scholarly journals Pulp Revascularization of Immature Permanent Teeth: A Review of the Literature and a Proposal of a New Clinical Protocol

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Mélanie Namour ◽  
Stephanie Theys
Keyword(s):  
Treatment Method ◽  
Permanent Teeth ◽  
Clinical Protocol ◽  
Therapeutic Success ◽  
Immature Teeth ◽  
Triple Antibiotic Paste ◽  
New Treatment ◽  
Near Future ◽  
Pulp Revascularization ◽  
Stimulation Of

Tissue engineering is a growing field. In the near future, it will probably be possible to generate a complete vital tooth from a single stem cell. Pulp revascularization is dependent on the ability of residual pulp and apical and periodontal stem cells to differentiate. These cells have the ability to generate a highly vascularized and a conjunctive rich living tissue. This one is able to colonize the available pulp space. Revascularization is a new treatment method for immature necrotic permanent teeth. Up to now, apexification procedures were applied for these teeth, using calcium dihydroxide or MTA to produce an artificial apical barrier. However, the pulp revascularization allows the stimulation of the apical development and the root maturation of immature teeth. Two pulp revascularization techniques are used in the literature, one using calcium dihydroxide and the second using a triple antibiotic paste. Based on these two different pulp revascularization protocols, which obtain the desired therapeutic success, the literature will be reviewed and analyzed according to the relevance of their choice of materials. Based on the literature, we propose a new relevant protocol and a new mixture of antibiotics.

scholarly journals Revascularization in Immature Permanent Teeth with Necrotic Pulp and Apical Pathology: Case Series

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
López Carmen ◽  
Mendoza Asunción ◽  
Solano Beatriz ◽  
Yáñez-Vico Rosa
Keyword(s):  
Case Series ◽  
Permanent Teeth ◽  
Pulp Chamber ◽  
Immature Teeth ◽  
Therapeutic Protocol ◽  
Triple Antibiotic Paste ◽  
Restorative Materials ◽  
Pulp Revascularization ◽  
Clinical Cases

Introduction. To present and discuss the results of five clinical cases treated using the revascularization protocol, showing clinical and radiographic monitoring. Necrotic immature teeth with periapical pathology present a challenge to dentists because the techniques used in apexification leave the tooth susceptible to fracture, since the root does not continue to grow in length and the canal walls are thin. Revascularization has emerged as an alternative to resolve these deficiencies, enabling apical closure, continued development of the roots, and thickening of the dentinal walls. Case Series. Five clinically and radiographically diagnosed necrotic immature permanent teeth were treated using revascularization treatment. The therapeutic protocol involved accessing the pulp chamber; irrigating copiously with NaOCl; applying a triple antibiotic paste as intracanal dressing; then provisionally sealing it. After 3 weeks, the canal was cleaned and the apex irritated with a size 15 K-file to induce blood that would serve as a scaffold for pulp revascularization. MTA was used to seal the chamber before final obturation (composite or metallic crown). Conclusion. The discussion of the results leads to debate about different restorative materials and other published protocols.

Metody leczenia endodontycznego zębów stałych z niezakończonym rozwojem wierzchołków korzenia – rewaskularyzacja, 12-miesięczna obserwacja. Część II

2018 ◽  
Vol 21 (1A) ◽  
Author(s):  
Renata Pazera ◽  
Magdalena Piechota-Urbańska ◽  
Patrycja Proc ◽  
Joanna Szczepańska
Keyword(s):  
Root Length ◽  
Treatment Method ◽  
Modern Method ◽  
Endodontic Treatment ◽  
Permanent Teeth ◽  
Control Group ◽  
Tissue Healing ◽  
New Treatment ◽  
Radiological Image ◽  
Irreversible Pulpitis

Introduction. Apexogenesis is the process of shaping the root for 3 years after the appearance of the crown in the oral cavity. The condition for continuing this process is to preserve the vitality of the tooth. Injury, caries or disorders of the anatomical structure may cause necrosis or irreversible pulpitis. The assumption of endodontic treatment of immature permanent teeth is to create a mineralized barrier closing the lumen of the canal (apexification) or continuing the development of the root (revascularization). Regeneration of the pulpo-dentinal complex allows for the increase of root length, thickening of its walls and narrowing of the apical hole. This can be achieved by a new treatment method – revascularization. The advantage of this therapeutic method is to avoid all the defects arising after endodontic treatment with the use of apexification, i.e. tooth brittleness, susceptibility to root fracture, discoloration of the tooth tissue. Aim. The aim of the study was to evaluate the modern method of treatment of necrosis or irreversible pulpitis in immature permanent teeth by revascularization in the aspect of tissue healing, regeneration of the pulp-dentinal complex, thickness growth and the length of the root walls. Material and methods. The study was conducted among 7 children aged 7-12, including 3 girls and 2 boys. Revascularization was performed in 7 teeth. The study involved 6 central incisors and 1 premolars. During the treatment, polyurethane paste and MTA were used. The control group consisted of patients who were tested using MTA due to the inability to perform revascularization. 23 patients aged 7-13 were qualified to the control group. Control tests were carried out after 3, 6, 12 months after treatment. The clinical condition of the tooth and the radiological image were evaluated. Results. Radiological examination was crucial in assessing the effectiveness of the revascularization procedure. It confirmed the decrease of periapical lesions, increase in root length, root wall thickness and closing of the apical hole. During the clinical examination, the subjective feelings of the patient, discoloration of the tooth's tissues, reaction to tapping, tooth mobility, depth of the gingival pocket, tenderness of the appendage and tightness of the final filling were controlled. The obtained results were compared with the control group. Conclusions. Revascularization is a promising treatment for immature permanent teeth due to the increase in the length of the root and the thickness of its walls. As a result, the teeth after treatment are more durable and are better for long-term maintenance in the mouth. The procedure of revascularization has some limitations at the stage of patient’s qualification for the procedure. If it is not possible to perform this procedure, the alternative is to apexify using MTA.

scholarly journals Single Sitting Revitalization of Nonvital Young Permanent Teeth

2020 ◽  
Vol 8 (03) ◽  
pp. 127-130
Author(s):  
Avninder Kaur ◽  
Anchal Soni ◽  
Harees Shabir
Keyword(s):  
Glass Ionomer Cement ◽  
Thick Layer ◽  
Permanent Teeth ◽  
Radiographic Examination ◽  
Radiographic Evaluation ◽  
Periapical Lesion ◽  
Immature Teeth ◽  
Pulp Revascularization ◽  
Ionomer Cement

AbstractA 9-year-old child reported with chief complaint of broken teeth (11 and 21) and discolored tooth (21). Diagnosis of pulp necrosis with apical periodontitis with regard to 11 and 21 was made based on clinical and radiographic examination. The canals were irrigated with sodium hypochlorite and then dried with paper points. Disinfection of canals was done using photoactivated disinfection (PAD). Platelet-rich fibrin (PRF) was placed as scaffold in canals till the cementoenamel junction (CEJ). A 2-mm thick layer of white MTA was placed, followed by dual seal using glass–ionomer cement (GIC) and composite resin. Follow-up examination was done for 1 year. Clinical examination showed no pain, tenderness on percussion, and no mobility and improvement in color of teeth. Radiographic evaluation revealed continued thickening of the dentinal walls, root lengthening, regression of the periapical lesion, and partial apical closure. This report of pulp revascularization shows that disinfection with photodynamic therapy combined with PRF resulted in satisfactory root development in necrotic immature teeth.

Regenerative Endodontic Therapy with Platelet Rich Fibrin: Case Series

2020 ◽  
Vol 44 (1) ◽  
pp. 15-19 ◽  
Author(s):  
G Kandemir Demirci ◽  
P Güneri ◽  
MK Çalışkan
Keyword(s):  
Case Series ◽  
Cone Beam ◽  
Permanent Teeth ◽  
Platelet Rich Fibrin ◽  
Periapical Lesions ◽  
Root Canals ◽  
Immature Teeth ◽  
Triple Antibiotic Paste ◽  
Cone Beam Computerized Tomography

Regenerative endodontic therapy (RET) provides a novel treatment modality for the immature teeth with pulp necrosis. The aim of this case series was to evaluate RET of immature permanent teeth using platelet rich fibrin (PRF) at 36-month follow-up periods. In the present case series, three immature maxillary incisors diagnosed with pulp necrosis and apical periodontitis were treated with RET. The root canals were irrigated with 1.5% sodium hypochlorite (NaOCl) and medicated with triple antibiotic paste(TAP). At the second visit, TAP was removed and root canals were conditioned with 17% EDTA. PRF was used as a scaffold. MTA was placed over PRF and the teeth were restored with composite resin. Periapical radiographs and cone beam computerized tomography(CBCT) were used to evaluate the healing. At the end of the 36-month follow-up periods, there was no response to pulp sensibility tests with cold and electric pulp tester, but all teeth showed decreased periapical lesions or evidence of healing.

scholarly journals Maturogenesis by Pulp Revascularization in an Immature Necrotic Permanent Tooth in a Pediatric Patient: A 15 Month Follow-up Case Report

2020 ◽  
Vol 1 (2) ◽  
pp. 46-50
Author(s):  
◽  
Kumar Pawan ◽  
Garg Ishika ◽  
Narang Saurabh ◽  
Namdev Ritu ◽  
...  
Keyword(s):  
Case Report ◽  
Blood Clot ◽  
Mineral Trioxide Aggregate ◽  
Permanent Teeth ◽  
Root Canal Filling ◽  
Promising Alternative ◽  
Maxillary Central Incisor ◽  
Pulp Revascularization ◽  
Stimulation Of

Endodontic treatment of immature necrotic permanent teeth is clinically challenging and poses a risk of inducing dentin wall fracture or extending gutta-percha into the periapical tissue during root canal filling. Pulp revascularization is a promising alternative for the treatment of such immature necrotic permanent teeth offering great potential to avoid the need for traditional apexification with calcium hydroxide or the need to achieve an artificial apical barrier with mineral trioxide aggregate. Pulp revascularization allows the stimulation of the apical development and the root maturation of immature teeth by physiologically strengthening the canal walls. The present case report describes the case of successful revascularization of the necrotic infected pulp space of an immature permanent maxillary central incisor induced in vivo by stimulation of a blood clot from the periapical tissues into the canal space. Thickening of the canal wall and complete apical closure were confirmed 15 months after the treatment.

scholarly journals Pulp revascularization: an alternative treatment to the apexification of immature teeth

2014 ◽  
Vol 62 (4) ◽  
pp. 401-410
Author(s):  
Maria Tereza Pedrosa ALBUQUERQUE ◽  
Juliana Yuri NAGATA ◽  
Adriana de Jesus SOARES ◽  
Alexandre Augusto ZAIA
Keyword(s):  
Calcium Hydroxide ◽  
Alternative Treatment ◽  
Treatment Protocols ◽  
Immature Teeth ◽  
Hygroscopic Properties ◽  
Proteolytic Activities ◽  
New Treatment ◽  
Treatment Alternatives ◽  
Pulp Revascularization

Pulp revascularization can be considered as a current alternative treatment to apexification, recommended for immature teeth cases, requiring endodontic treatment. Apexification involves long-term periodic exchanges of a calcium hydroxide paste into the root canal to induce the formation of a calcified barrier. Despite being the most classically therapy employed for these cases, the permanence of calcium hydroxide for long periods of time and also the successive changes may lead to a weakening of the root due to its hygroscopic properties and the proteolytic activities of calcium hydroxide, increasing the risk of fractures and contamination of the pulp space. Thus, a constant search for new treatment alternatives that provide the end of root development have been done to avoid the risk of future root fractures. So, revascularization has emerged as a new treatment option for cases of undeveloped teeth, that provides not only apical closure, as apexification, but also increase the dentin walls thickness. In the literature, there is an assortment of treatment protocols employing pulp revascularization procedure in attempt to attain the best way to achieve success. Assuming the diversity of protocols for revascularization treatment, it is important to go deep in the literature to collect, describe and discuss these protocols guiding new researches in this field and also conducting the clinicians. Therefore, this review aims to assess the literature on the different revascularization protocols.

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