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Zhou W, Jiang R, Gu Y, Tang Y. Unique anatomy of a rare type II dens invaginatus in a maxillary lateral incisor: a case report. BMC Oral Health 2025; 25:452. [PMID: 40155925 PMCID: PMC11954236 DOI: 10.1186/s12903-025-05823-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2024] [Accepted: 03/17/2025] [Indexed: 04/01/2025] Open
Abstract
BACKGROUND Dens invaginatus (DI) is a developmental anomaly arising from excessive proliferation or distortion of the enamel organ during tooth formation, often leading to the creation of a pocket or dead space within the tooth. This report presents a case of Type II DI in a maxillary lateral incisor with unique anatomy, diagnosed through cone-beam computed tomography (CBCT) and further analyzed with micro-computed tomography (micro-CT) post-extraction. CASE PRESENTATION A 20-year-old male patient presented with recurrent pain and gingival swelling around the apex of tooth #22 for 12 months, unresponsive to antibiotic therapy. CBCT examination revealed a well-defined radiolucent area measuring approximately 10.3 × 9.9 × 7.0 mm at the apex of tooth #22, with an oval shape and distinct cortical border. The CBCT images confirmed that the invagination extended into the pulp chamber but did not reach the root apex. Based on these findings, a diagnosis of Type II DI with chronic apical periodontitis was established. The patient opted for extraction, and histopathological analysis of the apical lesion confirmed a periapical granuloma. Micro-CT analysis of the extracted tooth revealed that the invagination communicated with the external oral cavity via a pit in the crown and with the internal root canal system, serving as the conduit for pulp infection. Multiple apical accessory canals were identified, contributing to the persistent periapical infection and development of a periapical granuloma. CONCLUSIONS This case highlights the complexity of DI and the challenges in treatment due to its unique anatomical features. The report underscores the value of three-dimensional imaging techniques, such as CBCT, in the diagnosis and management of DI.
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Affiliation(s)
- Wenyuan Zhou
- Department of Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666, Wujiang Dist, Suzhou, 215200, China
| | - Rongrong Jiang
- Department of Stomatology, Affiliated Hospital of Nantong University, Nantong, China
| | - Yongchun Gu
- Department of Dentistry, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666, Wujiang Dist, Suzhou, 215200, China.
| | - Ying Tang
- Department of Pathology, Ninth People's Hospital of Suzhou, Soochow University, Ludang Road 2666, Wujiang Dist, Suzhou, 215200, China.
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Inoue A, Kawanishi Y, Okamoto M, Hayashi M. Nonsurgical root canal treatment of an Oehlers type IIIa maxillary central incisor with dens invaginatus: a case report. FRONTIERS IN DENTAL MEDICINE 2024; 5:1458215. [PMID: 39917708 PMCID: PMC11797815 DOI: 10.3389/fdmed.2024.1458215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 09/30/2024] [Indexed: 02/09/2025] Open
Abstract
Dens invaginatus has a complex anatomy, making endodontic treatment challenging. We report the case of a 11-year-old girl who presented with radiolucency at the apex of the maxillary central incisor; she was diagnosed with symptomatic apical periodontitis. Cone-beam computed tomography (CBCT) revealed dens invaginatus. The invagination and root canal were observed using a dental operating microscope, and nonsurgical root canal treatment was performed. The invagination was connected to the periodontal tissue, and the tooth was classified as Oehlers type IIIa. Root canal preparations were performed using NiTi files and an ultrasonic device. A calcium hydroxide paste was used as an intracanal dressing. The root canal was filled using a single-cone hydraulic condensation technique with a highly fluid calcium silicate-based sealer. At the 2-year follow-up, no clinical symptoms were observed, and CBCT images revealed no radiographic lesions. Nonsurgical endodontic treatment using CBCT imaging, dental microscope, effective cleaning systems, and a highly fluid sealer facilitated the successful treatment of apical periodontitis attributed to dens invaginatus. The single-cone hydraulic condensation technique using a bio-ceramic sealer is considered effective even in cases with a complex morphology and open apex.
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Affiliation(s)
- Ayumi Inoue
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuzo Kawanishi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Motoki Okamoto
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
- Department of Oral Science and Translational Research, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Mikako Hayashi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
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Martin G, Cires F, Alberdi J, Rourera CI, Bonnin C, Rôças IN, Siqueira JF. Dens invaginatus Type II in an Immature Lateral Incisor With Apical Periodontitis Treated With Regenerative and Strategic Antimicrobial Procedures: A Case Report. J Endod 2024; 50:1515-1520. [PMID: 39025207 DOI: 10.1016/j.joen.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 07/05/2024] [Accepted: 07/08/2024] [Indexed: 07/20/2024]
Abstract
Dens invaginatus is a developmental dental anomaly that can predispose the tooth to pulp and periradicular disease. Management of this condition can be challenging because of anatomic and microbiologic issues. This case report describes the regenerative endodontic treatment using a strategic antimicrobial protocol for management of an immature maxillary lateral incisor with type-II dens invaginatus associated with apical periodontitis in a 13-year-old patient. The tooth presented with a complex anatomy and was associated with an active sinus tract. Because the true root canal was not negotiable in its coronal part due to the presence of the dens invaginatus, the closed end of the invagination (pseudocanal) was perforated to permit access to the apical segment of the true root canal for cleaning and disinfection. Both the invagination and the true canal were treated using an antimicrobial regimen based on chemomechanical preparation with sodium hypochlorite irrigation, supplementary disinfection with passive ultrasonic irrigation and interappointment calcium hydroxide medication. After 2 exchanges of calcium hydroxide medication, the sinus tract did not disappear, then the antimicrobial protocol was changed to include an antibiotic solution for irrigation and antibiotic paste for intracanal medication. After signs and symptoms disappeared, regenerative endodontic treatment was performed by inducing blood clot formation within the root canal. The coronal canal segment including the invagination was filled with Biodentine. Follow-up including cone-beam computed tomography examination showed complete healing of the apical periodontitis lesion and mineralized tissue formation at the apical portion of the true root canal.
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Affiliation(s)
- Gabriela Martin
- Department of Endodontics, Faculty of Dentistry, National University of Córdoba, Córdoba, Argentina; Posgraduate Program in Endodontics, Faculty of Health Sciences, Catholic University of Córdoba, Córdoba, Argentina.
| | - Florencia Cires
- Posgraduate Program in Endodontics, Faculty of Health Sciences, Catholic University of Córdoba, Córdoba, Argentina
| | - Jorge Alberdi
- Posgraduate Program in Endodontics, Faculty of Health Sciences, Catholic University of Córdoba, Córdoba, Argentina
| | - Cecilia I Rourera
- Posgraduate Program in Endodontics, Faculty of Health Sciences, Catholic University of Córdoba, Córdoba, Argentina
| | - Claudia Bonnin
- Department of Endodontics, Faculty of Dentistry, National University of Córdoba, Córdoba, Argentina; Posgraduate Program in Endodontics, Faculty of Health Sciences, Catholic University of Córdoba, Córdoba, Argentina
| | - Isabela N Rôças
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Brazil
| | - José F Siqueira
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Brazil
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Wei C, Wang D, Shen L, Lu P, Meng Z, Zhou R. Treatment opinions for dens invaginatus: A case series. Exp Ther Med 2024; 27:138. [PMID: 38476914 PMCID: PMC10928843 DOI: 10.3892/etm.2024.12426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 01/24/2024] [Indexed: 03/14/2024] Open
Abstract
Dens invaginatus (DI) is a rare congenital dental malformation characterized by enamel or cementum folded into dentine. Such teeth are susceptible to caries, pulp infection or necrosis and periradicular lesion. The complex anatomy of this disease results in difficult treatment and a high rate of therapeutic failure. Therapeutic options, such as debriding and filling invagination, root canal treatment (RCT) and intentional replantation, vary according to the morphology and infection of the involved tooth. The present study reports five cases of DI with chronic apical periodontitis. The treatment strategies and procedures, including RCT, removing the invagination, intentional replantation and surgical treatment, are discussed according to the classification and the condition of pulp and periapical tissue. The study also reports the prognosis: All patients were followed up for ≥12 months and all teeth demonstrated periapical healing and clinical asymptomatic. In summary, appropriate treatment is based on accurate analysis of the anatomical variation in different types of DI and intentional replantation is a reliable and viable treatment to preserve the tooth.
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Affiliation(s)
- Chengshi Wei
- Department of Stomatology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Dong Wang
- Department of Stomatology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Lili Shen
- Department of Stomatology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Ping Lu
- Department of Stomatology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
| | - Zhen Meng
- Biomedical Laboratory, Medical School of Liaocheng University, Liaocheng, Shandong 252000, P.R. China
| | - Rongjing Zhou
- Department of Stomatology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
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Siqueira JF, Rôças IN, Hernández SR, Brisson-Suárez K, Baasch AC, Pérez AR, Alves FRF. Dens invaginatus: clinical implications and antimicrobial endodontic treatment considerations. J Endod 2021; 48:161-170. [PMID: 34902355 DOI: 10.1016/j.joen.2021.11.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/27/2021] [Accepted: 11/29/2021] [Indexed: 02/07/2023]
Abstract
Dens invaginatus or dens in dente is a developmental dental anomaly resulting from an invagination of the enamel organ into the dental papilla during odontogenesis. Radiographically, it is usually seen as a radiolucent invagination surrounded by a radiopaque area (enamel) limited to the tooth crown or extending into the root. Because the invagination is opened to the oral cavity, it can retain saliva, food remnants, and bacteria. In conditions that the enamel lining of the invagination is naturally absent or lost due to caries, bacterial cells and products can diffuse from the invagination through the dentin tubules to reach the pulp and cause disease. Management of teeth with dens invaginatus include preventive sealing or filling of the invagination, or, if the pulp is affected, therapeutical options include vital pulp therapy, nonsurgical root canal treatment, apexification or regenerative endodontic procedures, periradicular surgery, intentional replantation, or extraction. It is recommended that the invagination be always approached, regardless of the type of dens invaginatus. The root canal should be treated whenever the pulp is irreversibly inflamed or necrotic. Endodontic management of teeth with dens invaginatus is often tricky because of its anatomical complexity, and special and customized strategies should be devised. This review discusses the endodontic implications of this anomaly and the current treatment recommendations based on anatomic, pathologic, and technologic considerations.
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Affiliation(s)
- José F Siqueira
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil; Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil; Endochat research group, Rio de Janeiro, RJ, Brazil
| | - Isabela N Rôças
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil; Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil; Endochat research group, Rio de Janeiro, RJ, Brazil
| | - Sandra R Hernández
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil; Endochat research group, Rio de Janeiro, RJ, Brazil; Department of Endodontics, Francisco Marroquín University, Guatemala City, Guatemala
| | - Karen Brisson-Suárez
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil; Endochat research group, Rio de Janeiro, RJ, Brazil
| | - Alessandra C Baasch
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil; Endochat research group, Rio de Janeiro, RJ, Brazil; Department of Endodontics, Santa María University, Caracas, Venezuela
| | - Alejandro R Pérez
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil; Endochat research group, Rio de Janeiro, RJ, Brazil; Department of Endodontics, University Rey Juan Carlos. Madrid, Spain
| | - Flávio R F Alves
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil; Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, RJ, Brazil.
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Laser Doppler for Accurate Diagnosis of Oehler’s Type III Dens Invaginatus: A Case Report. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11093848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
In vital pulp therapy, pulp testing aids in the differential diagnosis and influences the treatment plan. Different from previous doppler flowmetry studies that only recorded waves and data, we report the first time, the use of a laser doppler blood flow monitor and imager with a colored image to present pulp vitality information in the dental field. We report here a case of Oehlers type IIIa dens invaginatus of the right upper lateral incisor in a 31-year-old girl, with the opening of the invagination near CDJ and a peri-invagination lesion sized 8 × 9 mm2. Cone beam computed tomography was used to verify specific spatial and stereoscopic data. After removing the source of infection, mineral trioxide aggregate was selected to fill the invagination. Laser doppler was scheduled for further assessment. After three years of regular follow-up, the patient’s clinical condition improved, the peri-invagination lesion healed, and the laser doppler and electric pulp test both showed a positive reaction. Laser doppler has successfully improved the diagnostic accuracy Thus, unnecessary interventions can be avoided while reducing the treatment time by preserving the vitality. However, further work is needed to resolve the limitations of laser doppler.
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Sabrah AHA, Al-Asmar AA, Alsoleihat F, Al-Zer H. The discoloration effect of diluted minocycline containing triple antibiotic gel used in revascularization. J Dent Sci 2019; 15:181-185. [PMID: 32595899 PMCID: PMC7305458 DOI: 10.1016/j.jds.2019.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 06/24/2019] [Indexed: 11/16/2022] Open
Abstract
Background/purpose Triple antibiotic paste (TAP) has been successfully used in revascularization procedure. However, one of the problems associated with TAP use is teeth discoloration, which is attributed to the presence of minocycline constituent. The aim of this study is to investigate the discoloration effect of different concentrations of triple (TAP) and double (DAP) antibiotics pastes on root dentine. Materials and methods Sterilized dentine specimens (4 × 4 × 1) were prepared, and randomly assigned to 5 groups; 1000 mg/mL of Triple antibiotic paste (TAP), 1000 mg/mL of Double antibiotic paste (DAP), 1 mg/mL of TAP in Methylcellulose gel (MTAP), 1 mg/mL of DAP in Methylcellulose gel (MDAP), and distilled water control groups (n = 12). The assigned treatment was applied for 14 days. The CIE L*a*b calorimetric parameters were measured for all dentine specimens using a Chroma meter. One-way ANOVA and multiple comparisons were used for statistical analyses (p < 0.05). ΔE for the different treatments as compared to distilled water group was calculated. Results TAP and MTAP groups significantly affects the L* values of the root dentine (p < 0.05). ΔE change was noticeable between TAP and MTAP compared to the distilled water group. Conclusion The incorporation of minocycline in TAP medicaments, even in low concentrations, can still provoke a noticeable tooth discoloration.
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Affiliation(s)
- Alaa H A Sabrah
- Department of Conservative Dentistry, The University of Jordan, Amman, Jordan
| | - Ayah A Al-Asmar
- Department of Conservative Dentistry, The University of Jordan, Amman, Jordan
| | - Firas Alsoleihat
- Department of Conservative Dentistry, The University of Jordan, Amman, Jordan
| | - Heba Al-Zer
- Department of Conservative Dentistry, The University of Jordan, Amman, Jordan
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Abu Hasna A, Ungaro DMDT, de Melo AAP, Yui KCK, da Silva EG, Martinho FC, Gomes APM. Nonsurgical endodontic management of dens invaginatus: a report of two cases. F1000Res 2019; 8:2039. [PMID: 31885864 PMCID: PMC6915815 DOI: 10.12688/f1000research.21188.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/19/2019] [Indexed: 12/15/2022] Open
Abstract
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.
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Affiliation(s)
- Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontic Division, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245000, Brazil
| | - Daniela Maria de Toledo Ungaro
- Department of Science and Technology Applied to Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245000, Brazil
| | - Allana Agnes Pereira de Melo
- Department of Science and Technology Applied to Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245000, Brazil
| | - Karen Cristina Kazue Yui
- Department of Restorative Dentistry, Operative Dentistry Division, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245000, Brazil
| | - Eduardo Galera da Silva
- Department of Science and Technology Applied to Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245000, Brazil
| | - Frederico Canato Martinho
- Department of Endodontics, Prosthodontics and Operative Dentistry, School of Dentistry, University of Maryland, Baltimore, Baltimore, USA
| | - Ana Paula Martins Gomes
- Department of Science and Technology Applied to Dentistry, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, 12245000, Brazil
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Lee HN, Chen YK, Chen CH, Huang CY, Su YH, Huang YW, Chuang FH. Conservative pulp treatment for Oehlers type III dens invaginatus: A case report. World J Clin Cases 2019; 7:2823-2830. [PMID: 31616698 PMCID: PMC6789382 DOI: 10.12998/wjcc.v7.i18.2823] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 08/07/2019] [Accepted: 08/20/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Diverse presentations of dens invaginatus (DI) and root canal treatment with an immature open apex often pose challenges to dentists. Adequate treatment planning for DI is the main reason for successful approach, i.e., we should consider the shape and depth of the concave folding, the condition of the original pulp, and the growth stage of the root formation.
CASE SUMMARY A 9-year-old girl complained of severe pain of the right maxillary incisor (tooth 12) when chewing for two weeks. Following clinical and radiographic examinations, Oehlers type III DI of tooth 12, with an immature open apical foramen and a symptomatic periapical pathosis, was diagnosed. Cone-beam computed tomography verified the specific spatial and stereoscopic data regarding the communication between the main root canal and pseudo root canal of the involved tooth. After removing the source of infection, a mineral trioxide aggregate was selected to fill and seal the pseudo root canal; additionally, pulp capping of the main canal was performed through the interconnections between the root canals in the middle segment to preserve pulp vitality and enable continual root formation and eventual root apex closure.
CONCLUSION We propose to conduct main root canal pulp capping for DI with communication between the main and pseudo root canals.
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Affiliation(s)
- Hui-Na Lee
- Division of Conservative Dentistry, Dental Department, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung 80756, Taiwan
- Dental Department, Kaohsiung Municipal CiJin Hospital, Kaohsiung 80756, Taiwan
| | - Yuk-Kwan Chen
- Division of Oral Pathology and Radiology, Dental Department, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung 80756, Taiwan
- School of Dentistry, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Oral and Maxillofacial Radiology Center, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
| | - Cheng-Hui Chen
- Division of Conservative Dentistry, Dental Department, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung 80756, Taiwan
- School of Dentistry, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
| | - Chun-Yin Huang
- Department of Nuclear Medicine, E-DA Hospital, Kaohsiung 80756, Taiwan
| | - Ying-Hui Su
- Division of Conservative Dentistry, Dental Department, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung 80756, Taiwan
| | - Ying-Wei Huang
- Division of Conservative Dentistry, Dental Department, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung 80756, Taiwan
- Dental Department, Kaohsiung Municipal Hsiao Kang Hospital, Kaohsiung 80756, Taiwan
| | - Fu-Hsiung Chuang
- Division of Conservative Dentistry, Dental Department, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung 80756, Taiwan
- School of Dentistry, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
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Comparative Study between Revitalization of Necrotic Immature Permanent Anterior Teeth with and without Platelet Rich Fibrin: A Randomized Controlled Trial. J Clin Pediatr Dent 2019; 43:78-85. [PMID: 30730794 DOI: 10.17796/1053-4625-43.2.2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES This study was conducted to evaluate the effect of platelet rich fibrin (PRF) during revitalization of necrotic immature permanent anterior teeth after 6 months and 1 year follow up period. The following treatment protocols; Group A: revitalization using blood clot scaffold only, and Group B: revitalization using blood clot and PRF. STUDY DESIGN twenty-two patients (7-12 years old) suffering from immature necrotic permanent maxillary central incisors were randomly selected and randomly allocated into 2 groups. Clinical examinations were performed to detect any pain or swelling during the follow up period. Standardized radiographs were digitally evaluated for changes in root length, periapical radiolucency size, presence of apical or cervical calcific bridges. RESULTS After a follow-up period of 12 months, most of the cases showed radiographic evidence of periapical healing and showed calcific bridges either cervical and/or apical. No significant differences were shown between both groups. CONCLUSIONS The revitalization procedures succeeded to show continued development of roots in teeth with necrotic pulps. The use of PRF was not essential for repair but it helped during the procedures.
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11
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Zubizarreta-Macho Á, Ferreiroa A, Agustín-Panadero R, Rico-Romano C, Lobo-Galindo AB, Mena-Álvarez J. Endodontic re-treatment and restorative treatment of a dens invaginatus type II through new technologies. J Clin Exp Dent 2019; 11:e570-e576. [PMID: 31346380 PMCID: PMC6645261 DOI: 10.4317/jced.55840] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 05/01/2019] [Indexed: 12/11/2022] Open
Abstract
Background The complex anatomy of dens invaginatus makes access cavity to root canal system difficult, which has an impact on the prognosis of these teeth. A novel technique, based on new technologies, is proposed to make access cavity conservative and guided with minimal dental structure lost. Material and Methods This case report shows the root canal retreatment and the endodontic surgery of a dens invaginatus type II in a left lateral upper incisor previously treated which was affected by a chronic apical abscess and an apical fracture. A Cone Beam Computed Tomography was performed to better diagnosis the dental anatomy. An intraoral scan was performed to get a digital 3D model. A computer-guided implant planning software was used to plan the access cavity and design the splint guided. Finally, the clinical crown was restored by a resin nanoceramic veneer made by a chairside system made up of an intraoral scanning unit and a grinding unit. Last, the authors carried through the endodontic surgery to extract the apical fractured fragment. Results Follow-up appointments at 6, 12 and 18 months showed a radiographic reduction of the periapical lesion and absence of clinical signs. Conclusions The splint guide allowed a guided and conservative access cavity to root canal system. It facilitates the root canal retreatment and improves the prognosis of the teeth with dental malformations. Key words:CAD-CAM, Cone-Beam Computed Tomography, dens in dente, dens invaginatus, dental pulp cavity, endodontics.
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Affiliation(s)
- Álvaro Zubizarreta-Macho
- DDS, PhD. Associate professor. Department of Endodontics. Faculty of Health Sciences. Alfonso X el Sabio University. Madrid. Spain
| | - Alberto Ferreiroa
- DDS, PhD. Associate professor. Department of Dental Prosthesis. Faculty of Dentistry. Complutense University. Madrid. Spain
| | - Rubén Agustín-Panadero
- DDS, PhD.Adjunct Professor. Department of Dental Medicine. Faculty of Medicine and Dentistry. University of Valencia. Spain
| | - Cristina Rico-Romano
- DDS, PhD. Associate professor. Department of Endodontics. Faculty of Health Sciences. Alfonso X el Sabio University. Madrid. Spain
| | - Ana-Belén Lobo-Galindo
- DDS, MS. Associate professor. Department of Endodontics. Faculty of Health Sciences. Alfonso X el Sabio University. Madrid. Spain
| | - Jesús Mena-Álvarez
- DDS, PhD. Head Director. Department of Endodontics. Faculty of Health Sciences. Alfonso X el Sabio University. Madrid. Spain
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12
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Chisini LA, Conde MCM, Grazioli G, Martin ASS, Carvalho RVD, Sartori LRM, Demarco FF. Bone, Periodontal and Dental Pulp Regeneration in Dentistry: A Systematic Scoping Review. Braz Dent J 2019; 30:77-95. [PMID: 30970065 DOI: 10.1590/0103-6440201902053] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 07/02/2018] [Indexed: 02/07/2023] Open
Abstract
The aim of presented systematic scoping review was to investigate the actual and future clinical possibilities of regenerative therapies and their ability to regenerate bone, periodontal and pulp with histological confirmation of the nature of formed tissue. Electronic search was conducted using a combination between Keywords and MeSH terms in PubMed, Scopus, ISI-Web of Science and Cochrane library databases up to January 2016. Two reviewers conducted independently the papers judgment. Screened studies were read following the predetermined inclusion criteria. The included studies were evaluated in accordance with Arksey and O'Malley's modified framework. From 1349 papers, 168 completed inclusion criteria. Several characterized and uncharacterized cells used in Cell Therapy have provided bone regeneration, demonstrating bone gain in quantity and quality, even as accelerators for bone and periodontal regeneration. Synthetic and natural scaffolds presented good cell maintenance, however polyglycolid-polylactid presented faster resorption and consequently poor bone gain. The Growth Factor-Mediated Therapy was able to regenerate bone and all features of a periodontal tissue in bone defects. Teeth submitted to Revascularization presented an increase of length and width of root canal. However, formed tissues not seem able to deposit dentin, characterizing a repaired tissue. Both PRP and PRF presented benefits when applied in regenerative therapies as natural scaffolds. Therefore, most studies that applied regenerative therapies have provided promising results being possible to regenerate bone and periodontal tissue with histological confirmation. However, pulp regeneration was not reported. These results should be interpreted with caution due to the short follow-up periods.
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Affiliation(s)
- Luiz Alexandre Chisini
- Graduate Program in Dentistry, School of Dentistry, UFPel - Universidade Federal de Pelotas, RS, Brazil
- Graduate Program in Dentistry, School of Dentistry, UNIVATES - Universidade do Vale do Taquari, Lajeado, RS, Brazil
| | - Marcus Cristian Muniz Conde
- Graduate Program in Dentistry, School of Dentistry, UNIVATES - Universidade do Vale do Taquari, Lajeado, RS, Brazil
| | - Guillermo Grazioli
- Graduate Program in Dentistry, School of Dentistry, UNIVATES - Universidade do Vale do Taquari, Lajeado, RS, Brazil
| | - Alissa Schmidt San Martin
- Graduate Program in Dentistry, School of Dentistry, UNIVATES - Universidade do Vale do Taquari, Lajeado, RS, Brazil
| | | | | | - Flávio Fernando Demarco
- Graduate Program in Dentistry, School of Dentistry, UFPel - Universidade Federal de Pelotas, RS, Brazil
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Influence of Apical Diameter on the Outcome of Regenerative Endodontic Treatment in Teeth with Pulp Necrosis: A Review. J Endod 2018; 44:414-431. [DOI: 10.1016/j.joen.2017.10.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 10/10/2017] [Accepted: 10/16/2017] [Indexed: 12/12/2022]
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Management of dens invaginatus in a maxillar lateral incisor with open apex and persistent sinus tract: A case report. BALKAN JOURNAL OF DENTAL MEDICINE 2018. [DOI: 10.2478/bjdm-2018-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background/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.
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Plascencia H, Díaz M, Moldauer BI, Uribe M, Skidmore E. Non-Surgical Endodontic Management of Type II Dens Invaginatus with Closed and Open Apex. IRANIAN ENDODONTIC JOURNAL 2017; 12:534-539. [PMID: 29225655 DOI: 10.22037/iej.v12i3.10861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Dens invaginatus (DI) is a developmental anomaly that poses a significant challenge to the clinician if endodontic treatment is required. The type II (as per Oehlers) form exhibits complex internal anatomy and is frequently associated with incomplete root and apex formation. The purpose of this study is to present two cases of type II DI in the maxillary lateral incisors. In the first case, non-surgical endodontic therapy was performed utilizing calcium hydroxide as an intracanal dressing, showing significant periapical healing of the apical radiolucent area at the six month follow-up. In the second case, the development of the root and apex were affected by pulp necrosis, and the revascularization procedure was performed. Complete resolution of the pre-existing apical radiolucency, apical closure, thickening of the root canal walls, and increase in root length, after 32 months was observed. Early detection of teeth with DI type II and proper exploration of their internal anatomy are key factors for their successful management. As demonstrated in this report, conservative non-surgical endodontic treatment should be the first line of treatment for these cases. The use of revascularization protocols in teeth that develop pulp necrosis and exhibit early stage of root development could be a better alternative than traditional apexification techniques.
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Affiliation(s)
- Hugo Plascencia
- Endodontic Postgraduate Program, CUCS-CUAltos, University of Guadalajara, México
| | - Mariana Díaz
- Endodontic Postgraduate Program, CUCS-CUAltos, University of Guadalajara, México
| | - Bertram Ivan Moldauer
- Adjunct Assistant Professor in Endodontics and Surgical Course Co-Director, Nova Southeastern University, College of Dental Medicine, Fort Lauderdale, Florida, USA
| | - Mario Uribe
- Endodontic Postgraduate Program, CUCS, University of Guadalajara, México
| | - Eddy Skidmore
- Department of Endodontics, Nova Southeastern Universitiy College of Dental Medicine, Fort Lauderdale, Florida, USA
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Lin J, Zeng Q, Wei X, Zhao W, Cui M, Gu J, Lu J, Yang M, Ling J. Regenerative Endodontics Versus Apexification in Immature Permanent Teeth with Apical Periodontitis: A Prospective Randomized Controlled Study. J Endod 2017; 43:1821-1827. [DOI: 10.1016/j.joen.2017.06.023] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 06/09/2017] [Accepted: 06/16/2017] [Indexed: 12/16/2022]
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Peng C, Yang Y, Zhao Y, Liu H, Xu Z, Zhao D, Qin M. Long-term treatment outcomes in immature permanent teeth by revascularisation using MTA and GIC as canal-sealing materials: a retrospective study. Int J Paediatr Dent 2017; 27:454-462. [PMID: 28043087 DOI: 10.1111/ipd.12282] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pulp revascularisation with MTA sealing has been accepted as an alternative treatment for non-vital immature permanent teeth. Successful revascularisation cases with GIC sealing were also reported, but lack of long-term researches. AIM To evaluate long-term outcomes of revascularisation using MTA and GIC as canal-sealing materials in non-vital immature permanent teeth. DESIGN Clinical and radiographic data of 60 non-vital immature permanent teeth treated with revascularisation (36.8 ± 12.4 months of follow-up) were reviewed. Of these, 28 teeth were sealed with MTA, and 32 with GIC. Tooth survival, success rate, and increases in root length and dentine wall thickness were evaluated. RESULTS Teeth in MTA group showed a similar survival rate (96%) to GIC group (100%). The success rate in MTA group (93%) was greater than that in GIC group (59%). Eight of fourteen failed teeth due to recurrent apical disease (seven teeth in GIC group and one in MTA group) achieved complete root development. There was no statistically significant difference in root length or dentine wall thickness increase between the groups. CONCLUSIONS Long-term outcome of revascularisation in non-vital immature permanent teeth sealed with GIC was not as good as that with MTA. Although more recurrent apical disease developed, results on root development were acceptable in GIC sealed cases.
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Affiliation(s)
- Chufang Peng
- Department of Paediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yuan Yang
- Department of Paediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yuming Zhao
- Department of Paediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - He Liu
- Department of Paediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Zheng Xu
- Department of Paediatric Dentistry, University of Washington, Seattle, WA, USA
| | - Dianhong Zhao
- Department of Pharmacy, Peking University School of Stomatology, Beijing, China
| | - Man Qin
- Department of Paediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
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Regenerative Endodontic Treatment or Mineral Trioxide Aggregate Apical Plug in Teeth with Necrotic Pulps and Open Apices: A Systematic Review and Meta-analysis. J Endod 2017; 43:1806-1820. [DOI: 10.1016/j.joen.2017.06.029] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 06/12/2017] [Accepted: 06/16/2017] [Indexed: 12/29/2022]
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Ruan JY, Gong ZL, Zhang RZ, Zhang Z, Xu R, Li DX, Ren L, Tao H. Evaluation of Four Different Restorative Materials for Restoration of the Periodontal Condition of Wedge-Shaped Defect: A Comparative Study. Med Sci Monit 2017; 23:4462-4470. [PMID: 28917087 PMCID: PMC5612178 DOI: 10.12659/msm.902937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This study aimed to conduct a clinical evaluation of four restorative materials for restoration of dental wedge-shaped defect (WSD) and their impacts on periodontal tissues. MATERIAL AND METHODS A total of 280 maxillary premolars with dental WSD were selected from 106 patients; the patient cases were divided into eight groups according to different combinations of restorative materials (flowable resin composites, Dyract compomers, glass ionomer cement (GIC), light-curing composite resin), and WSD positions (approaching gingival and subgingival positions). Gingival crevicular fluid (GCF) volume, levels of aspartate aminotransferase (AST), alkaline phosphatase (ALP), and interleukin-1β (IL-1β) in GCF were analyzed, while probing depth (PD), plaque index (PLI), and sulcus bleeding index (SBI) were also measured. The periodontal conditions of all patients were followed prior to restoration, as well as six months and 12 months after restoration. RESULTS After six months of restoration, the overall clinical success rates of flowable resin composites, Dyract compomers, and light-curing composite resin were greater than those of GIC. GCF volume, GCF-AST, IL-1β levels, PD, PLI, and SBI of cases restored by GIC were higher than those restored by the other three materials. After 12 months of restoration, the overall clinical success rates of flowable resin composites and Dyract compomers were greater than those of light-curing composite resin and GIC. GCF volume, GCF-AST, GCF-ALP, IL-1β levels, PD, PLI, and SBI of cases restored by GIC were higher than those restored by the other three materials. CONCLUSIONS Our study provided evidence that the clinical efficacy of flowable resin composites, Dyract compomers, and light-curing composite resin was greater than that of GIC for restoration of dental WSD.
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Affiliation(s)
- Jian-Yong Ruan
- Department of General Dentistry, The Affiliated Stomatological Hospital of Fujian Medical University, Fuzhou, Fujian, China (mainland)
| | - Zheng-Lin Gong
- Department of Stomatology, Ankang Central Hospital, Ankang, Shaanxi, China (mainland)
| | - Rui-Zhi Zhang
- Department of Stomatology, Ankang Central Hospital, Ankang, Shaanxi, China (mainland)
| | - Zhe Zhang
- Department of Stomatology, The 1st Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
| | - Ran Xu
- Department of Stomatology, The 1st Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
| | - Da-Xu Li
- Department of Stomatology, The 1st Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
| | - Le Ren
- Department of Stomatology, The 1st Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
| | - Hong Tao
- Department of Stomatology, The 1st Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland)
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Conde MCM, Chisini LA, Sarkis-Onofre R, Schuch HS, Nör JE, Demarco FF. A scoping review of root canal revascularization: relevant aspects for clinical success and tissue formation. Int Endod J 2017; 50:860-874. [PMID: 27770435 DOI: 10.1111/iej.12711] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 10/19/2016] [Indexed: 12/11/2022]
Abstract
The aim of this scoping study was to evaluate the survival rate and nature of tissue formed inside root canals of human immature permanent teeth with necrotic pulps (NIPT) under root canal revascularization (RCR). The search was performed in SciVerse Scopus®, PubMed/MEDLINE, Web of Science®, BIREME and in the grey literature up to November 2015. The keywords were selected using MeSH terms and DECs. Two independent reviewers scrutinized the records obtained considering specific inclusion criteria. The included studies were evaluated in accordance with a modified Arksey and O' Malley's framework. From 375 studies that were evaluated, 75 were included. A total of 367 NIPT were submitted to RCR, from which only 21 needed further endodontic treatment. The weighted mean follow-up time was 17.6 months. The data were derived mainly from case reports (69%) or small case series (15%). NaOCl [0.5-6%] was applied as the disinfecting solution in almost all studies. Triple antibiotic paste was as effective as Ca(OH)2 as on intracanal medicament. De novo tissue was cementum and poorly mineralized bone positive to bone sialoprotein (BSP) but negative to dentine sialoprotein (DSP). Failures were associated mainly with reinfection of the root canal. The majority of included studies reported a significant increase in both root length and width. However, as most of these data came from case reports, they must be interpreted with care, as most were focused on treatment successes (not failures). Therefore, well-designed randomized controlled trials comparing RCR with available apexification treatments are needed to address this gap in the literature.
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Affiliation(s)
- M C M Conde
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - L A Chisini
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - R Sarkis-Onofre
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - H S Schuch
- Australian Research Centre for Population Oral Health (ARCPOH), School of Dentistry, The University of Adelaide, Adelaide, Australia
| | - J E Nör
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - F F Demarco
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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22
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Abstract
Regenerative endodontics has been defined as “biologically based procedure designed to replace damaged structures, including dentin and root structures, as well as cells of the pulp–dentin complex.” This is an exciting and rapidly evolving field of human endodontics for the treatment of immature permanent teeth with infected root canal systems. These procedures have shown to be able not only to resolve pain and apical periodontitis but continued root development, thus increasing the thickness and strength of the previously thin and fracture-prone roots. In the last decade, over 80 case reports, numerous animal studies, and series of regenerative endodontic cases have been published. However, even with multiple successful case reports, there are still some remaining questions regarding terminology, patient selection, and procedural details. Regenerative endodontics provides the hope of converting a nonvital tooth into vital one once again.
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Zeng Q, Nguyen S, Zhang H, Chebrolu HP, Alzebdeh D, Badi MA, Kim JR, Ling J, Yang M. Release of Growth Factors into Root Canal by Irrigations in Regenerative Endodontics. J Endod 2017; 42:1760-1766. [PMID: 27871480 DOI: 10.1016/j.joen.2016.04.029] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 04/11/2016] [Accepted: 04/20/2016] [Indexed: 12/18/2022]
Abstract
INTRODUCTION The aim of this study was to investigate the release of growth factors into root canal space after the irrigation procedure of regenerative endodontic procedure. METHODS Sixty standardized root segments were prepared from extracted single-root teeth. Nail varnish was applied to all surfaces except the root canal surface. Root segments were irrigated with 1.5% NaOCl + 17% EDTA, 2.5% NaOCl + 17% EDTA, 17% EDTA, or deionized water. The profile of growth factors that were released after irrigation was studied by growth factor array. Enzyme-linked immunosorbent assay was used to validate the release of transforming growth factor (TGF)-β1 and basic fibroblast growth factor (bFGF) at 4 hours, 1 day, and 3 days after irrigation. The final concentrations were calculated on the basis of the root canal volume measured by cone-beam computed tomography. Dental pulp stem cell migration on growth factors released from root segments was measured by using Transwell assay. RESULTS Total of 11 of 41 growth factors were detected by growth factors array. Enzyme-linked immunosorbent assay showed that TGF-β1 was released in all irrigation groups. Compared with the group with 17% EDTA (6.92 ± 4.49 ng/mL), the groups with 1.5% NaOCl + 17% EDTA and 2.5% NaOCl + 17% EDTA had significantly higher release of TGF-β1 (69.04 ± 30.41 ng/mL and 59.26 ± 3.37 ng/mL, respectively), with a peak release at day 1. The release of bFGF was detected at a low level in all groups (0 ng/mL to 0.43 ± 0.22 ng/mL). Migration assay showed the growth factors released from root segments induced dental pulp stem cell migration. CONCLUSIONS The root segment model in present study simulated clinical scenario and indicated that the current irrigation protocol released a significant amount of TGF-β1 but not bFGF. The growth factors released into root canal space induced dental pulp stem cell migration.
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Affiliation(s)
- Qian Zeng
- Operative Dentistry and Endodontics, Guanghua School of Stomatology, Affiliated Stomatological Hospital, Guangdong Province Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Sean Nguyen
- Department of Endodontology, Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania
| | - Hongming Zhang
- Department of Endodontology, Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania
| | - Hari Priya Chebrolu
- Department of Endodontology, Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania
| | - Dalia Alzebdeh
- Regenerative Health Laboratory, Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania
| | - Mustafa A Badi
- Division of Oral and Maxillofacial Radiology, Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania
| | - Jong Ryul Kim
- Department of Endodontology, Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania
| | - Junqi Ling
- Guanghua School of Stomatology, Affiliated Stomatological Hospital, Guangdong Province Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong, China.
| | - Maobin Yang
- Department of Endodontology, Kornberg School of Dentistry, Temple University, Philadelphia, Pennsylvania.
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Zhu J, Wang X, Fang Y, Von den Hoff JW, Meng L. An update on the diagnosis and treatment of dens invaginatus. Aust Dent J 2017; 62:261-275. [PMID: 28306163 DOI: 10.1111/adj.12513] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2017] [Indexed: 12/15/2022]
Affiliation(s)
- J Zhu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education; School and Hospital of Stomatology; Wuhan University; Wuhan China
- Affiliated Zhongshan Hospital; Sun Yat-sen University; Zhongshan China
| | - X Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education; School and Hospital of Stomatology; Wuhan University; Wuhan China
| | - Y Fang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education; School and Hospital of Stomatology; Wuhan University; Wuhan China
| | - JW Von den Hoff
- Department of Orthodontics and Craniofacial Biology; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - L Meng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education; School and Hospital of Stomatology; Wuhan University; Wuhan China
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Pereira TC, Vasconcelos LRSMD, Graeff MSZ, Duarte MAH, Bramante CM, Andrade FBD. Intratubular disinfection with tri-antibiotic and calcium hydroxide pastes. Acta Odontol Scand 2017; 75:87-93. [PMID: 27866468 DOI: 10.1080/00016357.2016.1256427] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of this study was to compare the in vitro intradentinal antimicrobial ability of the calcium hydroxide and tri-antibiotic pastes. MATERIALS AND METHODS Standard bovine dentin tubes were sterilized and then infected with Enterococcus faecalis by a new contamination protocol of great depths of dentin. The specimens were filled with the medications, divided into two test-groups: calcium hydroxide (Group 1) and tri-antibiotic (Group 2) pastes. After 15 days, the teeth were evaluated by microbiological culture and confocal laser scanning microscopy (CLSM) with viability dye assay LIVE/DEAD inside dentinal tubules. In experiment of culture, the bacterial collection of the dentin fragments was done for counting the colony-forming units. RESULTS The tri-antibiotic paste had a slightly greater antimicrobial effect; however, there was no statistical difference between the groups. CONCLUSIONS It was concluded that the tri-antibiotic paste and the calcium hydroxide paste exercise the same effect on intra-tubular decontamination against E. faecalis. So, due the multiples advantages, the calcium hydroxide paste can be the choice for dentinal decontamination in regenerative procedures.
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Affiliation(s)
- Thais Cristina Pereira
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | | | - Marcia Sirlene Zardin Graeff
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Clóvis Monteiro Bramante
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Flaviana Bombarda De Andrade
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
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Timmerman A, Parashos P. Delayed Root Development by Displaced Mineral Trioxide Aggregate after Regenerative Endodontics: A Case Report. J Endod 2017; 43:252-256. [DOI: 10.1016/j.joen.2016.10.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 09/29/2016] [Accepted: 10/10/2016] [Indexed: 02/05/2023]
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Araújo PRDS, Silva LB, Neto APDS, Almeida de Arruda JA, Álvares PR, Sobral APV, Júnior SA, Leão JC, Braz da Silva R, Sampaio GC. Pulp Revascularization: A Literature Review. Open Dent J 2017; 10:48-56. [PMID: 28567136 PMCID: PMC5421106 DOI: 10.2174/1874210601711010048] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 11/05/2016] [Accepted: 12/06/2016] [Indexed: 01/09/2023] Open
Abstract
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.
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Affiliation(s)
| | - Luciano Barreto Silva
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Pernambuco, Brazil
| | | | - José Alcides Almeida de Arruda
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Pernambuco, Brazil
| | - Pâmella Recco Álvares
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Pernambuco, Brazil
| | - Ana Paula Veras Sobral
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Pernambuco, Brazil
| | | | | | - Rodivan Braz da Silva
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Pernambuco, Brazil
| | - Gerhilde Callou Sampaio
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Pernambuco, Brazil
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Abazarpour R, Parirokh M, Farhadi A, Jalali Z, Kheirabadi N. Successful Ultra-Conservative Management of a Mandibular Premolar with Dens Invaginatus. IRANIAN ENDODONTIC JOURNAL 2017; 12:390-395. [PMID: 28808472 PMCID: PMC5527221 DOI: 10.22037/iej.v12i3.16559] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 05/03/2017] [Accepted: 05/24/2017] [Indexed: 02/05/2023]
Abstract
Dens invaginatus is one of the most common anomalies of tooth structure. It is caused by the invagination of the crown surface during odontogenesis that enters the pulp chamber of the affected tooth. Depending on the complexity of invagination, the tooth might present with pulp necrosis, open apex and a complicated root canal system. This case report presents an Oehlers' type 2 dens-invaginatus in a mandibular premolar with chronic apical abscess. In most cases, dens invaginatus is removed during treatment. However, in this case report, based on cone-beam computed tomography (CBCT) evaluation, non-surgical treatment and maintenance of the invaginated segment was chosen in order to prevent compromising the tooth structure and its susceptibility to future root fracture. This is a new treatment approach and has not been performed in previous reports. Calcium-enriched mixture (CEM) cement was used as an apical plug followed by gutta-percha in warm vertical compaction for root canal obturation. The case was followed up for 36 months after treatment. This report highlights the importance of selecting the appropriate treatment approach based on CBCT evaluation.
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Affiliation(s)
| | - Masoud Parirokh
- Endodontology Research Center, Kerman University of Medical Sciences, Kerman, Iran;
| | - Aida Farhadi
- Endodontic Department, Dental School, Kerman University of Medical Sciences, Kerman, Iran;
| | - Zahra Jalali
- Restorative Department, Dental School, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Nasir Kheirabadi
- Endodontic Department, Dental School, Kerman University of Medical Sciences, Kerman, Iran;
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29
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Ceyhanli KT, Celik D, Altintas SH, Taşdemir T, S Sezgin O. Conservative treatment and follow-up of type III dens invaginatus using cone beam computed tomography. J Oral Sci 2016; 56:307-10. [PMID: 25500929 DOI: 10.2334/josnusd.56.307] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Dens invaginatus is a well-recognized phenomenon, and its endodontic treatment poses a challenge, especially for peri-invagination lesions with vital pulp. Here we describe the outcome of conservative treatment and follow-up in a case of type III dens invaginatus. Cone-beam computed tomography was used for diagnosis and follow-up. Pulp vitality was preserved with endodontic treatment of only an invaginated canal. At the 24-month follow-up examination, the tooth was asymptomatic and repair of the lesion was evident radiographically. This case was managed successfully with endodontic treatment of the invagination. (J Oral Sci 56, 307-310, 2014).
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Affiliation(s)
- Kadir T Ceyhanli
- Department of Endodontics, Faculty of Dentistry, Karadeniz Technical University
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30
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Pagliarin CML, Londero CDLD, Felippe MCS, Felippe WT, Danesi CC, Barletta FB. Tissue characterization following revascularization of immature dog teeth using different disinfection pastes. Braz Oral Res 2016; 30:S1806-83242016000100273. [PMID: 27556552 DOI: 10.1590/1807-3107bor-2016.vol30.0074] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 04/28/2016] [Indexed: 12/19/2022] Open
Abstract
Revascularization of immature teeth with necrotic pulps traditionally involves the use of triple antibiotic paste, which may sometimes lead to undesirable complications. The objective of this study was to assess tissue repair in immature dog teeth with apical periodontitis subjected to revascularization, comparing two different pastes used for root canal disinfection. Apical periodontitis was induced in 30 dog premolars. Teeth were randomly divided into three experimental groups: root canals filled with triple antibiotic paste (n = 10); root canals filled with 1% propolis paste (n = 10); and no medication (n = 10). An additional group (n = 10, no intervention) was used as control. After 7 months, the jaws were histologically evaluated for the following variables: newly formed mineralized tissue (present/absent); vital tissue in the canal space (absent/periodontal ligament-like/pulp-like); apical extension of root (present/absent); and severity of inflammatory process (absent/mild/moderate/severe). There were no statistically significant differences among the experimental groups in new mineralized tissue formation and apical root development. The formation of vital tissue in the canal space, in turn, was statistically different between the triple paste and propolis groups: vital tissues were present in all revascularized teeth disinfected with propolis paste (100%), compared to 71% of those disinfected with the triple paste. Severity of inflammatory process was different between the triple paste and no medication groups. The new tissues formed onto canal walls and in the root canal space showed characteristics of cementum and periodontal ligament, respectively. Propolis may have some advantages over the triple paste for the revascularization of immature teeth.
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Affiliation(s)
| | | | - Mara Cristina Santos Felippe
- Universidade Federal de Santa Catarina - UFSC, School of Dentistry, Department of Dentistry, Florianópolis, SC, Brazil
| | - Wilson Tadeu Felippe
- Universidade Federal de Santa Catarina - UFSC, School of Dentistry, Department of Dentistry, Florianópolis, SC, Brazil
| | - Cristiane Cademartori Danesi
- Universidade Federal de Santa Maria - UFSM, School of Dentistry, Department of Pathology, Santa Maria, RS, Brazil
| | - Fernando Branco Barletta
- Universidade Luterana do Brazil - ULBRA, School of Dentistry, Department of Endodontics, Canoas, RS, Brazil
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31
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Kahler B, Rossi-Fedele G. A Review of Tooth Discoloration after Regenerative Endodontic Therapy. J Endod 2016; 42:563-9. [DOI: 10.1016/j.joen.2015.12.022] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 11/21/2015] [Accepted: 12/22/2015] [Indexed: 12/31/2022]
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32
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Cho WC, Kim MS, Lee HS, Choi SC, Nam OH. Pulp revascularization of a severely malformed immature maxillary canine. J Oral Sci 2016; 58:295-8. [DOI: 10.2334/josnusd.15-0715] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Won Chang Cho
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University
| | - Mi Sun Kim
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University
| | - Hyo-Seol Lee
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University
| | - Sung Chul Choi
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University
| | - Ok Hyung Nam
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University
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33
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Chen YP, Jovani-Sancho MDM, Sheth CC. Is revascularization of immature permanent teeth an effective and reproducible technique? Dent Traumatol 2015; 31:429-36. [DOI: 10.1111/edt.12214] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Yu-Po Chen
- Dentistry Department; School of Health Sciences; Universidad CEU Cardenal Herrera; Moncada Valencia Spain
| | | | - Chirag C. Sheth
- Department of Biomedical Sciences; School of Health Sciences; Universidad CEU Cardenal Herrera; Moncada Valencia Spain
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34
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Nagata JY, Rocha-Lima TF, Gomes BP, Ferraz CC, Zaia AA, Souza-Filho FJ, De Jesus-Soares A. Pulp revascularization for immature replanted teeth: a case report. Aust Dent J 2015. [DOI: 10.1111/adj.12342] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- JY Nagata
- Department of Restorative Dentistry; Endodontics area; State University of Campinas-UNICAMP; Piracicaba Brazil
| | - TF Rocha-Lima
- Department of Restorative Dentistry; Endodontics area; State University of Campinas-UNICAMP; Piracicaba Brazil
| | - BP Gomes
- Department of Restorative Dentistry; Endodontics area; State University of Campinas-UNICAMP; Piracicaba Brazil
| | - CC Ferraz
- Department of Restorative Dentistry; Endodontics area; State University of Campinas-UNICAMP; Piracicaba Brazil
| | - AA Zaia
- Department of Restorative Dentistry; Endodontics area; State University of Campinas-UNICAMP; Piracicaba Brazil
| | - FJ Souza-Filho
- Department of Restorative Dentistry; Endodontics area; State University of Campinas-UNICAMP; Piracicaba Brazil
| | - A De Jesus-Soares
- Department of Restorative Dentistry; Endodontics area; State University of Campinas-UNICAMP; Piracicaba Brazil
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35
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Bezgin T, Sönmez H. Review of current concepts of revascularization/revitalization. Dent Traumatol 2015; 31:267-73. [DOI: 10.1111/edt.12177] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2015] [Indexed: 01/31/2023]
Affiliation(s)
- Tuğba Bezgin
- Faculty of Dentistry; Department of Pediatric Dentistry; Ankara University; Ankara Turkey
| | - Hayriye Sönmez
- Faculty of Dentistry; Department of Pediatric Dentistry; Ankara University; Ankara Turkey
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36
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Regenerative Endodontic Therapy: A Data Analysis of Clinical Protocols. J Endod 2015; 41:146-54. [DOI: 10.1016/j.joen.2014.08.003] [Citation(s) in RCA: 125] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 08/08/2014] [Accepted: 08/18/2014] [Indexed: 12/13/2022]
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37
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Regenerative endodontic treatment of an infected immature dens invaginatus with the aid of cone-beam computed tomography. Case Rep Dent 2014; 2014:403045. [PMID: 25530890 PMCID: PMC4229997 DOI: 10.1155/2014/403045] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 08/18/2014] [Indexed: 01/27/2023] Open
Abstract
Dens invaginatus is a developmental anomaly that results in an enamel-lined cavity intruding into the crown or root before the mineralization phase. This report presents regenerative endodontic treatment of a necrotic immature tooth with Oehler's type III dens invaginatus of a nine-year-old female patient. A diagnosis of dens invaginatus (Oehler's type III) and a large periapical lesion was established with the aid of cone-beam computed tomography (CBCT). In the presented case contrary to the classic revascularization protocol, mechanical instrumentation was performed which apparently did not interfere with the regeneration process. After mechanical instrumentation of the invaginated canal by manual K-files, the invaginated canal space was disinfected by triple antibiotic paste followed by blood clot induction from the periapical tissues and the placement of mineral trioxide aggregate. At one-year follow-up, the tooth remained clinically asymptomatic. Radiographic examination revealed complete healing of the periapical lesion. At the 20-month follow-up, the radiographic examination also showed that the open apex was closed and the walls of the root canal were thickened.
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38
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Successful Nonsurgical Endodontic Outcome of a Severely Affected Permanent Maxillary Canine with Dens Invaginatus Oehlers Type 3. J Endod 2014; 40:1702-7. [DOI: 10.1016/j.joen.2014.06.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 06/09/2014] [Accepted: 06/18/2014] [Indexed: 11/19/2022]
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39
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Wayama MT, Valentim D, Gomes-Filho JE, Cintra LTA, Dezan E. 18-Year Follow-up of Dens Invaginatus: Retrograde Endodontic Treatment. J Endod 2014; 40:1688-90. [DOI: 10.1016/j.joen.2014.01.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 01/28/2014] [Accepted: 01/30/2014] [Indexed: 10/25/2022]
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40
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Liji MP, Chandrababu K, Kumar MR, Jayashree S. Type II canal configuration and Type I Dens invaginatus. J Conserv Dent 2014; 17:382-4. [PMID: 25125855 PMCID: PMC4127701 DOI: 10.4103/0972-0707.136517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Revised: 08/13/2013] [Accepted: 03/24/2014] [Indexed: 12/04/2022] Open
Abstract
The prevalent notion about maxillary central incisor with normal external morphology is a tooth with single root and root canal. A case in which all four maxillary incisors were having Type II canal configurations (Vertucci's classification) is reported, in addition, the lateral incisors revealed dens invaginatus with a Type I pattern as suggested by Ohler's classification and a large periapical lesion was seen in relation to the right lateral incisor. The diagnosis was confirmed with the aid of spiral computed tomography (CT) and canals obturated. Nonsurgical healing of the lesion was assessed by reviewing the case at prefixed intervals of time.
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Affiliation(s)
- Mele Puthukudy Liji
- Department of Conservative Dentistry and Endodontics, Governement Dental College, Kozhikode, Kerala, India
| | - Krishnankutty Chandrababu
- Department of Conservative Dentistry and Endodontics, Governement Dental College, Kozhikode, Kerala, India
| | - Maroli Ramesh Kumar
- Department of Conservative Dentistry and Endodontics, Governement Dental College, Kozhikode, Kerala, India
| | - Santhadevi Jayashree
- Department of Conservative Dentistry and Endodontics, Governement Dental College, Kozhikode, Kerala, India
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41
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Levels of Evidence for the Outcome of Regenerative Endodontic Therapy. J Endod 2014; 40:1045-53. [DOI: 10.1016/j.joen.2014.03.013] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 02/28/2014] [Accepted: 03/10/2014] [Indexed: 11/21/2022]
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42
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Microbial Evaluation of Traumatized Teeth Treated with Triple Antibiotic Paste or Calcium Hydroxide with 2% Chlorhexidine Gel in Pulp Revascularization. J Endod 2014; 40:778-83. [DOI: 10.1016/j.joen.2014.01.038] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 01/22/2014] [Accepted: 01/24/2014] [Indexed: 01/08/2023]
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43
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Torabinejad M, Faras H, Corr R, Wright KR, Shabahang S. Histologic examinations of teeth treated with 2 scaffolds: a pilot animal investigation. J Endod 2014; 40:515-20. [PMID: 24666902 DOI: 10.1016/j.joen.2013.12.025] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 12/08/2013] [Accepted: 12/17/2013] [Indexed: 01/14/2023]
Abstract
INTRODUCTION A growing body of evidence is building a case for the possibility of tissue regeneration within the root canal of necrotic teeth, allowing for continued root development. However, it remains unknown what type of tissue is produced after regenerative endodontics. The purpose of this study was to use blood clots and platelet-rich plasma (PRP) as scaffolds in regenerative endodontics under ideal conditions in a ferret model to examine the tissues generated within the root canals. METHODS The pulps of 21 canine teeth from 7 young ferrets were extirpated using broaches without filing the canal walls. Bleeding was stimulated from the periapical tissues, and a blood clot was induced in the canal space to the level of the cementoenamel junction in 12 teeth. PRP was prepared and placed in the canals to the level of the cementoenamel junction in 9 teeth. The coronal access was sealed with mineral trioxide aggregate. Seven canines were not operated on and served as controls. Three months later, block sections including each canine and its surrounding tissues were removed for histologic evaluation. The tissues found in the canals of experimental teeth were compared with those in the control teeth. RESULTS Almost all of the experimental teeth showed the presence of intracanal bonelike tissue. No evidence of dentinal wall thickening or apical narrowing was noted in the experimental teeth. CONCLUSIONS In this experimental model, the use of either PRP or blood clots during regenerative endodontics leads to the formation of intracanal bonelike tissue without continual root maturation.
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Affiliation(s)
| | - Hadi Faras
- Loma Linda University, Loma Linda, California
| | - Robert Corr
- Loma Linda University, Loma Linda, California
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44
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Diogenes A, Henry MA, Teixeira FB, Hargreaves KM. An update on clinical regenerative endodontics. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/etp.12040] [Citation(s) in RCA: 209] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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