The Role of Vital Pulp Therapy in the Management of Periapical Lesions

Asgary, Saeed; Parhizkar, Ardavan

doi:10.14744/eej.2020.04706

Cited by 7 publications

(9 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Calcification of pulp horns and hard tissue formation beneath indirect pulp capping material and excavated caries is a clear indication of clinical and histological success [15,16]. Moreover, in immature teeth continued apexogenesis after pulp capping procedures will guarantee vitality and long-term prognosis of the immature permanent tooth with reduced risk of fracture [6].…”

Section: Discussionmentioning

confidence: 99%

“…Mejare and Cvek [1] advocated partial pulpotomy in pulp-exposed carious immature molars or even stepwise indirect technique (group 1) with some success. His early trial used CH as a capping material; however, higher success rates resulting in apexogenesis have been reported with materials like MTA and CEM cement, as materials like CH may leak or disintegrate through time [16,18]. In this case, the hard tissue formation beneath the CEM cement and the obvious calcification of the pulp horns on re-entry demonstrates complete success.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the removal of the bulk of bacteria and toxins and infected dentine and the sealing off of the cavity will help to reduce inflammation and trigger hard tissue barrier formation even with the presence of some semi-soft dentine [1,17,22]. CEM cement has repeatedly been shown to produce hard tissue barrier formation like MTA [23] in permanent mature and immature teeth [16] superior to that of CaOH and Dycal ® due to their long-term seal, biocompatibility [9,11], non-toxicity [24], resistance to bacterial penetration and dentine bridge formation [16,21]. Additionally, CEM cement has been claimed to have easier handling characteristics [11].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

A successful case of maturogenesis by stepwise excavation using calcium-enriched mixture cement

Asgary,

Alim Marvasti

2023

Exploration of Medicine

View full text Add to dashboard Cite

This case report demonstrates the successful induction of apexogenesis in an extensively carious lower right first molar with immature roots through the use of stepwise excavation and calcium-enriched mixture (CEM) cement as an indirect pulp capping material. The patient, an 8-year-old boy, presented with pain and carious pulp exposure. The initial treatment involved removing soft dentin and applying CEM cement as an indirect pulp cap. The patient experienced pain relief after 24 h, and subsequent follow-up appointments showed complete healing and maturation of the tooth. The case highlights the potential of indirect pulp treatment with CEM cement and emphasizes the importance of regenerative biomaterials in promoting healing and dentin bridge formation. Further clinical work and research are recommended to explore the efficacy of this treatment approach.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A successful case of maturogenesis by stepwise excavation using calcium-enriched mixture cement

Asgary,

Alim Marvasti

2023

Exploration of Medicine

View full text Add to dashboard Cite

show abstract

“…The finding of apical periodontitis in radiographic images does not necessarily mean that the pulp is necrotic. The inflamed vital dental pulp causes an immunological response, which could lead to local changes in peri-apical connective tissues [17,36,37]. Hence, clinical signs and symptoms of the patient do not reflect the actual extent of inflammation in the pulp tissue.…”

Section: Discussionmentioning

confidence: 99%

BiodentineTM Full Pulpotomy in Mature Permanent Teeth with Irreversible Pulpitis and Apical Periodontitis

2021

View full text Add to dashboard Cite

Vital pulp therapy, including direct pulp capping and partial and full pulpotomy, is primarily indicated for immature or mature permanent teeth with reversible pulpitis. Mature permanent teeth with irreversible pulpitis are frequently treated with root canal therapy. This report presents two cases of full pulpotomy using BiodentineTM in mature permanent teeth with irreversible pulpitis and acute apical periodontitis. The periapical radiograph illustrated a deep carious lesion extended to the pulp with apical radiolucency lesion or widened periodontal ligament space. Full pulpotomy with a tricalcium silicate-based cement was chosen as the definitive treatment. After decayed tissue excavation under a rubber dam, the exposed pulp tissue was amputated to the level of the canal orifice with a new sterile bur. BiodentineTM was applied as the pulp capping agent after hemostasis was obtained and for temporary restoration. The clinical signs disappeared quickly after the treatment. After one month, the coronal part of the temporary restoration was removed, and a composite resin was placed over the capping agent as a final restoration. At two-year follow-ups, the teeth were asymptomatic. Radiographs showed healing of the periapical lesion and periodontal ligament. BiodentineTM full pulpotomy of mature permanent teeth with irreversible pulpitis and apical periodontitis can be an alternative option to root canal therapy.

show abstract

“…Notably, although pulpal necrosis has traditionally been considered the primary aetiological factor for AP, scientific evidence supports that teeth diagnosed with irreversible pulpitis can be accompanied by AP ( 23 ). Cone-beam computed tomography studies have reported the presence of preoperative hypodense lesions compatible with AP in 13.7% of teeth diagnosed with symptomatic irreversible pulpitis ( 24 ).…”

Section: Etiopathogenesis Of the Inflammatory Radicular Cystmentioning

confidence: 99%

The paradigm of the inflammatory radicular cyst: biological aspects to be considered

Osorio¹

2022

Eur Endod J

View full text Add to dashboard Cite

Inflammatory radicular cysts (IRCs) are chronic lesions that follow the development of periapical granulomas (PGs). IRCs result from multiple inflammatory reactions led initially by several pro-inflammatory interleukins and growth factors that provoke the proliferation of epithelial cells derived from epithelial cell rests of Malassez present in the granulomatous tissue, followed by cyst formation and growth processes. Multiple theories have been proposed to help explain the molecular process involved in the development of the IRC from a PG. However, although multiple studies have demonstrated the presence of epithelial cells in most PGs, it is still not fully understood why not all PGs turn into IRCs, even though both are stages of the same inflammatory phenomenon and receive the same antigenic stimulus. Histopathological examination is currently the diagnostic gold standard for differentiating IRCs from PGs. Although multiple studies have evaluated the accuracy of non-invasive or minimally invasive methods in assessing the histopathological nature of the AP before the intervention, these studies' results are still controversial. This narrative review addresses the biological insights into the complex molecular mechanisms of IRC formation and its histopathological features. In addition, the relevant inflammatory molecular mediators for IRC development and the accuracy of non-invasive or minimally invasive diagnostic approaches are summarised.

show abstract

The Role of Vital Pulp Therapy in the Management of Periapical Lesions

Cited by 7 publications

References 22 publications

A successful case of maturogenesis by stepwise excavation using calcium-enriched mixture cement

A successful case of maturogenesis by stepwise excavation using calcium-enriched mixture cement

BiodentineTM Full Pulpotomy in Mature Permanent Teeth with Irreversible Pulpitis and Apical Periodontitis

The paradigm of the inflammatory radicular cyst: biological aspects to be considered

Contact Info

Product

Resources

About