE and  event free survival within 30 days follow up. So, PCI is a safe  and effective method of myocardial revascularization  irrespective of lesion morphology and type of stents used at  immediate and 30 days follow up. DOI: http://dx.doi.org/10.3329/medtoday.v24i1.14106 Medicine TODAY Vol.24(1) 2012 pp.8-11


2012 ◽  
Vol 37 (2) ◽  
pp. 143-147 ◽  
Author(s):  
P Airen ◽  
A Shigli ◽  
B Airen

Aim: The aim of the present study was to clinically and radiographically evaluate Mineral Trioxide Aggre-gate (MTA) as an agent for pulpotomy in primary teeth and to compare it with that of Formocresol (FC) pulpotomy. Method: Seventy first and second primary mandibular molars of children were chosen on patients who required minimum two pulpotomies in either arch or same arch. After the standardized technique of Pulpotomy with MTA and Formocresol, all molars were treated with a thick mix of Zinc oxide Eugenol cement into the coronal pulp chamber followed by preformed stainless steel crown. The children were followed up for clinical and radio graphical examination after 6,12 and 24 month for Pain, Swelling, Sinus/ fistula, Periapical changes, Furcation radiolucency and internal resorption. Results: MTA represents 97% clinical success rate in comparison to Formocresol with 85% success. Radiographically also MTA showed more promising results with 88.6% success in comparison to Formocresol with 54.3%. Conclusions: Thus, MTA pulpotomy has emerged as an easier line of treatment to save the premature loss of primary teeth due to caries or trauma.


2021 ◽  
Author(s):  
Kritika Selvakumar ◽  
Sujatha V ◽  
Srinivasan N ◽  
Senthil Kumar Renganathan ◽  
Sekar Mahalaxmi

Abstract Regenerative endodontic procedures has gained momentum as a treatment modality of young immature permanent teeth. Literature reports reveal that platelet rich fibrin (PRF) stimulates growth factors and induces regeneration. This study was undertaken to assess the regenerative potential of non-vital immature permanent maxillary central incisors using PRF with a follow up for 2yrs. 19 patients in the age group of 9-25yrs with immature, non-vital permanent maxillary central incisors (n=23) with/without signs and/or symptoms of periapical pathosis and open apex were included in this study. In the first appointment, access opening, canal disinfection and triple antibiotic paste placement was done. In the subsequent visit, PRF was prepared and placed inside the canal. Access was sealed with Mineral trioxide aggregate plug and composite. The patient was reviewed upto 24mths. The mean difference was statistically analysed using Friedman test followed by Dunn post hoc test and adjusted by Bonferroni correction (p<0.05). As per AAE guidelines, the primary and secondary goals were achieved. A significant (p<0.001) gradual increase in the root length, thickness of dentinal walls and decrease in apical diameter were observed. Within the limitations of this study, PRF placement was clinically and radiographically effective in inducing regeneration of non-vital immature permanent teeth.


2020 ◽  
Vol 32 (3) ◽  
pp. 335-343
Author(s):  
Benedikt W. Burkhardt ◽  
Andreas Simgen ◽  
Gudrun Wagenpfeil ◽  
Philipp Hendrix ◽  
Matthias Dehnen ◽  
...  

OBJECTIVEThere is currently no consensus on whether adjacent-segment degeneration (ASD), loss of disc height (DH), and loss of sagittal segmental angle (SSA) are due to anterior cervical discectomy and fusion (ACDF). The purpose of the present study was to assess the grade of segmental degeneration after ACDF and to analyze if there is a difference with respect to clinical outcome, diagnosis, and number of operated levels.METHODSA total of 102 patients who underwent ACDF with a minimum follow-up of 18 years were retrospectively identified. At final follow-up, the clinical outcome according to Odom’s criteria, the Neck Disability Index (NDI), and reoperation for symptomatic ASD (sASD) was assessed. MRI was performed, and DH, SSA, and the segmental degeneration index (SDI, a 5-step grading system that includes disc signal intensity, anterior and posterior disc protrusion, narrowing of the disc space, and foraminal stenosis) were assessed for evaluation of the 2 adjacent and 4 adjoining segments to the ACDF. MRI findings were compared with respect to clinical outcome (NDI: 0%–20% vs > 20%; Odom’s criteria: success vs no success), reoperation for sASD, initial diagnosis (cervical disc herniation [CDH] vs cervical spondylotic myelopathy [CSM] and spondylosis), and the number of operated levels (1 vs 2–4 levels).RESULTSThe mean follow-up was 25 years (range 18–45 years), and the diagnosis was CDH in 74.5% of patients and CSM/spondylosis in 25.5%. At follow-up, the mean NDI was 12.4% (range 0%–36%), the clinical success rate was 87.3%, and the reoperation rate for sASD was 15.7%. For SDI, no significant differences were seen with respect to NDI, Odom’s criteria, and sASD. Patients diagnosed with CDH had significantly more degeneration at the adjacent segments (cranial, p = 0.015; caudal, p = 0.017). Patients with a 2- to 4-level procedure had less degeneration at the caudal adjacent (p = 0.011) and proximal adjoining (p = 0.019) segments. Aside from a significantly lower DH at the proximal cranial adjoining segment in cases of CSM/spondylosis and without clinical success, no further differences were noted. The degree of SSA was not significantly different with respect to clinical outcome.CONCLUSIONSNo significant differences were seen in the SDI grade and SSA with respect to clinical outcome. The SDI is higher after single-level ACDF and with the diagnosis of CDH. The DH was negligibly different with respect to clinical outcome, diagnosis, and number of operated levels.


Author(s):  
Yogesh Somwanshi ◽  
Pankaj Chavhan ◽  
Arun Sajjanar ◽  
Snehal Ughade ◽  
Nutan Gutte ◽  
...  

Purpose: The aim of this present study was to observe clinical, radiographic response of pulp to Ferric Sulphate and Mineral Trioxide Aggregate when used as pulpotomy agent in primary molars. Materials and Methods: Sixty restorable primary molars were selected for the study. The children were chosen who require minimum two pulpotomies in either arch preferably each on the opposite side (i.e. right and left). Primary molars on the right side of the patient were assigned to Ferric Sulphate (FS) (Group A) and left side was assigned for the Mineral Trioxide Aggregate (MTA) (Group B). Statistical analysis was done for pain, swelling, sinus, and fistula and for internal resorption, furcation radiolucency and periapical pathology using the chi-square test. Results: outcome of the present study was observed at 3 month interval and after 6 months. The clinical success rate for MTA (AQUA) and ferric sulphate during 3 and 6 month follow up was 100%. The radiographic follow up of MTA was 100% during 3 and 6 month, whereas it was 96.6% for 3 and 6 month follow up with respect to ferric sulphate. There were no significant differences in the clinical (p>0.1) and radiographic (p>0.98) success rates among both the groups. Conclusion: ferric sulphate was found to be equally effective when compared with MTA. Radiographic success rate was lower for Ferric sulphate (Group A) than that of MTA (Group B) with occurrence of one internal resorption seen with first primary molar.


2021 ◽  
Vol 10 (8) ◽  
pp. 1600
Author(s):  
Radovan Žižka ◽  
Šimon Belák ◽  
Jiří Šedý ◽  
Kamila Fačevicová ◽  
Iva Voborná ◽  
...  

Regenerative endodontic procedure (REP) is a progressive treatment modality for immature permanent teeth with necrotic pulp. The ambiguousness about the predictability of REP outcome in relation to complete disinfection of the root canal system and the occurrence of discoloration still exists. The aim of this retrospective study was to analyze two treatment protocols on clinical success rate, radiographic root development and the occurrence of discoloration. Eighteen patients were treated by a single operator by either treatment protocol according to the American Association of Endodontists (AAEP, n = 9) or a modified protocol (MP, n = 9) with the use of 5% sodium hypochlorite and sandblasting. Patients were followed up after 3, 6, 9, 12, 18 and 24 months and clinical success, radiographic root development and the occurrence of discoloration were assessed. The clinical success of MP was significantly higher in two years follow-up (p = 0.015), but the change in radiographic root area was higher for AAEP (p = 0.017) and the occurrence of discoloration was higher in AAEP (p = 0.029). The use of 5% sodium hypochlorite for a longer period of time leads to a higher success rate. The sandblasting of the access cavity reduces the occurrence of discoloration.


Phlebologie ◽  
2010 ◽  
Vol 39 (02) ◽  
pp. 69-71 ◽  
Author(s):  
T. M. Proebstle ◽  

Summary Background: Radiofrequency powered segmental thermal ablation Closure FAST has become a globally engaged technology for ablation of incompetent great saphenous veins (GSVs). Mid-term results of slowly resolving side effects are still not described. Methods: RSTA-treated GSVs (n = 295) were followed for 24 months in a prospective multicenter trial. Clinical control visits included flow and reflux analysis by duplex-ultrasound and assessment of treatment related side effects at all times. Results: 280 of 295 treated GSVs (94.9%) were available for 24 months follow-up. According to the method of Kaplan and Meier at 24 months after the intervention 98.6% of treated legs remained free of clinically relevant axial reflux. The average VCSS score improved from 3.9 ± 2.1 at screening to 0.7 ± 1.2 at 24 months follow-up (p < 0.0001). While only 41.1% of patients were free of pain before treatment, at 24 months 99.3% reported no pain and 96.4% did not experience pain during the 12 months before. At 24 months n=3 legs showed pigmentation along the inner thigh and one leg showed study-treatment related paresthesia. Conclusion: Radiofrequency powered segmental thermal ablation Closure FAST showed a very moderate side-effect profile in conjunction with a high and durable clinical success rate.


2000 ◽  
Vol 24 (4) ◽  
pp. 269-272 ◽  
Author(s):  
Hamijeta Ibricevic ◽  
Qumasha Al-Jame

Seventy primary molar teeth, carious exposed, symptom free, without any sign of root resorption in children aged from 3 to 6 years (main age 4.3yr) were treated with conventional pulpotomy procedures. Ferric sulfate 15.5% solution (applied for 15 second for 35 teeth) and formocresol solution (five minute procedure of Buckley's formula for next 35 teeth) have been used as pulpotomy agents. In both groups, pulp stumps were covered with zinc-oxide eugenol paste. Permanent restorations were stainless steel crowns. Clinical check up was every three-months and radiographic follow-up time was six and twenty months after treatment. Our results within this period revealed 100% clinical success rate in both groups. Radiographic success rate was in both groups 97.2%, while in 2.8% cases has shown internal root resorption. On the basis of these results, we can recommend ferric sulfate as a pulpotomy agent in primary teeth in substitution for formocresol at the moment.


Author(s):  
Florin Eggmann ◽  
Thomas J. W. Gasser ◽  
Hanjo Hecker ◽  
Mauro Amato ◽  
Roland Weiger ◽  
...  

Abstract Objectives This study aimed to retrospectively evaluate clinical and radiographic outcomes of partial pulpotomy performed in permanent teeth with carious pulp exposure. Materials and methods Records of patients undergoing treatment at an undergraduate dental clinic between 2010 and 2019 were screened for partial pulpotomies in teeth with a presumptive diagnosis of normal pulp or reversible pulpitis. The follow-up had to be ≥ 1 year. Patient data were retrieved and analyzed using Mantel-Cox chi square tests and Kaplan–Meier statistics. The level of significance was set at α = 0.05. Results Partial pulpotomy was performed in 111 cases, of which 64 (58%) fulfilled the eligibility criteria. At the time of partial pulpotomy, the mean age was 37.3 (± 13.5) years (age range 18–85). The mean observation period was 3.1 (± 2.0) years. Two early failures (3.1%) and five late failures (7.7%) were recorded. The overall success rate of maintaining pulp vitality was 89.1%, with 98.4% tooth survival. The cumulative pulp survival rates of partial pulpotomy in patients aged < 30 years, between 30 and 40 years, and > 40 years were 100%, 75.5%, and 90.5%, respectively, with no significant difference between the age groups (p = 0.225). At follow-up, narrowing of the pulp canal space and tooth discoloration were observed in 10.9% and 3.1% of cases, respectively. Conclusions Across age groups, partial pulpotomy achieved favorable short and medium-term outcomes in teeth with carious pulp exposure. Clinical relevance Adequate case selection provided, partial pulpotomy is a viable operative approach to treat permanent teeth with deep carious lesions irrespective of patients’ age.


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