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Ageel BM, El Meligy OA, Quqandi SMA. Mineral Trioxide Aggregate Apexogenesis: A Systematic Review. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2023; 15:S11-S17. [PMID: 37654389 PMCID: PMC10466563 DOI: 10.4103/jpbs.jpbs_530_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/15/2022] [Accepted: 12/16/2022] [Indexed: 09/02/2023] Open
Abstract
Objectives To evaluate the clinical and radiographic outcomes of apexogenesis with mineral trioxide aggregate (MTA) against other pulpotomy agents in carious/traumatized immature permanent teeth. Data Source A web-based search for possibly relevant scientific papers in the English language between January 2013 and August 2022 was undertaken in the databases such as PubMed, Scopus, Cochrane Library, and EMBASE. Only randomized clinical trials that compared MTA against other pulpotomy medicaments conducted in vital immature permanent dentition with open apex, having a sample size of not less than 20 with at least 6 months follow-up, reporting clinical or radiographic outcomes were included in the current review. Case studies, case series, animal studies, in vitro studies, non-clinical/clinical trials on mature/necrotic permanent or primary dentition, systematic reviews, and letters to the editor were excluded. Study Selection A total of 236 articles were retrieved from the databases during the search procedure. Two independent investigators conducted a full-text review of 83 studies following a screening of titles and abstracts. Eventually, seven studies were considered for the review. The Cochrane bias assessment tool was used to evaluate the quality of included studies. Five of the selected studies were assigned a low evidence level, whereas two were rated a high evidence level. Conclusion The present review indicated that the diverse pulpotomy agents had comparable clinical outcomes with MTA for apexogenesis in traumatized or carious immature permanent teeth. However, there is a lack of substantial information to draw firm conclusions about the benefits of one material over another.
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Affiliation(s)
| | - Omar A. El Meligy
- Professor of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- Professor of Pediatric Dentistry, Faculty of Dentistry, Alexandria University, Egypt
| | - Sarah M. A. Quqandi
- Department of Pediatric Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Lee HN, Liang C, Liao L, Tian WD. Advances in Research on Stem Cell-Based Pulp Regeneration. Tissue Eng Regen Med 2021; 18:931-940. [PMID: 34536210 DOI: 10.1007/s13770-021-00389-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/17/2021] [Accepted: 08/18/2021] [Indexed: 02/05/2023] Open
Abstract
Although root canal therapy is the most common and widely used treatment at clinical presentation, there are still some postoperative complications. As cell biology and tissue engineering techniques advance rapidly, the use of biological therapy to regenerate dental pulp has become a new trend; Relevant literatures in recent five years were searched using key words such as "root canal therapy", "Dental pulp stem cells", "Dental pulp regeneration", and "Cell homing" in PubMed, Web of Science, etc; Dental pulp stem cells (DPSCs) have multi-differentiation potential, self-renewal capability, and high proliferative ability. Stem cell-based dental pulp regeneration has emerged as a new research hot spot in clinical therapy. Recently, dental pulp-like structures have been generated by the transplantation of exogenous DPSCs or the induction of homing of endogenous DPSCs. Studies on DPSCs are important and significant for dental pulp regeneration and dental restoration; In this review, the existing clinical treatment methods, dental pulp regeneration, and DPSC research status are revealed, and their application prospects are discussed. The stem cell-based pulp regeneration exerts promising potential in clinical therapy for pulp regeneration.
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Affiliation(s)
- Hua-Nien Lee
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases and Engineering Research Center of Oral Translational Medicine, Ministry of Education and National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, 610044, China
| | - Cheng Liang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases and Engineering Research Center of Oral Translational Medicine, Ministry of Education and National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, 610044, China
| | - Li Liao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases and Engineering Research Center of Oral Translational Medicine, Ministry of Education and National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, 610044, China.
| | - Wei-Dong Tian
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases and Engineering Research Center of Oral Translational Medicine, Ministry of Education and National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, 610044, China.
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Different Approaches to the Regeneration of Dental Tissues in Regenerative Endodontics. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11041699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
(1) Background: The regenerative procedure has established a new approach to root canal therapy, to preserve the vital pulp of the tooth. This present review aimed to describe and sum up the different approaches to regenerative endodontic treatment conducted in the last 10 years; (2) Methods: A literature search was performed in the PubMed and Cochrane Library electronic databases, supplemented by a manual search. The search strategy included the following terms: “regenerative endodontic protocol”, “regenerative endodontic treatment”, and “regenerative endodontics” combined with “pulp revascularization”. Only studies on humans, published in the last 10 years and written in English were included; (3) Results: Three hundred and eighty-six potentially significant articles were identified. After exclusion of duplicates, and meticulous analysis, 36 case reports were selected; (4) Conclusions: The pulp revascularization procedure may bring a favorable outcome, however, the prognosis of regenerative endodontics (RET) is unpredictable. Permanent immature teeth showed greater potential for positive outcomes after the regenerative procedure. Further controlled clinical studies are required to fully understand the process of the dentin–pulp complex regeneration, and the predictability of the procedure.
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Abuelniel GM, Duggal MS, Kabel N. A comparison of MTA and Biodentine as medicaments for pulpotomy in traumatized anterior immature permanent teeth: A randomized clinical trial. Dent Traumatol 2020; 36:400-410. [DOI: 10.1111/edt.12553] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 02/15/2020] [Accepted: 02/16/2020] [Indexed: 12/20/2022]
Affiliation(s)
| | | | - Nihal Kabel
- Misr University for Sciences and Technology 6th of October City Egypt
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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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Ghoddusi J, Moushekhian S, Arian E, Ghiasi J, Forghani M. The Effectiveness of Sonic-Activated Irrigation in Reducing Intratubular Enterococcus faecalis. IRANIAN ENDODONTIC JOURNAL 2019; 14:63-67. [PMID: 36879604 PMCID: PMC9984808 DOI: 10.22037/iej.v14i1.22436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/24/2018] [Accepted: 12/10/2018] [Indexed: 03/08/2023]
Abstract
Introduction The purpose of this in vitro study was to compare the effectiveness of sonic activation and syringe irrigation of 5.25% sodium hypochlorite in removing the Enterococcus faecalis (E. faecalis) biofilm. Methods and Materials Root canals of 54 extracted human single-rooted central incisors were prepared with ProTaper S1-S2-F1-F2 and Gates Gliden burs size 1, and 2 at the working length. After sterilization, the root canals were contaminated with E. faecalis suspension and randomly assigned to three groups: G1, conventional syringe irrigation; G2, sonic agitation of NaOCl with Endo Activator system; and G3, no subjected to the mentioned irrigation techniques (negative control). Canals were sampled after the disinfection procedure. The colony forming units (CFU) count was evaluated. Samples were also visualized under fluorescent microscope to count viable bacteria. Data were statistically analyzed using the Kruskal-Wallis and one-way ANOVA followed by Tukey's test (P<0.05). Results There was a significant reduction in the CFU count after both irrigation techniques. There was no significant difference between two techniques (P=0.874). Using bacterial viability kit, Endo Activator displayed the least viable bacteria than the other groups (P<0.001) and control group showed the greatest one (P<0.001). Conclusion In this in vitro study, the Endo Activator system was more successful in reducing intratubular viable bacteria compared with NaOCl syringe irrigation alone.
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Affiliation(s)
- Jamileh Ghoddusi
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Siavash Moushekhian
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Arian
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Maryam Forghani
- Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Santos LGPD, Chisini LA, Springmann CG, Souza BDMD, Pappen FG, Demarco FF, Felippe MCS, Felippe WT. Alternative to Avoid Tooth Discoloration after Regenerative Endodontic Procedure: A Systematic Review. Braz Dent J 2018; 29:409-418. [DOI: 10.1590/0103-6440201802132] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/11/2018] [Indexed: 12/18/2022] Open
Abstract
Abstract This systematic review aimed to evaluate whether alternative materials to conventional triple antibiotic paste (TAP - metronidazole, ciprofloxacin, and minocycline) and grey mineral trioxide aggregate (GMTA) could avoid tooth discoloration in teeth submitted to Regenerative Endodontic Procedure (REP). It was also investigated if dental bleaching is able to reverse the color of darkened teeth due to REP. The search was conducted in four databases (Medline via PubMed, Scopus, ISI Web of Science and BVS - Virtual health library), following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The retrieved papers were uploaded in the software EndNoteTM and two reviewers independently selected the studies and extracted the data. Only studies in humans (case reports, case series, clinical trials) were included in the review. From 1,122 potentially eligible studies, 83 were selected for full-text analysis, and 38 were included in the review. The included studies were mainly case reports (76.3 %). The studies described a total of 189 teeth submitted to REP. From these, about 54% of teeth presented some degree of discoloration. Most teeth presenting color alteration were treated with TAP, especially when combined with GMTA. Only three studies performed dental bleaching to restore the color of teeth and neither bleaching technique was able to restore the original color of the crowns. The use of alternative materials to TAP and GMTA, such as double antibiotic paste or Ca(OH)2 pastes and white mineral trioxide aggregate or BiodentineTM, reduces the occurrence of tooth discoloration.
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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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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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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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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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Peng C, Zhao Y, Wang W, Yang Y, Qin M, Ge L. Histologic Findings of a Human Immature Revascularized/Regenerated Tooth with Symptomatic Irreversible Pulpitis. J Endod 2017; 43:905-909. [DOI: 10.1016/j.joen.2017.01.031] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 01/10/2017] [Accepted: 01/25/2017] [Indexed: 10/19/2022]
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Sungurtekin Ekçi E. Rejeneratif Pulpa Tedavilerine Genel Bir Bakış. CUMHURIYET DENTAL JOURNAL 2017. [DOI: 10.7126/cumudj.298907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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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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Al-Tammami MF, Al-Nazhan SA. Retreatment of failed regenerative endodontic of orthodontically treated immature permanent maxillary central incisor: a case report. Restor Dent Endod 2016; 42:65-71. [PMID: 28194367 PMCID: PMC5299758 DOI: 10.5395/rde.2017.42.1.65] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 08/30/2016] [Indexed: 01/10/2023] Open
Abstract
A revascularization procedure was shown to be the best alternative therapy for immature teeth with necrotic pulp and apical infection. A 12 year old female with a history of trauma to her upper central incisor and a sinus tract was referred for endodontic treatment. She was an active orthodontic patient and had undergone regenerative endodontic treatment for the past 2 years. Clinical examination revealed no response to sensibility, percussion, and palpation tests. The preoperative radiograph showed an open apex and apical rarefaction. The case was diagnosed as previously treated tooth with asymptomatic apical periodontitis. Regenerative endodontic retreatment was performed, and the case was followed for 3 years. Clinical, radiographic, and cone-beam computed tomography follow-up examination revealed an asymptomatic tooth, with evidence of periapical healing and root maturation.
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Affiliation(s)
| | - Saad A Al-Nazhan
- Department of Restorative Dental Science, Division of Endodontics, King Saudi University, College of Dentistry, Riyadh, Saudi Arabia
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16
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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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17
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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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18
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Lee BN, Moon JW, Chang HS, Hwang IN, Oh WM, Hwang YC. A review of the regenerative endodontic treatment procedure. Restor Dent Endod 2015; 40:179-87. [PMID: 26295020 PMCID: PMC4534721 DOI: 10.5395/rde.2015.40.3.179] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 01/29/2015] [Indexed: 01/09/2023] Open
Abstract
Traditionally, apexification has been used to treat immature permanent teeth that have lost pulp vitality. This technique promotes the formation of an apical barrier to close the open apex so that the filling materials can be confined to the root canal. Because tissue regeneration cannot be achieved with apexification, a new technique called regenerative endodontic treatment was presented recently to treat immature permanent teeth. Regenerative endodontic treatment is a treatment procedure designed to replace damaged pulp tissue with viable tissue which restores the normal function of the pulp-dentin structure. After regenerative endodontic treatment, continued root development and hard tissue deposition on the dentinal wall can occur under ideal circumstances. However, it is difficult to predict the result of regenerative endodontic treatment. Therefore, the purpose of this study was to summarize multiple factors effects on the result of regenerative endodontic treatment in order to achieve more predictable results. In this study, we investigated the features of regenerative endodontic treatment in comparison with those of other pulp treatment procedures and analyzed the factors that have an effect on regenerative endodontic treatment.
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Affiliation(s)
- Bin-Na Lee
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - Jong-Wook Moon
- School of Dentistry, Chonnam National University, Gwangju, Korea
| | - Hoon-Sang Chang
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - In-Nam Hwang
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - Won-Mann Oh
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - Yun-Chan Hwang
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
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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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20
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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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21
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Li Y, Shu LH, Yan M, Dai WY, Li JJ, Zhang GD, Yu JH. Adult stem cell-based apexogenesis. World J Methodol 2014; 4:99-108. [PMID: 25332909 PMCID: PMC4202485 DOI: 10.5662/wjm.v4.i2.99] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Revised: 01/04/2014] [Accepted: 03/14/2014] [Indexed: 02/06/2023] Open
Abstract
Generally, the dental pulp needs to be removed when it is infected, and root canal therapy (RCT) is usually required in which infected dental pulp is replaced with inorganic materials (paste and gutta percha). This treatment approach ultimately brings about a dead tooth. However, pulp vitality is extremely important to the tooth itself, since it provides nutrition and acts as a biosensor to detect the potential pathogenic stimuli. Despite the reported clinical success rate, RCT-treated teeth are destined to be devitalized, brittle and susceptible to postoperative fracture. Recently, the advances and achievements in the field of stem cell biology and regenerative medicine have inspired novel biological approaches to apexogenesis in young patients suffering from pulpitis or periapical periodontitis. This review mainly focuses on the benchtop and clinical regeneration of root apex mediated by adult stem cells. Moreover, current strategies for infected pulp therapy are also discussed here.
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Güven Polat G, Yıldırım C, Akgün OM, Altun C, Dinçer D, Ozkan CK. The use of platelet rich plasma in the treatment of immature tooth with periapical lesion: a case report. Restor Dent Endod 2014; 39:230-4. [PMID: 25110649 PMCID: PMC4125589 DOI: 10.5395/rde.2014.39.3.230] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 04/23/2014] [Indexed: 01/08/2023] Open
Abstract
This study describes the treatment of an immature permanent tooth with periapical lesion which was treated with regenerative approach using platelet rich plasma (PRP). The root canal of immature human permanent tooth with periapical lesion was gently debrided of necrotic tissue and disinfected with 2.5% NaOCl, and then medicated with triple antibiotic paste comprised of ciprofloxacin, metronidazole, and tetracycline. When the tooth was asymptomatic, PRP and mineral trioxide aggregate (MTA) were placed into the root canal. Six months after PRP treatment, radiographical examination revealed resolution of the radiolucency and progressive thickening of the root wall and apical closure. Our findings suggest that PRP can be used for the treatment of immature permanent teeth with periapical lesion, as part of a regenerative endodontic treatment procedure.
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Affiliation(s)
- Günseli Güven Polat
- Department of Pediatric Dentistry, Center for Dental Sciences, Gulhane Medical Academy, Ankara, Turkey
| | - Ceren Yıldırım
- Department of Pediatric Dentistry, Center for Dental Sciences, Gulhane Medical Academy, Ankara, Turkey
| | - Ozlem Martı Akgün
- Department of Pediatric Dentistry, Center for Dental Sciences, Gulhane Medical Academy, Ankara, Turkey
| | - Ceyhan Altun
- Department of Pediatric Dentistry, Center for Dental Sciences, Gulhane Medical Academy, Ankara, Turkey
| | - Didem Dinçer
- Department of Dermatology, Gulhane Medical Academy, Ankara, Turkey
| | - Cansel Köse Ozkan
- Center for Pharmaceutical Sciences, Gulhane Medical Academy, Ankara, Turkey
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Wang Y, Li J, Song W, Yu J. Mineral trioxide aggregate upregulates odonto/osteogenic capacity of bone marrow stromal cells from craniofacial bones via JNK and ERK MAPK signalling pathways. Cell Prolif 2014; 47:241-8. [PMID: 24635197 DOI: 10.1111/cpr.12099] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Accepted: 12/21/2013] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate effects of mineral trioxide aggregate (MTA) on odonto/osteogenic differentiation of bone marrow stromal cells (BMSCs) from craniofacial bones. MATERIALS AND METHODS Craniofacial BMSCs were isolated from rat mandible and effects of MTA on their proliferation, differentiation and MAPK pathway involvement were subsequently investigated, in vitro. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2,5-tetrazoliumbromide) assay was performed to evaluate proliferation of the MTA-treated cells. Alkaline phosphatase (ALP) activity, alizarin red staining, real-time reverse transcription polymerase chain reaction and western blot assays were used to assess differentiation capacity as well as MAPK pathway involvement. RESULTS 0.02 mg/ml MTA-treated BMSCs had significantly higher ALP activity and formed more mineralized nodules than the untreated group. Odonto/osteoblastic marker genes/proteins (Alp, Runx2/RUNX2, Osx/OSX, Ocn/OCN and Dspp/DSP respectively) in MTA-treated cells were remarkably upregulated compared to untreated ones. Mechanistically, phosphorylated Jun N-terminal kinase (P-JNK) and phosphorylated extracellular regulated protein kinases (P-ERK) in MTA-treated BMSCs increased significantly in a time-dependent manner, while inhibition of JNK and ERK MAPK pathways dramatically blocked MTA-induced odonto/osteoblastic differentiation, as indicated by reduced ALP levels, weakened mineralization capacity and downregulated levels of odonto/osteoblastic marker genes (Alp, Runx2, Osx, Ocn and Dspp). CONCLUSION Mineral trioxide aggregate promoted odonto/osteogenic capacity of craniofacial BMSCs via JNK and ERK MAPK signalling pathways.
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Affiliation(s)
- Y Wang
- Endodontic Department, The Affiliated Stomatological Hospital of Soochow University, Suzhou, Jiangsu, 215005, China; Institute of Stomatology, Nanjing Medical University, Nanjing, Jiangsu, 210029, China
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Hotwani K, Sharma K. Platelet rich fibrin - a novel acumen into regenerative endodontic therapy. Restor Dent Endod 2014; 39:1-6. [PMID: 24516822 PMCID: PMC3916499 DOI: 10.5395/rde.2014.39.1.1] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 10/15/2013] [Indexed: 12/13/2022] Open
Abstract
Research into regenerative dentistry has added impetus onto the field of molecular biology. It can be documented as a prototype shift in the therapeutic armamentarium for dental disease. Regenerative endodontic procedures are widely being added to the current armamentarium of pulp therapy procedures. The regenerative potential of platelets has been deliberated. A new family of platelet concentrates called the platelet rich fibrin (PRF) has been recently used by several investigators and has shown application in diverse disciplines of dentistry. This paper is intended to add light on the various prospects of PRF and clinical insights to regenerative endodontic therapy.
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Affiliation(s)
- Kavita Hotwani
- Department of Pedodontics and Preventive Dentistry, Sharad Pawar Dental College, Sawangi(M), Wardha, Maharashtra, India
| | - Krishna Sharma
- Department of Orthodontics and Dentofacial Orthopaedics, Sharad Pawar Dental College, Sawangi(M), Wardha, Maharashtra, India
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