Drawbacks and Unfavorable Outcomes of Regenerative Endodontic Treatments of Necrotic Immature Teeth: A Literature Review and Report of a Case

Nosrat, Ali; Homayounfar, Negar; Oloomi, Kaveh

doi:10.1016/j.joen.2012.06.025

Cited by 196 publications

(195 citation statements)

References 48 publications

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“…The containers were stored at 37°C for one or four weeks. The two time points were selected to represent the intra-canal application time of medicaments as reported in some cases of endodontic regeneration [4,17]. For the four-week groups, each specimen was hydrated with 0.07 mL of de-ionized water weekly.…”

Section: Treatment Proceduresmentioning

confidence: 99%

A novel approach to evaluate the effect of medicaments used in endodontic regeneration on root canal surface indentation

Yassen¹,

Chu²,

Gallant³

et al. 2013

Clin Oral Invest

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Objectives: To investigate the capability of a novel reference point indentation apparatus to test the indentation properties of root canal surface dentine treated with three intracanal medicaments used in endodontic regeneration. Materials and Methods:Immature human premolars were selected (n=22). Four specimens were obtained from each root and randomly assigned to three treatment groups and a control group. Each specimen was exposed to one of three treatment pastes (triple antibiotic (TAP), double antibiotic (DAP), or calcium hydroxide [Ca(OH) 2 ] or neutral de-ionized water (control) for one or four weeks. After each time-interval, the indentation properties of the root canal dentine surfaces were measured using a BioDent reference point indenter. Two-way ANOVA and Fisher's Protected Least Significant Differences were used for statistical analyses.Results: Significant differences in indentation parameters and estimated hardness between all groups at both time points were found. TAP treated dentine had the highest significant indentation parameters, followed by DAP treated dentine, untreated control dentine and Ca(OH) 2 treated dentine, respectively. Furthermore, TAP treated dentine had the lowest significant estimated hardness, followed by DAP treated dentine, untreated control dentine and Ca(OH) 2 treated dentine, respectively. Conclusion: BioDent reference point indenter was able to detect significant differences in indentation properties of root canal dentine treated with various medicaments.Clinical Relevance: The use of a reference point indenter is a promising approach to characterize the indentation properties of root canal surfaces without any surface modification. This might provide an in vitro mechanical measurement that is more representative of the actual clinical situation.

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Section: Treatment Proceduresmentioning

confidence: 99%

A novel approach to evaluate the effect of medicaments used in endodontic regeneration on root canal surface indentation

Yassen¹,

Chu²,

Gallant³

et al. 2013

Clin Oral Invest

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“…Although this treatment has been performed and reported with successful clinical outcomes such as radiographic signs of tooth maturation and symptom reduction, there are still significant drawbacks and undesirable outcomes, including tooth discoloration, cervical fracture, and especially ectopic hard tissue formation. 6 In regenerative endodontics, cell homing appears to be a more promising strategy than intentional bleeding in the near future. 7,8 The concept depends on a scaffold, normally a cellular matrix, and growth factors or cytokines to promote host cell migration into the pulp space and finally regeneration of resident tissues by the host cells.…”

Section: Introductionmentioning

confidence: 99%

Effects of Stem Cell Factor on Cell Homing During Functional Pulp Regeneration in Human Immature Teeth

Ruangsawasdi

Zehnder

Patcas

et al. 2017

Tissue Engineering Part A

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Conventional root canal treatment in immature permanent teeth can lead to early tooth loss in children because root formation is discontinued. We investigated whether the stem cell factor (SCF) could facilitate cell homing in the pulpless immature root canal and promote regeneration of a functional pulp. In vitro, human mesenchymal stem cells (hMSCs) were exposed to SCF at various concentrations for assessing cell migration, proliferation, and differentiation toward odonto/osteoblasts by 3D-chemotaxis slides, WST-1 assay, and alkaline phosphatase activity, respectively. Fibrin gels were used to deliver 15 g/mL SCF for in vivo experiments. The release kinetic of SCF was assessed in vitro. Two corresponding human immature premolars, with or without SCF, were placed at rat calvariae for 6 and 12 weeks. All tooth specimens were either analyzed histologically and the percentage of tissue ingrowth determined or the cells were extracted from the pulp space, and the mRNA level of DMP1, DSPP, Col1, NGF, and VEGF were assessed by quantitative polymerase chain reaction. In the presence of SCF, we saw an increase in hMSCs directional migration, proliferation, and odonto/osteogenic differentiation. SCF also increased the extent of tissue ingrowth at 6 weeks but not at 12 weeks. However, at this time point, the formed tissue appeared more mature in samples with SCF. In terms of gene transcription, DMP1, Col1, and VEGF were the significantly upregulated genes, while DSPP and NGF were not affected. Our results suggest that SCF can accelerate cell homing and the maturation of the pulp-dentin complex in human immature teeth. Conventional root canal treatment in immature permanent teeth can lead to early tooth loss in children because root formation is discontinued. We investigated whether the stem cell factor (SCF) could facilitate cell homing in the pulpless immature root canal and promote regeneration of a functional pulp. In vitro, human mesenchymal stem cells (hMSCs) were exposed to SCF at various concentrations for assessing cell migration, proliferation, and differentiation toward odonto/osteoblasts by 3D-chemotaxis slides, WST-1 assay, and alkaline phosphatase activity, respectively. Fibrin gels were used to deliver 15 mg/mL SCF for in vivo experiments. The release kinetic of SCF was assessed in vitro. Two corresponding human immature premolars, with or without SCF, were placed at rat calvariae for 6 and 12 weeks. All tooth specimens were either analyzed histologically and the percentage of tissue ingrowth determined or the cells were extracted from the pulp space, and the mRNA level of DMP1, DSPP, Col1, NGF, and VEGF were assessed by quantitative polymerase chain reaction. In the presence of SCF, we saw an increase in hMSCs directional migration, proliferation, and odonto/ osteogenic differentiation. SCF also increased the extent of tissue ingrowth at 6 weeks but not at 12 weeks. However, at this time point, the formed tissue appeared more mature in samples with SCF. In terms of gene transcription, DMP1, Col1, a...

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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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Drawbacks and Unfavorable Outcomes of Regenerative Endodontic Treatments of Necrotic Immature Teeth: A Literature Review and Report of a Case

Cited by 196 publications

References 48 publications

A novel approach to evaluate the effect of medicaments used in endodontic regeneration on root canal surface indentation

A novel approach to evaluate the effect of medicaments used in endodontic regeneration on root canal surface indentation

Effects of Stem Cell Factor on Cell Homing During Functional Pulp Regeneration in Human Immature Teeth

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

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