scholarly journals Maturogenesis by Pulp Revascularization in an Immature Necrotic Permanent Tooth in a Pediatric Patient: A 15 Month Follow-up Case Report

2020 ◽  
Vol 1 (2) ◽  
pp. 46-50
Author(s):  
◽  
Kumar Pawan ◽  
Garg Ishika ◽  
Narang Saurabh ◽  
Namdev Ritu ◽  
...  
Keyword(s):  
Case Report ◽  
Blood Clot ◽  
Mineral Trioxide Aggregate ◽  
Permanent Teeth ◽  
Root Canal Filling ◽  
Promising Alternative ◽  
Maxillary Central Incisor ◽  
Pulp Revascularization ◽  
Stimulation Of

Endodontic treatment of immature necrotic permanent teeth is clinically challenging and poses a risk of inducing dentin wall fracture or extending gutta-percha into the periapical tissue during root canal filling. Pulp revascularization is a promising alternative for the treatment of such immature necrotic permanent teeth offering great potential to avoid the need for traditional apexification with calcium hydroxide or the need to achieve an artificial apical barrier with mineral trioxide aggregate. Pulp revascularization allows the stimulation of the apical development and the root maturation of immature teeth by physiologically strengthening the canal walls. The present case report describes the case of successful revascularization of the necrotic infected pulp space of an immature permanent maxillary central incisor induced in vivo by stimulation of a blood clot from the periapical tissues into the canal space. Thickening of the canal wall and complete apical closure were confirmed 15 months after the treatment.

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).

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.

scholarly journals Surgical Retreatment of an Invaginated Maxillary Central Incisor Following Overfilled Endodontic Treatment: A Case Report

2010 ◽  
Vol 04 (03) ◽  
pp. 324-328 ◽  
Author(s):  
Hakan Ozbas ◽  
Rustem Kemal Subay ◽  
Melike Ordulu
Keyword(s):  
Case Report ◽  
Clinical Symptoms ◽  
Present Report ◽  
Mineral Trioxide Aggregate ◽  
Central Incisor ◽  
Class Iii ◽  
Root Canal Filling ◽  
Maxillary Central Incisor ◽  
Mucoperiosteal Flap ◽  
Periapical Healing

This case report presents the periapical surgical retreatment of an Oehlers Class III invaginated maxillary central incisor with extruded root canal filling into the periapical lesion. After local anesthesia, a full-thickness mucoperiosteal flap was reflected, and the granulomatous tissue and extruded gutta-percha points were curetted carefully. A deep and wide root-end cavity was prepared and filled with mineral trioxide aggregate (MTA). At 6 months and 2 years after the treatment, the tooth exhibited no clinical symptoms, and the radiograph performed during the 2-year follow-up showed a complete periapical healing around the root end. The present report indicates that MTA retrofilling can be used successfully in the surgical retreatment of dens invaginatus type III cases in which the invagination exits apically. (Eur J Dent 2010;4:324-328)

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 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 Radicular Perforation Repair with Mineral Trioxide Aggregate: A Case Report with 10-Year Follow-up

2016 ◽  
Vol 10 (1) ◽  
pp. 733-738 ◽  
Author(s):  
Leopoldo Cosme-Silva ◽  
Breno Carnevalli ◽  
Vivien Thiemy Sakai ◽  
Naiana Viana Viola ◽  
Leon Franco de Carvalho ◽  
...  
Keyword(s):  
Case Report ◽  
Root Canal ◽  
Mineral Trioxide Aggregate ◽  
Radiographic Examination ◽  
Root Canal Filling ◽  
Second Molar ◽  
Iatrogenic Perforation ◽  
Iatrogenic Complications ◽  
Root Canal Retreatment

Background: Iatrogenic complications such as accidental perforation of the root or the floor of the pulp chamber may occur. Case Report: Patient was referred for root canal retreatment of the mandibular left second molar with periapical lesion evidenced through radiographic examination. During post removal, iatrogenic perforation occurred at the mesial face of the distal root. After clinical localization of the perforation and bleeding control, MTA was applied. In a second appointment, the root canal filling was removed and the chemical-surgical retreatment of the canals was performed, followed by the obturation with gutta-percha and sealer. Patient returned after three days reporting no pain. After 6 months, 3, 7 and 10 years of follow-up. Conclusion: Absence of pain, normal periodontal probing and lack of radiolucent area at the region of perforation and the periapices were detected, which evidenced the successful repair of the tooth.

scholarly journals Viability and Stimulation of Human Stem Cells from the Apical Papilla (hSCAPs) Induced by Silicate-Based Materials for Their Potential Use in Regenerative Endodontics: A Systematic Review

Materials ◽  
2020 ◽  
Vol 13 (4) ◽  
pp. 974 ◽  
Author(s):  
José Luis Sanz ◽  
Leopoldo Forner ◽  
Alicia Almudéver ◽  
Julia Guerrero-Gironés ◽  
Carmen Llena
Keyword(s):  
Stem Cells ◽  
Blood Clot ◽  
Present Review ◽  
Permanent Teeth ◽  
Human Stem Cells ◽  
Qualitative Synthesis ◽  
Alizarin Red ◽  
Apical Papilla ◽  
Stimulation Of

Blood clot formation in the apical third of the root canal system has been shown to promote further root development and reinforcement of dentinal walls by the deposition of mineralized tissue, resulting in an advancement from traditional apexification procedures to a regenerative endodontic treatment (RET) for non-vital immature permanent teeth. Silicate-based hydraulic biomaterials, categorized as bioactive endodontic cements, emerged as bright candidates for their use in RET as coronal barriers, sealing the previously induced blood clot scaffold. Human stem cells from the apical papilla (hSCAPs) surviving the infection may induce or at least be partially responsible for the regeneration or repair shown in RET. The aim of this study is to present a qualitative synthesis of available literature consisting of in vitro assays which analyzed the viability and stimulation of hSCAPs induced by silicate-based hydraulic biomaterials. A systematic electronic search was carried out in Medline, Scopus, Embase, Web of Science, Cochrane and SciELO databases, followed by a study selection, data extraction, and quality assessment following the PRISMA protocol. In vitro studies assessing the viability, proliferation, and/or differentiation of hSCAPs as well as their mineralization potential and/or osteogenic, odontogenic, cementogenic and/or angiogenic marker expression in contact with commercially available silicate-based materials were included in the present review. The search identified 73 preliminary references, of which 10 resulted to be eligible for qualitative synthesis. The modal materials studied were ProRoot MTA and Biodentine. Both bioceramic materials showed significant positive results when compared to a control for hSCAP cell viability, migration, and proliferation assays; a significant up-regulation of hSCAP odontogenic/osteogenic marker (ALP, DSPP, BSP, Runx2, OCN, OSX), angiogenic growth factor (VEGFA, FIGF) and pro-inflammatory cytokine (IL-1α, IL-1β, IL-6, TNF-α) expression; and a significant increase in hSCAP mineralized nodule formation assessed by Alizarin Red staining. Commercially available silicate-based materials considered in the present review can potentially induce mineralization and odontogenic/osteogenic differentiation of hSCAPs, thus prompting their use in regenerative endodontic procedures.

scholarly journals Apice closure in Pulp Revascularization Therapy. Case report and literature review

2021 ◽  
Vol 10 (9) ◽  
pp. e21110917814
Author(s):  
Hadassa Fonsêca da Silva ◽  
Alice Pinho André Gomes Morais ◽  
Guilherme Marinho Sampaio ◽  
Gabriel Henrique Queiroz Oliveira ◽  
Paulo Melo Júnior ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Real Option ◽  
Permanent Teeth ◽  
Cochrane Library ◽  
Line Searches ◽  
Open Apices ◽  
Revascularization Therapy ◽  
The Cochrane Library ◽  
Pulp Revascularization

Background: Endodontic Regenerative Procedures, especially pulp revascularization therapy, have become a real option for the treatment for immature permanent teeth with open apices. This sort of approach has saved many teeth that otherwise would have been extracted. The technique is simple and effective, and can be accomplished by any odontologist. Objective: This article aimed to make a literature review to give support for a case report of an Endodontic Regenerative Procedure of a twelve-year-old male patient with immature open apice of tooth 21. Methodology: Articles were researched concerning pulp revascularization to reach root end formation. On line searches were accomplished, whose database include BVS/BIREME, Web of Science, PUBMED Central, Science Direct, Higher Level Personnel Improvement Coordinator (CAPES), The Cochrane Library, and PROSPERO). Results: the articles researched showed that Endodontic Regenerative Procedures are efficient in stimulating root end formation. The case report described matched the results offered by the articles, showing an immature open apice tooth that had its root end completely formed after pulp revascularization therapy. Conclusion: Pulp revascularization therapy is an efficient and practical treatment for immature teeth with open apices.

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.

scholarly journals Nonsurgical Endodontic Retreatment of Advanced Inflammatory External Root Resorption Using Mineral Trioxide Aggregate Obturation

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Shivani Utneja ◽  
Gaurav Garg ◽  
Shipra Arora ◽  
Sangeeta Talwar
Keyword(s):  
Root Canal ◽  
Root Resorption ◽  
Clinical Symptoms ◽  
Mineral Trioxide Aggregate ◽  
Radiographic Examination ◽  
Apical Region ◽  
Central Incisor ◽  
Root Canal Filling ◽  
Maxillary Central Incisor ◽  
External Root Resorption

Inflammatory external root resorption is one of the major complications after traumatic dental injury. In this case report, we describe treatment of a maxillary central incisor affected by severe, perforating external root resorption. An 18-year-old patient presented with a previously traumatized, root-filled maxillary central incisor associated with pain and sinus tract. Radiographic examination revealed periradicular lesion involving pathologic resorption of the apical region of the root and lateral root surface both mesially and distally. After removal of the root canal filling, the tooth was disinfected with intracanal triple antibiotic paste for 2 weeks. The antibiotic dressing was then removed, and the entire root canal was filled with mineral trioxide aggregate. The endodontic access cavity was restored with composite resin. After 18 months, significant osseous healing of the periradicular region and lateral periodontium had occurred with arrest of external root resorption, and no clinical symptoms were apparent.

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