Pulp Revascularization of Immature Dog Teeth With Apical Periodontitis

Thibodeau, Blayne; Teixeira, Fabrício B.; Yamauchi, Mitsuo; Caplan, Daniel J.; Trope, Martin

doi:10.1016/j.joen.2007.03.001

Cited by 276 publications

(309 citation statements)

References 32 publications

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“…If pulp and apical papilla are totally lost, then the root canal space may be occupied by cementum, PDL, and bone (35)(36)(37)(38)(39)(40). By tracing the migration of periodontal cells after pulpectomy in immature teeth, Vojinovic and Vojinovic (41) found that periodontal cells migrate into the apical pulp space during the repair process.…”

Section: The Potential Role Of Scap In Replantation and Transplantationmentioning

confidence: 99%

The Hidden Treasure in Apical Papilla: The Potential Role in Pulp/Dentin Regeneration and BioRoot Engineering

Huang

Sonoyama

Liu

et al. 2008

Journal of Endodontics

632

526

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Some clinical case reports have shown that immature permanent teeth with periradicular periodontitis or abscess can undergo apexogenesis after conservative endodontic treatment. A call for a paradigm shift and new protocol for the clinical management of these cases has been brought to attention. Concomitantly, a new population of mesenchymal stem cells residing in the apical papilla of permanent immature teeth recently has been discovered and was termed stem cells from the apical papilla (SCAP). These stem cells appear to be the source of odontoblasts that are responsible for the formation of root dentin. Conservation of these stem cells when treating immature teeth may allow continuous formation of the root to completion. This article reviews current findings on the isolation and characterization of these stem cells. The potential role of these stem cells in the following respects will be discussed: (1) their contribution in continued root maturation in endodontically treated immature teeth with periradicular periodontitis or abscess and (2) their potential utilization for pulp/ dentin regeneration and bioroot engineering. KeywordsApexogenesis; apical papilla; bioroot engineering; dental pulp stem cells; immature teeth; periodontal ligament stem cells; pulp regeneration; stem cells from human exfoliated deciduous teeth; stem cells from the apical papilla A number of recent clinical case reports have revealed the possibilities that many teeth that traditionally would receive apexification may be treated for apexogenesis. A call for a paradigm shift and new protocol for the clinical management of these cases has been made by the authors (1-3). A recent scientific finding, which may explain in part why apexogenesis can occur in these infected immature permanent teeth, is the discovery and isolation of a new population of mesenchymal stem cells (MSCs) residing in the apical papilla of incompletely developed teeth (4,5). These cells are termed stem cells from the apical papilla (SCAP), and they differentiate

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Section: The Potential Role Of Scap In Replantation and Transplantationmentioning

confidence: 99%

The Hidden Treasure in Apical Papilla: The Potential Role in Pulp/Dentin Regeneration and BioRoot Engineering

Huang

Sonoyama

Liu

et al. 2008

Journal of Endodontics

632

526

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show abstract

“…Literature reports have shown promising treatments for these conditions with pulp revascularization and apexification 17 . Revascularization has been studied as an alternative treatment in some cases of incomplete root formation, because it stimulates the thickening and apical closure of immature teeth [18][19] . However, revascularization may present potential clinical and biological complications, such as crown discoloration 20 , development of resistant bacterial strains and allergic reaction to the intracanal medication 21 .…”

Section: Discussionmentioning

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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“…25,26 However, a recent study on dog teeth has shown that the ingrowth of tissue is more likely to originate from the periodontal ligament consisting of cementum, bone, and dentinelike material rather than pulp tissue. 27,28 These authors suggest that there is approximately a 30% chance of pulp tissue re-entering the pulp space. 28 Further histological research on dogs by this group has reported that the canal dentinal walls were thickened by the apposition of cementum-like tissue they termed 'intra-canal cementum'.…”

Section: Discussionmentioning

confidence: 99%

“…Shah et al attempted regenerative endodontics with a different protocol. 27 Fourteen teeth were irrigated with 2.5% sodium hypochlorite and 3% hydrogen peroxide and formocresol was used as an inter-appointment medicament rather than tri-antibiotic paste. Over a follow-up period of 0.5 to 3.5 years, radiographic resolution was considered good to excellent in 93% (13 ⁄ 14) of teeth.…”

Section: Discussionmentioning

confidence: 99%

Regenerative endodontics – biologically‐based treatment for immature permanent teeth: a case report and review of the literature

Thomson

Kahler

2010

Australian Dental Journal

109

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Background: A paradigm shift in the treatment of immature, necrotic teeth has occurred with biologically-based principles and regenerative endodontic protocols replacing traditional 'apexification' procedures. Preliminary research suggests that stem and progenitor cells from the pulp and ⁄ or periodontium contribute to continued root development when regenerative procedures are followed. Methods: A mandibular premolar tooth with a chronic periapical abscess was irrigated with sodium hypochlorite with minimal instrumentation and then dressed with tri-antibiotic paste consisting of ciprofloxacin, metronidazole and amoxicillin. At a subsequent visit a blood clot was evoked in the canal by irritating periapical tissues and the canal sealed with mineral trioxide aggregate, glass ionomer cement and composite resin. Results: Resolution of apical periodontitis and the draining sinus, continued root maturation and apical closure occurred over an 18-month period. The tooth became responsive to pulp sensibility testing. Conclusions: It is important that dentists recognize the potential of regenerative endodontics in the treatment of necrotic, immature teeth. Initial management should involve irrigation with sodium hypochlorite only. Intra-canal medicaments, such as calcium hydroxide, are contraindicated as they inhibit further root growth. This report uses a variation of the triantibiotic paste currently recommended for regenerative procedures that avoided the discolouration of the crown associated with current protocols. Regenerative endodontics with continued root growth may reduce the risk of fracture and premature tooth loss associated with traditional 'apexification' procedures where the root remains thin and weak.

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Pulp Revascularization of Immature Dog Teeth With Apical Periodontitis

Cited by 276 publications

References 32 publications

The Hidden Treasure in Apical Papilla: The Potential Role in Pulp/Dentin Regeneration and BioRoot Engineering

The Hidden Treasure in Apical Papilla: The Potential Role in Pulp/Dentin Regeneration and BioRoot Engineering

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

Regenerative endodontics – biologically‐based treatment for immature permanent teeth: a case report and review of the literature

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