Article Data

  • Views 1041
  • Dowloads 198

Case Reports

Open Access

Regenerative Endodontic Treatment versus Apical Plug in Immature Teeth: Three-Year Follow-Up

  • Saeed Asgary1
  • Mahta Fazlyab1,*,
  • Ali Nosrat1

1From Iranian Center For Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

DOI: 10.17796/1053-4628-40.5.356 Vol.40,Issue 5,September 2016 pp.356-360

Published: 01 September 2016

*Corresponding Author(s): Mahta Fazlyab E-mail: dr.mfazlyab@gmail.com

Abstract

This report compares and evaluates the treatment outcomes of regenerative endodontic treatment and apical plug as two accepted treatment protocols in a pair of necrotic immature maxillary central incisors of a 12- year old female. The patient was referred complaining of a dull pain and swelling in her upper lip area. She had a history of trauma to the anterior maxilla two years earlier. Both teeth were clinically diagnosed with pulp necrosis and periapical radiographs revealed that separate periapical radiolucent lesions surrounded the immature apices of both teeth. The left and right incisors were treated with apical plug and regenerative endodontic treatment, respectively, using calcium-enriched mixture (CEM) cement. The patient was followed-up for three years. During this period, both teeth were clinically asymptomatic and showed complete radiographic healing of the periapical lesions. The right central incisor showed root development. No tooth discoloration was evident. Apexification by apical plug placement and pulp regeneration are both reliable treatments for immature non-vital teeth. In order to choose the right treatment the advantages of either technique should be weighed against its drawbacks. CEM cement can be successfully applied for both purposes. This biomaterial causes less discoloration of the tooth.

Keywords

Calcium-Enriched Mixture, Pulp, Revascularization, Regeneration

Cite and Share

Saeed Asgary,Mahta Fazlyab,Ali Nosrat. Regenerative Endodontic Treatment versus Apical Plug in Immature Teeth: Three-Year Follow-Up. Journal of Clinical Pediatric Dentistry. 2016. 40(5);356-360.

References

1. Rafter M. Apexification : A review. Dental Traumatology 21: 1-8, 2005.

2. Trope M. Treatment of the immature tooth with a non-vital pulp and apical periodontitis. Dental Clinics of North America 54: 313-324, 2010.

3. Hargreaves KM, Diogenes A, Teixeira FB. Treatment options: biological basis of regenerative endodontic procedures. Journal of Endodontics 39: S30-43, 2013.

4. Mente J, Leo M, Panagidis D, Ohle M, Schneider S, Lorenzo Bermejo J, et al. Treatment outcome of mineral trioxide aggregate in open apex teeth. Journal of Endodontics 39: 20-26, 2013.

5. Sheehy E, Roberts G. Use of calcium hydroxide for apical barrier formation and healing in non-vital immature permanent teeth: a review. British Dental Journal 183: 241-246, 1997.

6. Kerekes K, Heide S, Jacobsen I. Follow-up examination of endodontic treatment in traumatized juvenile incisors. Journal of Endodontics 6: 744-748, 1980.

7. Fouad A, Nosrat A. Pulp regeneration in previously infected root canal space. Endodontic Topics 28: 24-37, 2013.

8. Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review--Part III: Clinical applications, drawbacks, and mechanism of action. J Endod 36: 400-413, 2010.

9. Asgary S, Eghbal MJ, Parirokh M, Ghoddusi J, Kheirieh S, Brink F. Comparison of mineral trioxide aggregate’s composition with Portland cements and a new endodontic cement. J Endod 35: 243-250, 2009.

10. Asgary S, Kamrani F. Antibacterial effects of five different root canal sealing materials. Journal of Oral Science 50: 469-474, 2008.

11. Rahimi S, Mokhtari H, Shahi S, Kazemi A, Asgary S, Eghbal MJ, et al. Osseous reaction to implantation of two endodontic cements: Mineral trioxide aggregate (MTA) and calcium enriched mixture (CEM). Med Oral Patol Oral Cir Bucal 17: e907-911, 2012.

12. Asgary S, Shahabi S, Jafarzadeh T, Amini S, Kheirieh S. The Properties of a New Endodontic Material. Journal of Endodontics 34: 990-993, 2008.

13. Banchs F, Trope M. Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod 30: 196-200, 2004.

14. Wigler R, Kaufman AY, Lin S, Steinbock N, Hazan-Molina H, Torneck CD. Revascularization: a treatment for permanent teeth with necrotic pulp and incomplete root development. Journal of Endodontics 39: 319-326, 2013.

15. Kontakiotis EG, Filippatos CG, Agrafioti A. Levels of evidence for the outcome of regenerative endodontic therapy. Journal of Endodontics 40: 1045-1053, 2014.

16. Lenzi R, Trope M. Revitalization procedures in two traumatized incisors with different biological outcomes. Journal of Endodontics 38: 411-414, 2012.

17. Nosrat A, Homayounfar N, Oloomi K. Drawbacks and unfavorable outcomes of regenerative endodontic treatments of necrotic immature teeth: a literature review and report of a case. Journal of Endodontics 38: 1428-1434, 2012.

18. Nosrat A, Li KL, Vir K, Hicks ML, Fouad AF. Is pulp regeneration necessary for root maturation? Journal of Endodontics 39: 1291-1295, 2013.

19. Alobaid AS, Cortes LM, Lo J, Nguyen TT, Albert J, Abu-Melha AS, et al. Radiographic and clinical outcomes of the treatment of immature permanent teeth by revascularization or apexification: a pilot retrospective cohort study. Journal of Endodontics 40: 1063-1070, 2014.

20. Jeeruphan T, Jantarat J, Yanpiset K, Suwannapan L, Khewsawai P, Hargreaves KM. Mahidol study 1: comparison of radiographic and survival outcomes of immature teeth treated with either regenerative endodontic or apexification methods: a retrospective study. Journal of Endodontics 38: 1330-1336, 2012.

21. Fouad AF. Are antibiotics effective for endodontic pain? Endodontic Topics 3: 52-66, 2002.

22. Siqueira J, Barnett F. Interappointment pain: mechanisms, diagnosis, and treatment. Endodontic Topics 7: 93-109, 2004.

23. Nygaard-Ostby B, Hjortdal O. Tissue formation in the root canal following pulp removal. Scand J Dent Res 79: 333-349, 1971.

24. Reynolds K, Johnson JD, Cohenca N. Pulp revascularization of necrotic bilateral bicuspids using a modified novel technique to eliminate potential coronal discolouration: a case report. Int Endod J 42: 84-92, 2009.

25. Iwaya S, Ikawa M, Kubota M. Revascularization of an immature permanent tooth with apical periodontitis and sinus tract. Dental Traumatology 17: 185-187, 2001.

26. Petrino JA, Boda KK, Shambarger S, Bowles WR, McClanahan SB. Challenges in regenerative endodontics: a case series. J Endod 36: 536-541, 2010.

27. Shin SY, Albert JS, Mortman RE. One step pulp revascularization treatment of an immature permanent tooth with chronic apical abscess: a case report. Int Endod J 42: 1118-1126, 2009.

28. Chueh LH, Huang GT. Immature teeth with periradicular periodontitis or abscess undergoing apexogenesis: a paradigm shift. J Endod 32: 1205- 1213, 2006.

29. Nosrat A, Seifi A, Asgary S. Regenerative endodontic treatment (revascularization) for necrotic immature permanent molars: a review and report of two cases with a new biomaterial. J Endod 37: 562-567, 2011.

30. Chueh LH, Ho YC, Kuo TC, Lai WH, Chen YH, Chiang CP. Regenerative endodontic treatment for necrotic immature permanent teeth. J Endod 35: 160-164, 2009.

31. Johns DA, Shivashankar VY, Krishnamma S, Johns M. Use of photoactivated disinfection and platelet-rich fibrin in regenerative Endodontics. J Conserv Dent 17: 487-490, 2014.

32. Shah N, Logani A, Bhaskar U, Aggarwal V. Efficacy of revascularization to induce apexification/apexogensis in infected, nonvital, immature teeth: a pilot clinical study. J Endod 34: 919-925; Discussion 1157, 2008.

33. Martin G, Ricucci D, Gibbs JL, Lin LM. Histological Findings of Revascularized/Revitalized Immature Permanent Molar with Apical Periodontitis Using Platelet-rich Plasma. Journal of Endodontics 39: 138-144, 2013.

34. Shimizu E, Ricucci D, Albert J, Alobaid AS, Gibbs JL, Huang GT, et al. Clinical, radiographic, and histological observation of a human immature permanent tooth with chronic apical abscess after revitalization treatment. Journal of Endodontics 39: 1078-1083, 2013.

35. Kakoli P, Nandakumar R, Romberg E, Arola D, Fouad AF. The effect of age on bacterial penetration of radicular dentin. Journal of Endodontics 35: 78-81, 2009.

36. Ruparel NB, Teixeira FB, Ferraz CC, Diogenes A. Direct effect of intracanal medicaments on survival of stem cells of the apical papilla. Journal of Endodontics 38: 1372-1375, 2012.

37. Lenherr P, Allgayer N, Weiger R, Filippi A, Attin T, Krastl G. Tooth discoloration induced by endodontic materials: a laboratory study. Int Endod J 45: 942-949, 2012.

38. Akcay M, Arslan H, Yasa B, Kavrik F, Yasa E. Spectrophotometric analysis of crown discoloration induced by various antibiotic pastes used in revascularization. J Endod 40: 845-848, 2014.

39. Huang GT. Apexification: the beginning of its end. Int Endod J 42: 855-866, 2009.

40. Torabinejad M, Faras H, Corr R, Wright KR, Shabahang S. Histologic examinations of teeth treated with 2 scaffolds: a pilot animal investigation. J Endod 40: 515-520, 2014.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Scopus: CiteScore 1.8 (2023) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Submission Turnaround Time

Conferences

Top