Management of an Immature Necrotic Permanent Molar with Apical Periodontitis Treated by Regenerative Endodontic Protocol Using Calcium Hydroxide and MM-MTA: A Case Report with Two Years Follow Up

Ajram, Jessy; Khalil, Issam; Gergi, Richard; Zogheib, Carla

doi:10.3390/dj7010001

Cited by 13 publications

(8 citation statements)

References 30 publications

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“…Among the included studies, six studies illustrated negative outcomes in regard to endodontic regeneration therapy in the management of immature necrotic permanent teeth [ 29 , 34 , 46 , 48 , 49 , 54 ]. On the other hand, 40 studies showed significant positive outcomes for endodontic regeneration treatment in these kinds of teeth due to root development, root wall thickening, root lengthening, and formation of hard tissue barrier or apical closure [ 3 , 4 , 6 , 16 , 20 , 22 , 26 – 28 , 30 – 33 , 35 – 45 , 47 , 50 – 53 , 55 – 65 ]. The outcomes of these 46 studies include different types of intracanal medications, scaffolds, pulpal space/barrier, root maturation stage, follow-up duration, and updating studies on their effect in periapical periodontitis and periapical healing.…”

Section: Resultsmentioning

confidence: 99%

Regenerative Endodontic Therapy in the Management of Immature Necrotic Permanent Dentition: A Systematic Review

Alghamdi

Alqurashi

2020

The Scientific World Journal

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Background and Objective. Management of immature permanent teeth exhibiting necrotic pulp is clinically challenging. An appropriate diagnosis, case selection, and good management ensure good outcomes. The objective of this review reviews all up-to-date data in regard to endodontic regeneration therapy in the management of immature permanent teeth with necrotic pulp and which conducts are most used and appropriate for this procedure in human and animal investigations. Materials and Methods. The electronic databases PubMed and Google Scholar were used to search the literature for relevant studies after applying specific inclusion and exclusion criteria. Studies that fulfilled both the inclusion and exclusion criteria were included in this systematic review. The search was conducted by two independent reviewers following the PRISMA guidelines. Results. Only 46 studies that fulfilled both the inclusion and exclusion criteria, which were conducted within the last 10 years, were included in this systematic review. These studies investigated different aspects of regenerative endodontic therapy including different types of scaffolds, intracanal medications, pulpal space/barriers, root maturation stage, follow-up duration, and updated studies on their use in the management of immature necrotic permanent teeth. Conclusions. This review concluded the compiled data observed that endodontic regenerative therapy was more efficient in treating immature necrotic permanent teeth and offered a greater advantage that should lead to wider acceptance among endodontists for effective results compared to different treatment options. However, more clinical trials with a standardized protocol and defined clinical, radiographic, and histopathological outcomes with longer follow-up periods are warranted.

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Section: Resultsmentioning

confidence: 99%

Regenerative Endodontic Therapy in the Management of Immature Necrotic Permanent Dentition: A Systematic Review

Alghamdi

Alqurashi

2020

The Scientific World Journal

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“…6,14 Furthermore, in the case of performing apexification procedures, proper root development cannot be achieved, and the tooth may be more susceptible to fracturing. 15 Previous studies have reported numerous minimally invasive caries removal methods with the purpose of reducing noise, vibration, fear, excessive removal of uninfected dentine, and pain. 14,[16][17][18] For example, carbon steel, tungsten carbide, or polymer burs, hand instruments (excavators, chisels), air abrasion, air polishing, ultrasonics, sono-abrasion, CMCR agents, lasers, photo-active disinfection (PAD), or ozone were used for selective caries removal.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Two Aerosol-Free Caries Removal Methods - A Split Mouth Randomized Clinical Trial

Duman

Kalaoglu

Çapan

et al. 2021

Cumhuriyet Dental Journal

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The management of deep caries lesions in immature permanent molars can be challenging in clinical practice, but minimally invasive caries removal methods can maintain apexogenesis by preventing extensive tissue loss. Here we compare a chemo-mechanical caries removal (CMCR) gel and polymer bur in terms of time spent on caries removal, patient acceptability, and clinical success. Materials and Methods:The teeth of 30 children were randomly divided into two groups. The duration of each method, the level of cooperation during each method, and the child's choice of caries removal method were recorded. Patients were followed at six-month intervals for at least two years. Results:The difference between the patients' preferences was not statistically significant, while the average caries removal time of the polymer bur method was significantly shorter (p<0.05) than the CMCR method. The rates of apical closure without pathology in the CMCR and polymer bur groups were 63.2% and 73.7%, respectively; 10% of each group underwent further treatment due to their clinical and/or radiographic pathology.Conclusions: These methods were thought to serve as an interim treatment in managing immature permanent teeth with deep caries. Furthermore, these methods, which do not involve water cooling, can minimize the risk of contamination and cross-infection.

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“…The 18 included studies had a total sample of 250 successful cases of RET. 13,[28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] The types of studies included in this systematic review were as follows: 7 case reports/case series 28,30,[35][36][37]41,44 ; 3 prospective studies 33,39,43 ; 5 retrospective studies 31,32,34,38,40 ; and 3 randomized clinical trials (RCTs). 13,29,42 The number of successful RET cases ranged from 1 to 45, with the total number of 250.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Preoperatively, all of the 250 successful cases of RET included across the 18 studies illustrated pretreatment radiographic evidence of periapical pathology. 13,[28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] Postoperatively, clinical signs indicative of infection (pain, swelling and the sinus tract) were absent from 239 (96%) of the RET cases. There was a trend toward a reduction in the size of periapical pathology early after the initiation of RET (reported at less than 1 year) and the complete absence of periapical pathology after at least 2.5 years (Table 3).…”

Section: Primary Outcomesmentioning

confidence: 99%

Regenerative endodontic treatment: A systematic review of successful clinical cases

Alghamdi¹,

Alsulaimani²

2021

Dent. Med. Probl.

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This systematic review was designed to evaluate and compare successful cases of regenerative endodontic treatment (RET) in terms of etiology, diagnosis, treatment protocols, and signs of success. An electronic search was performed in the PubMed and Google Scholar databases. The search was completed by 2 independent reviewers following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. All in vivo studies in humans that reported at least 1 successful case of RET were included in this review. Successful RET cases were defined as any case that involved the absence of clinical signs/symptoms of periapical inflammation and the presence of continued root maturation, especially apical closure, after the completion of the initial RET. A total of 250 successful cases of RET from 18 studies were selected in this review. A total of 98 (39%) successful cases were detected at least 2.5 years after the initiation of RET. A total of 239 (96%) successful RET cases were presented with the healing/absence of periapical lesions, and no further treatment was required. Furthermore, 45% of the successful RET cases showed root development maturation (stage V). Finally, the clinical outcomes of these RET cases are presented in this systematic review. Prudent case selection and excellent operative protocols are considered to be essential to achieve successful RET outcomes. Future studies are needed to identify a variety of relevant data, including preoperative, intraoperative and postoperative factors, in order to provide a better understanding of successful cases after RET.

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Management of an Immature Necrotic Permanent Molar with Apical Periodontitis Treated by Regenerative Endodontic Protocol Using Calcium Hydroxide and MM-MTA: A Case Report with Two Years Follow Up

Cited by 13 publications

References 30 publications

Regenerative Endodontic Therapy in the Management of Immature Necrotic Permanent Dentition: A Systematic Review

Regenerative Endodontic Therapy in the Management of Immature Necrotic Permanent Dentition: A Systematic Review

Comparison of Two Aerosol-Free Caries Removal Methods - A Split Mouth Randomized Clinical Trial

Regenerative endodontic treatment: A systematic review of successful clinical cases

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