Management of Immature Necrotic Permanent Teeth with Regenerative Endodontic Procedures - A Review of Literature

Hameed, Muhammad Hasan; Gul, Meisha; Ghafoor, Robia; Badar, Sheikh Bilal

doi:10.5455/jpma.294366

Cited by 24 publications

(30 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…According to a data analysis performed by Kontakiotis et al, in 68% of clinical case reports there was no mechanical instrumentation of the canal walls [107]. Some studies have suggested that complete instrumentation may be unfavorable for regenerative treatment, by removing vital tissues from the apical area of the canal and also weakening root walls [49,108]. Nevertheless, mechanical debridement seems to be required for biofilm structure removal, because its remaining causes persistent inflammation, and significantly decreases the chance of regenerative procedure success [104,109].…”

Section: Discussionmentioning

confidence: 99%

Different Approaches to the Regeneration of Dental Tissues in Regenerative Endodontics

Krupińska

Skośkiewicz−Malinowska

Staniowski

2021

Applied Sciences

View full text Add to dashboard Cite

(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.

show abstract

Section: Discussionmentioning

confidence: 99%

Different Approaches to the Regeneration of Dental Tissues in Regenerative Endodontics

Krupińska

Skośkiewicz−Malinowska

Staniowski

2021

Applied Sciences

View full text Add to dashboard Cite

show abstract

“…The primary agent is sodium hypochlorite (NaOCl) of which the concentration used by various authors varies between 1% and 6% [30]. According to some researchers, high concentrations are not advisable, due to the potential risk of damaging stem cells in the periapical region [11,31]. It was shown that an increase in the concentration of sodium hypochlorite improves the bactericidal effect but at the same time hinders cell proliferation [32][33][34].…”

Section: Root Canal Disinfectionmentioning

confidence: 99%

“…The use of EDTA is justified because of its ability to remove the smear layer, resulting in better penetration of the topically applied therapeutic agents. In addition, the chelating effect after EDTA application promotes the release of growth factors from dentinal tubules, migration and differentiation of stem cells, and adhesion of newly forming tissue to the root canal walls [11,29,39].…”

Section: Root Canal Disinfectionmentioning

confidence: 99%

“…By binding to cell receptors, they influence a number of interactions between the cells and the extracellular matrix (ECM). In addition, they act as regulators of migration, differentiation, cell proliferation, and tissue formation [11,[72][73][74][75][76][77] (Table 2). The scaffold creates a suitable environment for the processes mentioned above and provides support for the emerging new tissue [16].…”

Section: Components Of the Pulp Regeneration Processmentioning

confidence: 99%

“…For this process to occur, three essential components must be present in the root canal: a scaffold for newly forming tissue, stem cells, and growth factors [10]. The key processes that occur in the root canal after regenerative procedures are angiogenesis, reinnervation, and the differentiation of cells responsible for root development [11]. This leads to the formation of vital pulp-, bone-, cementum-or periodontal-like tissue in the canal and thus, root formation [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Regenerative Endodontics as the Future Treatment of Immature Permanent Teeth

2021

View full text Add to dashboard Cite

The regenerative endodontic procedure (REP) is an alternative solution for endodontic treatment of permanent teeth with incomplete root apex development. It results in angiogenesis, reinnervation, and further root formation. Indications for REP include immature permanent teeth with necrotic pulp and inflammatory lesions of the periapical tissues. The main contraindications comprise significant destruction of the tooth tissues and a lack of patient cooperation. We distinguish the following stages of this procedure: disinfection of the canal, delivery of the REP components, closure of the cavity, and follow-up appointments. For effective canal disinfection, the use of both rinsing agents and intracanal medicaments is suggested. Sodium hypochlorite and triple antibiotic paste are used most commonly. Light-activated disinfection is proposed as an alternative method. The prerequisite for the regeneration process of the pulp is the supply of its essential components: stem cells, growth factors, and scaffolds to the canal lumen. Blood clotting, platelet-rich plasma, and platelet-rich fibrin are used for this purpose. For a proper course of REP, it is also necessary to close the tooth canal tightly. For this purpose, mineral trioxide aggregate (MTA), tricalcium silicate (Biodentine), or types of glass ionomer cement are employed. The patient should attend regularly scheduled follow-up appointments and each time undergo a thorough interview, physical and radiological examination. The most important indicator of a successful REP is the continued growth of the root in length and thickness and the closure of the root apex visible on X-rays. Many different proposals for a management protocol have been published; the following paper proposes the authors’ original scheme. Regenerative endodontics is the future of the endodontic treatment of immature permanent teeth; however, it still requires a lot of research to refine and standardize the treatment protocol. The application of tissue engineering methods seems to be promising, also for mature teeth treatment.

show abstract

Radiographic differences observed following apexification vs revascularization in necrotic immature molars and incisors: a follow-up study of 18 teeth

Caleza-Jiménez

Ribas-Perez

Biedma-Perea

et al. 2022

Eur Arch Paediatr Dent

View full text Add to dashboard Cite

Purpose To evaluate the effectiveness of apexification versus revascularization in the treatment of necrotic immature teeth and determine which strategy affords the greatest radiological success rate. Methods An analysis was made of 18 teeth subjected to mineral trioxide aggregate (MTA) apical plugging and regenerative endodontic treatment, assessing healing of the apical lesions and the changes in root dimensions. Results Significantly greater root growth was observed with revascularization in terms of the percentage change in length (12.75% at 6 months) and dentin thickness (34.57% at 6 months) (p < 0.05). There were no significant differences between the two treatments in terms of the apical healing scores after 6 months of follow-up (p > 0.05). Conclusion Apexification with an MTA apical plug and pulp regeneration are reliable treatments for non-vital immature teeth. The radiographic outcomes are comparable between the immature teeth subjected to MTA apexification versus those subjected to revascularization. The results of the present study indicate a greater increase in root length and width with regenerative endodontic treatment.

show abstract

Management of Immature Necrotic Permanent Teeth with Regenerative Endodontic Procedures - A Review of Literature

Cited by 24 publications

References 61 publications

Different Approaches to the Regeneration of Dental Tissues in Regenerative Endodontics

Different Approaches to the Regeneration of Dental Tissues in Regenerative Endodontics

Regenerative Endodontics as the Future Treatment of Immature Permanent Teeth

Radiographic differences observed following apexification vs revascularization in necrotic immature molars and incisors: a follow-up study of 18 teeth

Contact Info

Product

Resources

About