Regenerative Endodontic Treatment or Mineral Trioxide Aggregate Apical Plug in Teeth with Necrotic Pulps and Open Apices: A Systematic Review and Meta-analysis

Torabinejad, Mahmoud; Nosrat, Ali; Verma, Prashant; Oyoyo, Udo

doi:10.1016/j.joen.2017.06.029

Cited by 170 publications

(158 citation statements)

References 161 publications

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“…, Torabinejad et al . ) demonstrated that the primary goal of RET could be reliably achieved with high probabilities (91–94% of periapical healing).…”

Section: Discussionmentioning

confidence: 99%

“…, Torabinejad et al . ). To minimize the risk of discolouration, Biodentine instead of MTA can be used (Marconyak et al .…”

Section: Crown Discolourationmentioning

confidence: 97%

“…, Torabinejad et al . ). Secondary outcomes of increased root development (80%) and apical closure (76%) were more variable results.…”

Section: Is Ret Successful?mentioning

confidence: 97%

“…, Silujjai & Linsuwanont , Torabinejad et al . ). However, further root maturation can only be achieved in teeth treated with RET (Bose et al .…”

Section: Comparisons With Alternative Approachesmentioning

confidence: 97%

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Regenerative endodontics: a comprehensive review

et al. 2018

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The European Society of Endodontology and the American Association for Endodontists have released position statements and clinical considerations for regenerative endodontics. There is increasing literature on this field since the initial reports of Iwaya et al. (Dental Traumatology, 17, 2001, 185) and Banchs & Trope (Journal of Endodontics, 30, 2004, 196). Endogenous stem cells from an induced periapical bleeding and scaffolds using blood clot, platelet rich plasma or platelet-rich fibrin have been utilized in regenerative endodontics. This approach has been described as a 'paradigm shift' and considered the first treatment option for immature teeth with pulp necrosis. There are three treatment outcomes of regenerative endodontics; (i) resolution of clinical signs and symptoms; (ii) further root maturation; and (iii) return of neurogenesis. It is known that results are variable for these objectives, and true regeneration of the pulp/dentine complex is not achieved. Repair derived primarily from the periodontal and osseous tissues has been shown histologically. It is hoped that with the concept of tissue engineering, namely stem cells, scaffolds and signalling molecules, that true pulp regeneration is an achievable goal. This review discusses current knowledge as well as future directions for regenerative endodontics. Patient-centred outcomes such as tooth discolouration and possibly more appointments with the potential for adverse effects needs to be discussed with patients and parents. Based on the classification of Cvek (Endodontics and Dental Traumatology, 8, 1992, 45), it is proposed that regenerative endodontics should be considered for teeth with incomplete root formation although teeth with near or complete root formation may be more suited for conventional endodontic therapy or MTA barrier techniques. However, much is still not known about clinical and biological aspects of regenerative endodontics.

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“…, Torabinejad et al . ) demonstrated that the primary goal of RET could be reliably achieved with high probabilities (91–94% of periapical healing).…”

Section: Discussionmentioning

confidence: 99%

“…, Torabinejad et al . ). To minimize the risk of discolouration, Biodentine instead of MTA can be used (Marconyak et al .…”

Section: Crown Discolourationmentioning

confidence: 97%

“…, Torabinejad et al . ). Secondary outcomes of increased root development (80%) and apical closure (76%) were more variable results.…”

Section: Is Ret Successful?mentioning

confidence: 97%

“…, Silujjai & Linsuwanont , Torabinejad et al . ). However, further root maturation can only be achieved in teeth treated with RET (Bose et al .…”

Section: Comparisons With Alternative Approachesmentioning

confidence: 97%

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Regenerative endodontics: a comprehensive review

et al. 2018

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“…The review conducted by Torabinejad et al . () found that 40% of the studies in the RET group reported tooth discolouration after treatment, including cases in which triple antibiotic paste was replaced by Augmentin or calcium hydroxide paste.…”

Section: Clinical Implications Of the Use Of Antibiotics In Repsmentioning

confidence: 99%

Effectiveness and clinical implications of the use of topical antibiotics in regenerative endodontic procedures: a review

et al. 2018

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Regenerative endodontic procedures (REPs) are biologically based procedures planned to replace damaged tissues, including dentinee and root structures, as well as cells of the pulp-dentine complex. Effective sterilization of the root canal is essential in REPs, and antibiotics have been widely used to disinfect root canals. The aim of this paper was to review the scientific literature on (i) Effectiveness of antibiotics used in REPs against bacteria implicated in endodontic disease; (ii) Scientific evidence supporting the use of topical antibiotics in REPs; (iii) Clinical implications of the use of antibiotics in REPs and the possible side effects; (iv) Effect of antibiotics on dental pulp stem cells; and (v) Ongoing research on the use of antibiotics in REPs. Antibiotics used in REPs are effective against bacteria implicated in endodontic infections. Triple antibiotic pastes with minocycline attain complete disinfection of immature teeth with necrotic pulps, without affecting SCAP. Experimental studies carried out in dogs support the use of antibiotics in REPs. Clinical studies report high success rates of RET using antibiotics as intracanal dressings. However, tooth discolouration is an important side effect of the use of TAP. An antibiotic paste containing only metronidazole and ciprofloxacin could be a good alternative to the use of TAP. The use of antibiotic-containing scaffolds or clindamycin-modified triple antibiotic (metronidazole, ciprofloxacin and clindamycin) polymer could be a biologically safe antimicrobial drug delivery system in REPs.

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