The effect of changing apical foramen diameter on regenerative potential of mature teeth with necrotic pulp and apical periodontitis

Abada, Hisham; Hashem, Ahmed A.; Abu‐Seida, Ashraf M.; Nagy, Muhammad

doi:10.1007/s00784-021-04159-1

Cited by 11 publications

(11 citation statements)

References 42 publications

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“…In the present work, there was no evidence of bone resorption. This finding contrasts with the findings of a previous study that found bone resorption in some revascularization samples up to three months after surgery as a result of an inflammatory response accompanied by the release of inflammatory mediators like prostaglandins and interleukins [ 11 ].…”

Section: Discussioncontrasting

confidence: 99%

“…In last decade, RET of necrotic teeth gained more attention due to its ability to overcome many difficulties of the conventional endodontic therapy like risk of fracture, multiple visits, and expensive costs [ 10 , 11 ]. The present study compared DAT and DL980 as methods of root canal disinfection during RET and concluded that both methods have nearly similar efficacy.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, RET has shown promising outcomes in mature teeth [ 10 , 11 ]. Instead of a mechanical seal made by artificial obturating materials, pulp regeneration offers a biological seal and increases the fracture resistance of the apical part of the root canal [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Regenerative endodontic therapy in mature teeth with necrotic pulp and apical periodontitis using two disinfection protocols

2023

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Objective This study compared the effect of diode laser (DL) 980 nm and double antibiotic paste (DAP) on response of mature teeth with necrotic pulp and apical periodontitis to regenerative endodontic therapy in a dog model. Methods Pulp necrosis and periapical pathosis were induced in 40 mature double rooted premolars in four 2-year-old mongrel dogs. These teeth were randomly divided according to disinfection protocol into four equal groups (10 teeth each/20 roots), group I: DAP; group II: DL980 nm; group III: positive control (without treatment) and group IV: negative control (untouched teeth). These groups were further subdivided into 2 subgroups (5 teeth each/10 roots) according to evaluation period, subgroup (A): one month and subgroup (B): three months. Revascularization techniques were performed using bleeding induction and application of platelet rich fibrin (PRF). The coronal cavities were sealed with mineral trioxide aggregate (MTA) and glass ionomer cement. The inflammatory response, vital tissue in-growth, new hard tissue formation and bone resorption were assessed. Statistical analysis was done utilizing ANOVA, Tukey’s post hoc and paired t tests. Results In both subgroups, there were no significant differences between DAP and DL980 in terms of inflammatory cell count, vital tissue in-growth, new hard tissue formation and bone resorption (P ≤ 0.05). Conclusion Diode laser 980 nm can alternate DAP as a disinfection method of the root canal during RET for mature necrotic teeth, therefore it may accelerate regenerative endodontic therapy for both the patient and dentist and allows for RET in a single appointment.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Regenerative endodontic therapy in mature teeth with necrotic pulp and apical periodontitis using two disinfection protocols

2023

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“…The apical foramenae of the selected teeth measured wider than 1.1-1.5 mm. in diameter (preoperative measurements using image J software, because it was found that the shorter the tooth and the wider the apical opening, the better chances for the revascularization treatment to succeed and the greater the increase in the thickness and length of the root, the more apical narrowing [1,6].It was also found that wider apical diameter was related to decreased count of in ammatory cells in immature teeth with necrotic pulps and apical periodontitis treated with regenerative protocol [7]. This could be attributed to the ease of cleaning in teeth with wide apical openings, facilitating the action of chemical disinfection.…”

Section: Discussionmentioning

confidence: 99%

The Influence of Two Etiological Factors of Pulp Diseases on the Success of Regenerative Endodontic Procedures in Immature Human Teeth (A Comparative in-Vivo Study)

AbdulRahman

Batouty

Nagy

2022

Preprint

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Objective This study was done to assess the influence of caries and trauma as two etiological factors of pulp diseases on the success of endodontic revascularization procedures (RET). Methods In our study, a sample of 48 permanent, immature teeth of patients (10–16 years old) were selected and equally divided into 2 groups according to the etiology of pulp disease. Both groups received endodontic revascularization protocol (blood clot formation) as per the clinical considerations of the AAE. Patients were followed up for 12 months. Standardized radiographs were assessed for the root length and thickness increase, and the apical diameter decrease. Results After the follow-up period, the majority of cases demonstrated periapical healing radiographically. The regenerative ability revealed a significant progressive increase in root length in the caries group than in the trauma group. Both groups showed similar results in regards to the increase in root thickness and the decrease in apical diameter. Conclusion Revascularization was successful in both groups, but the regenerative capacity in teeth affected by caries showed better results than in teeth affected by trauma in terms of the increase in root length. Clinical Relevance RET could be more successful in immature teeth affected by caries than by trauma.

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“…71 Noteworthily, the minimal apical diameter required for REPs is still controversial. Laureys et al 79 found newly formed tissue in the root canals with the smallest apical diameter ranging between 0.24 mm and 0.53 mm, while Abada et al 80 showed an increase of the ingrowth tissue in the root canals with increased apical diameter. And clinical success was achieved in teeth with apical diameter smaller than 1 mm after REPs based on the clinical and radiographic results of periapical healing and continued root development, with the highest clinical success rate of 95.65% in teeth with apical diameters of 0.5~1.0 mm.…”

Section: Considerations In Case Selectionmentioning

confidence: 99%

Expert consensus on regenerative endodontic procedures

Wei

Yang

Lin³

et al. 2022

Int J Oral Sci

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Regenerative endodontic procedures (REPs) is a biologic-based treatment modality for immature permanent teeth diagnosed with pulp necrosis. The ultimate objective of REPs is to regenerate the pulp-dentin complex, extend the tooth longevity and restore the normal function. Scientific evidence has demonstrated the efficacy of REPs in promotion of root development through case reports, case series, cohort studies, and randomized controlled studies. However, variations in clinical protocols for REPs exist due to the empirical nature of the original protocols and rapid advancements in the research field of regenerative endodontics. The heterogeneity in protocols may cause confusion among dental practitioners, thus guidelines and considerations of REPs should be explicated. This expert consensus mainly discusses the biological foundation, the available clinical protocols and current status of REPs in treating immature teeth with pulp necrosis, as well as the main complications of this treatment, aiming at refining the clinical management of REPs in accordance with the progress of basic researches and clinical studies, suggesting REPs may become a more consistently evidence-based option in dental treatment.

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The effect of changing apical foramen diameter on regenerative potential of mature teeth with necrotic pulp and apical periodontitis

Cited by 11 publications

References 42 publications

Regenerative endodontic therapy in mature teeth with necrotic pulp and apical periodontitis using two disinfection protocols

Regenerative endodontic therapy in mature teeth with necrotic pulp and apical periodontitis using two disinfection protocols

The Influence of Two Etiological Factors of Pulp Diseases on the Success of Regenerative Endodontic Procedures in Immature Human Teeth (A Comparative in-Vivo Study)

Expert consensus on regenerative endodontic procedures

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