Histological assessment of human regenerative endodontic procedures (REP) of immature permanent teeth with necrotic pulp/apical periodontitis: A systematic review.

The aim of this study was to systematically review the histological evidence of the neo-formed tissues inside the root canals of human teeth having previously received regenerative endodontic treatment. An electronic research was performed in the MEDLINE, Web of Science, Scopus and Cochrane Library databases using controlled vocabulary. The retrieved studies were screened by two reviewers according to the predetermined inclusion and extrusion criteria and were full-text-evaluated. Research resulted in 160 studies. Among them, twelve fitted the inclusion criteria and were critically appraised. The tissues formed in the root canals of immature human teeth treated with REP indicate repair or a combination of repair and regeneration. Pulp remnants and healthy periapical tissues seem to improve regeneration. The level of available evidence was low. Further clinical studies are needed in order to establish the appropriate treatment protocol related to the pretreatment status of the dental pulp and the periapical tissues.

Assessment of simulated internal resorption cavities using digital and digital subtraction radiography: a comparative study.

AIM: To compare the diagnostic accuracy of digital radiography with that of digital subtraction radiography in the detection of simulated internal resorption cavities. MATERIALS AND METHODS: Simulated internal resorption cavities of varying sizes were created using round burs in 18 single-rooted teeth with visible pulp chamber, which had been extracted from dentate dry mandibles and split into two halves in a mesio-distal direction. Resorption cavities were created in the buccal half of the root in the cervical, middle, and apical third. Digital radiographs were taken from three different horizontal view angles before and after the creation of the cavities. This process was followed by digital subtraction radiography to evaluate their detection. Seven experienced observers and all specialists in endodontics were asked to examine the digital and digital subtraction images for the presence of the cavities. The data were analyzed using SPSS 14. RESULTS: The overall sensitivity of digital subtraction radiography was superior to digital radiography and with statistically better results for all cavities regardless of their location (cervical, middle, apical third) (P < 0.05). The detection of the cavities was affected by the root third in which they were located. Cavities in the apical third were more easily detected compared with those in the middle or cervical third of the root. Small-sized lesions (0.5 mm, 0.6 mm) in the middle and apical third were more frequent and more easily detected using subtraction imaging. CONCLUSION: Digital subtraction radiography is superior to digital radiography for the detection and monitoring of the progress of internal root resorption.