Challenges in Regenerative Endodontics: A Case Series

Petrino, Joseph A.; Boda, Krisztina; Shambarger, Sandra; Bowles, Walter R.; McClanahan, Scott B.

doi:10.1016/j.joen.2009.10.006

Cited by 330 publications

(355 citation statements)

References 22 publications

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“…TAP consisting of metronidazole, ciprofloxacin and minocycline, has been successfully used to disinfect the canals in RET, achieving closure of the apex and thickening of the dentinal walls [3][4][5][6][7] . A potential disadvantage when using TAP is the possibility of tooth discoloration 4,12,13) due to minocycline 4,13) . The double antibiotic paste (DAP), that excludes minocycline, has also been successfully used for RET 14,15) .…”

Section: Introductionmentioning

confidence: 99%

Antibacterial efficacy of several intracanal medicaments for endodontic therapy

et al. 2017

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The antibacterial efficacy of intracanal medicaments for 2 and 7 days, in open apex root canals contaminated with Enterococcus faecalis biofilms was compared. One hundred and thirty-eight standardized uniradicular human roots were inoculated with E. faecalis. Colony forming units (CFU) were recorded before and after medication. Samples were divided in two (2/7 days), and subdivided (n=8/group): triple antibiotic paste (TAP); double antibiotic paste (DAP); dental base paste (DBP), consisting of calcium hydroxide, propylene glycol and calcium carbonate; DBP+0.2% chlorhexidine (CHX); DBP+0.2% cetrimide (CTR); DBP+0.2% CHX+0.2% CTR; 2.5% sodium hypochlorite (NaOCl); and distilled water. At both periods TAP, DAP, DBP+0.2% CHX, DBP+0.2% CTR and DBP+0.2% CHX+0.2% CTR exhibited no growth (NG) of E. faecalis. Distilled water and 2.5% NaOCl obtained the lowest CFU reduction. No growth with DBP was reached only at 7 days. CHX and/or CTR pastes were as effective as DAP and TAP. A 2-day period provided an effective disinfection.

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Section: Introductionmentioning

confidence: 99%

Antibacterial efficacy of several intracanal medicaments for endodontic therapy

et al. 2017

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“…Apexification is the classic treatment and involves periodic changes of intracanal dressing during a period of 6 to 24 months until a calcified mineralized barrier is formed, allowing apical sealing of the tooth 7 . More recently, pulp revascularization has demonstrated promising results, with root end development in immature teeth with indication for endodontic therapy [8][9][10] . Nevertheless, there are situations in which pulp revascularization may not be the first choice, considering the need for rehabilitation with intracanal retainers, root resorption and possibility of complications of this little known therapy.…”

Section: Introductionmentioning

confidence: 99%

Intracanal dressing paste composed by calcium hydroxide, chlorhexidine and zinc oxide for the treatment of immature and mature traumatized teeth

Soares¹,

Lima²,

Nagata³

et al. 2014

Braz. J. Oral Sci.

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Aim: To evaluate clinical and radiographic aspects before and after endodontic treatment with an intracanal dressing paste composed of calcium hydroxide, chlorhexidine and zinc oxide in traumatized teeth followed-up for 1 year. Methods: Patients (n=105) treated at the Dental Trauma Service of Piracicaba School of Dentistry, Brazil were enrolled in the study. Two groups of teeth were formed: immature (G1) (n=28) and completely developed teeth (G2) (n=174). All teeth were endodontically treated and received an intracanal dressing with a paste composed by calcium hydroxide, 2% chlorhexidine gel and zinc oxide at a 2:1:2 rate. Clinical and radiographic aspects were evaluated initially, monthly and after 1-year. Results: Most of the immature teeth suffered extrusive luxation (39.3%), whereas intrusive luxation (40.8%) was more common in completely developed teeth. There was a significant reduction in pain on percussion and mobility (p=0.0001) for immature teeth. Mature teeth showed reduction of spontaneous pain, fistula, mobility and pain on percussion (p<0.0001). Radiographic examination showed decrease in all evaluated parameters for both groups, in addition to stabilization of root resorption. Conclusions: This new intracanal dressing paste for traumatized teeth showed promising results in both immature and completely developed teeth, and may prevent posttraumatic complications.

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“…Além dos estudos in vitro; a ação antimicrobiana desta pasta composta por antibióticos tem sido relatada in vivo em estudos com cães (Windley et al, 2005;Wang et al, 2010) e estudos clínicos (Petrino, 2007;Jung et al, 2008;Shah et al, 2008;Ding et al, 2009;Reynolds et al, 2009;Kim et al, 2010;Petrino et al, 2010;Thomson;Kahler, 2010;Nosrat et al, 2011;Turman, 2011;Jeeruphan et al, 2012;Lenzi;Trope, 2012;Nosrat et al, 2012).…”

Section: Medicações Intracanalunclassified

“…A maioria dos protocolos propostos na literatura envolve a manipulação dos tecidos periapicais, com o objetivo de promover o sangramento para induzir a formação de um coágulo sanguíneo no espaço do canal radicular (Banchs;Trope, 2004;Huang, 2006;Petrino, 2007;Thibodeau;Cotti et al, 2008;Jung et al, 2008;Shah et al, 2008;Ding et al, 2009;Reynolds et al, 2009;Shin et al, 2009;Thibodeau, 2009;Kim et al, 2010;Petrino et al, 2010;Thomson;Kahler, 2010;Cehreli et al, 2011;Nosrat et al, 2011;Chen et al, 2012;Jeeruphan et al, 2012;Lenzi;Trope, 2012;Nosrat et al, 2012;Soares et al, 2013;Nagata et al, 2014a,b Turman, 2011).…”

Section: Scaffolfd-coágulo Sanguíneounclassified

“…Há também outros tipos de "scaffolds" biodegradáveis ou permanentes disponíveis como colágeno, ácido hialurônico ou sintéticos como o ácido poliglicólico ou hidroxiapatita (Gotlieb et al, 2008;Chandrahasa et al, 2011 (Banchs;Trope, 2004;Petrino, 2007;Thibodeau;Cotti et al, 2008;Jung et al, 2008;Ding et al, 2009;Reynolds et al, 2009;Shin et al, 2009;Thibodeau, 2009;Kim et al, 2010;Petrino et al, 2010;Thomson;Kahler, 2010;Cehreli et al, 2011;Turman, 2011;Chen et al, 2012;Jeeruphan et al, 2012;Lenzi;Trope, 2012;Nosrat et al, 2012). Nosrat et al (2011) utilizaram uma mistura enriquecida de cálcio (CEM), uma substância que tem características de selamento e biocompatibilidade semelhantes ao MTA, é capaz de promover a formação de hidroxiapatita, induzir diferenciação de células-tronco e induzir a formação de tecido mineralizado (Asgary et al, 2009 (Lovelace et al, 2011).…”

Section: Scaffolfd-coágulo Sanguíneounclassified

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Influência de medicações intracanal utilizadas em procedimentos endodônticos regenerativos na sobrevivência de células da papila apical in vitro

Oliveira¹

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Oliveira AP. Influence of intracanal medications used in regenerative endodontic procedures on survival of apical papilla cells in vitro [thesis]. São Paulo: Universidade de São Paulo, Faculdade de Odontologia; 2014. Versão Corrigida.Regenerative Endodontic procedures have provided changes in treatment of patients with immature teeth and apical periodontitis enabling full root development and lower incidence of dental fracture. Intracanal dressings are used for disinfection; however, their effect on apical papilla cells is poorly elucidated. Additionally, the effect of these substances on cells previously subjected to proinflammatory condition is still unknown. The aim of this study was to evaluate the cytotoxicity of intracanal dressings used in Endodontics regenerative procedures on cultured human apical papilla cells at physiologic and activated condition. Cell culture was established from the apical papilla removed from an extracted immature third molar. The substances studied were triple antibiotic modified paste: ciprofloxacin, metronidazole and cephalosporin (1:1:1); CFC: ciprofloxacin, metronidazole and calcium hydroxide (1:1:2) and modified CFC: ciprofloxacin , metronidazole and calcium hydroxide (2:2:1). Part of the cells was stimulated previously with lipotheichoic acid (LTA) of Enterococcus faecalis por 7 days. Once plated, cells were exposed to increasing concentration of the medications for 1, 3, 5 and 7 days. Cell viability was evaluated by means of 3-bromide (4.5-dimetiliazol-2-yl) -2.5-difeniltetraze (MTT) and Nitric Oxide (NO) release was assessed by the Griess method. The statistical analysis was done through analysis of variance with 1 criteria (ANOVA) followed by Tukey test with 5% of significance level. Modified CFC was the medication that demonstrated the less cytotoxic effect on cell viabilityat the experimental periods studied while CFC promoted significant decrease on cell viability specially after 7 days of contact. The modified triple antibiotic paste resulted in important alteration of cell viability being considered the most citotoxic. Cellular activation by LTA resulted in increased levels of mitochondrial activity for all medications being more evident at the longer experimental periods. Cellular activation also contributed to higher levels of nitric oxide release. In conclusion, the cytotoxic effect of the tested medications is dependent on concentration, time of contact and cellular condition, being the triple antibiotic modified paste the most cytotoxic in high concentrations leading clinically in the decreased of the cells viability of the apical papilla, decreasing the success of regenerative procedures.

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Challenges in Regenerative Endodontics: A Case Series

Cited by 330 publications

References 22 publications

Antibacterial efficacy of several intracanal medicaments for endodontic therapy

Antibacterial efficacy of several intracanal medicaments for endodontic therapy

Intracanal dressing paste composed by calcium hydroxide, chlorhexidine and zinc oxide for the treatment of immature and mature traumatized teeth

Influência de medicações intracanal utilizadas em procedimentos endodônticos regenerativos na sobrevivência de células da papila apical in vitro

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