Regenerative Endodontics: An Evidence Based Review

Gupta, Pankaj; Gada, Sneha; Shetty, Heeresh

doi:10.18049/jcmad/312

Cited by 2 publications

(3 citation statements)

References 68 publications

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“…While high concentration sodium hypochlorite denatures the growth factors embedded in the dentin, EDTA stabilizes them and increases their bioavailability (5,19).…”

Section: Discussionmentioning

confidence: 99%

“…The major difference in regenerative endodontic procedures for mature teeth with infected, necrotic pulps is that complete mechanical debridement is required to help eliminate root canal infection and remove necrotic tissue (3).The importance of pulp vitality in mature tooth can be understood from the biological rational of endodontics which is to prevent or treat apical periodontitis (4). Conventional root canal therapy leads to the loss of reparative capacity, brittleness and the loss of a protective mechanism against noxious stimuli (5). Additionally, the removal of the pulp and the subsequent loss of moisture inside the root may alter the light-transmitting properties of root-filled teeth leading to change of the translucency of the tooth (6).…”

Section: Introductionmentioning

confidence: 99%

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Revascularization in Mature Permanent Teeth With Necrotic Pulp and Apical Periodontitis: Case Series

Samra

Backly

Aly

et al. 2018

Alexandria Dental Journal

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INTRODUCTION:Revascularization procedures have been limited to immature teeth but application to mature teeth should be clinically investigated as an alternative to conventional root canal treatment. The translation of regenerative endodontic procedures into treating mature teeth is challenging and depends on efficient root canal disinfection, proper size of the apical foramen, the availability and delivery of stem cells into the root canal system. OBJECTIVES: Evaluation of revascularization in mature teeth after enlargement of the apical foramen to size 35 K-file. MATERIALS AND METHODS: Three necrotic incisors with mature roots and apical periodontitis in three patients ranging from 20-30 years old were treated by revascularization procedures. Access opening was performed. The canal was mechanically instrumented to the radiographic apex. The apical foramen was enlarged with a size 35 K-file. Triple antibiotic paste (0.1 mg/ml) was applied in the canal using a syringe. After three weeks, the medication was removed with 20 ml of 1.5% sodium hypochlorite followed by final irrigation with 20 ml of 17% EDTA. Bleeding was induced in the root canal and mineral trioxide aggregate (MTA) was placed approximately 3-4 mm below the CEJ. The tooth was restored with a layer of glass ionomer followed by composite resin. The patient was scheduled for follow up and evaluation of healing after 3 months, 6 months and 9 months. Resolution of apical periodontitis and regression of clinical signs and symptoms were observed during the follow up periods. RESULTS: After a follow-up period of 9 months, the three teeth demonstrated radiographic evidence of periapical healing with absence of clinical signs and symptoms. CONCLUSIONS: The present cases demonstrated a favorable outcome of the revascularization procedure in mature necrotic incisors with chronic apical periodontitis.

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“…While high concentration sodium hypochlorite denatures the growth factors embedded in the dentin, EDTA stabilizes them and increases their bioavailability (5,19).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Revascularization in Mature Permanent Teeth With Necrotic Pulp and Apical Periodontitis: Case Series

Samra

Backly

Aly

et al. 2018

Alexandria Dental Journal

View full text Add to dashboard Cite

show abstract

“…Mature permanent teeth with necrotic pulps have long been treated with conventional root canal therapy (RCT) to preserve natural dentition, thereby ensuring function and aesthetics (Ng et al, 2007). RCT involves cleaning and shaping of the root canal system, intracanal medication and obturation with an inert, biocompatible, artificial material, which fails to restore pulp tissue vitality, and results in the loss of protective mechanisms, and increases the brittleness of the tooth (Gupta et al, 2015). Moreover, discolouration and loss of natural translucency of teeth are usually observed because of the loss of moisture inside the root as a result of the removal of the pulp tissue (Ahmed & Abbott, 2012).…”

Section: Introductionmentioning

confidence: 99%

Regenerative endodontic procedures for the treatment of necrotic mature teeth: A preliminary randomized clinical trial

et al. 2022

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Aim: This preliminary randomized, prospective, controlled trial aimed to compare the clinical and radiographic outcomes of two regenerative endodontic procedures (REPs), revitalization and a platelet-rich fibrin (PRF)-based technique, in the treatment of mature permanent teeth with necrotic pulps. Methodology:The trial has been reported according to the Preferred Reporting Items for Randomized Trials in Endodontics 2020 guidelines. The study protocol was registered at the clinical trial registry (Clini calTr ials.gov) with identifier number NCT04158232. Twenty patients with mature necrotic anterior teeth with large periapical lesions were randomly allocated into two groups (n = 10): group I, treated with revitalization with the blood clot (BC) technique and group II, treated with a PRF-based technique. The follow-up was for 12 months. Periradicular healing was assessed using standardized radiographs taken at baseline, and at 6 and 12 months after treatment. An electric pulp tester was used to assess whether pulp sensibility had been regained during the follow-up period. Statistical analysis was conducted using Mann-Whitney test and Wilcoxon test for non-parametric data. For parametric data, repeated measures analysis of variance was used. The significance level was set at p ≤ .05.Results: There was a significant increase in periradicular healing in both groups at 6 and 12 months, compared to that at baseline, with no significant difference between the studied groups after 12 months (p = .143). There was a significant difference between the tooth sensibility readings at baseline, 6-month and 12-month follow-up timepoints (p < .001). Conclusions:The findings of this preliminary trial indicate the potential for using REPs, such as revitalization or PRF-based techniques, as treatment options for mature teeth with necrotic pulps. A higher level of evidence obtained through adequately powered clinical trials and longer follow-up periods are required to conclusively validate the different outcomes of REPs.

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Regenerative Endodontics: An Evidence Based Review

Abstract: Abstract

Cited by 2 publications

References 68 publications

Revascularization in Mature Permanent Teeth With Necrotic Pulp and Apical Periodontitis: Case Series

Revascularization in Mature Permanent Teeth With Necrotic Pulp and Apical Periodontitis: Case Series

Regenerative endodontic procedures for the treatment of necrotic mature teeth: A preliminary randomized clinical trial

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