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1.
Eur J Paediatr Dent ; 21(3): 248-250, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32893661

RESUMO

Treatment of necrotic immature permanent anterior teeth with Portland cements apical plug. The long-term success of endodontic treatment depends on the quality of the apical and coronal seal. In necrotic immature teeth the treatment can be challenging for the clinician as the endodontic anatomy and the presence of bacterial infection need to be addressed with special techniques and materials in order to obtain an effective and biocompatible apical seal. Unfortunately, despite the best treatments, immature permanent teeth have a reduced resistance to fracture due to the arrest of root walls development.


Assuntos
Necrose da Polpa Dentária , Endodontia , Criança , Dentição Permanente , Humanos , Tratamento do Canal Radicular
2.
J Endod ; 46(8): 1085-1090, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32553418

RESUMO

INTRODUCTION: This report describes the treatment of an immature mandibular molar by combining vital pulp therapy (VPT) and regenerative endodontic procedures (REPs). It details the use of REP to regain functionality and continued root development of an immature root with pulp necrosis and VPT for an immature root containing vital pulpal tissues. METHODS: An 8-year old male presented for evaluation of a mandibular first right molar with mild buccal swelling and a nontraceable sinus tract. He recently had received a restoration. After intraoral and radiographic examination, a diagnosis of pulp necrosis and chronic apical abscess was made. After access, pulp necrosis was confirmed in the distal root; however, vital pulp tissues were present in the mesial canals. It was decided on pulpotomy (VPT) in the mesial and REP in the distal root. At the initial visit, pulpotomy was completed in the mesial root, and REP was initiated in the distal root. Three weeks later, the patient was asymptomatic and the sinus tract absent. REP was completed in the distal root, and the tooth was restored. RESULTS: At the 6-, 12-, and 18-month follow-up, the patient presented without symptoms, and the tooth responded positively to pulp sensibility tests. Radiographic examinations showed resolution of the apical radiolucency and completed root development. CONCLUSIONS: Combined treatment using both VPT and REP for immature molars with different pulpal status in individual roots may be a preferable treatment option because preservation of vital pulp tissues and regeneration of new vital tissues allow for continued root development and functionality.


Assuntos
Dente Molar , Criança , Necrose da Polpa Dentária , Humanos , Masculino , Pulpotomia , Endodontia Regenerativa , Raiz Dentária
3.
J Endod ; 46(8): 1074-1084, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32560972

RESUMO

INTRODUCTION: Factors that influence clinical outcomes for regenerative endodontic procedures (REPs) are unknown. This retrospective study aimed to assess tooth healing, root development, pulp vitality, and esthetics post-REPs and categorize them into clinician- and patient-centered outcomes. Furthermore, this study identified significant predictors affecting such outcomes. METHODS: Immature permanent teeth diagnosed with pulp necrosis treated with REPs between 2008 and 2018 with a minimum of 1-year follow-up were included. Outcomes included success and survival rates, changes in root development using 2-dimensional radiographic root area (RRA) and 3-dimensional measurements, pulp vitality, and tooth discoloration. Predictor variables of success included age, sex, etiology of pulp necrosis (PN), type of medicament, sodium hypochlorite (NaOCl) concentration, type of biomaterial used over the blood clot, and preoperative apical diagnosis. Statistical analyses included Cox proportional hazard analyses and generalized regression models. RESULTS: Fifty-one teeth with an average of 2.1 years of follow-up satisfied the criteria. The survival rate was 92%. The success rate was 84.3% with age, etiology of PN, type of medicament, and NaOCl concentration being significant predictors of failure. Root development occurred in 91.4% of cases with age, sex, etiology of PN, type of medicament, NaOCl concentration, and apical diagnosis being significant predictors for RRA change. Positive pulp sensibility responses were associated with greater RRA change, and, finally, the type of biomaterial was a significant predictor for tooth discoloration after treatment. CONCLUSIONS: REPs provide a high survival rate. Patient and clinical factors may affect outcomes, and this knowledge may help to define the criteria for optimal treatment planning of REPs.


Assuntos
Endodontia Regenerativa , Polpa Dentária , Necrose da Polpa Dentária , Dentição Permanente , Humanos , Estudos Retrospectivos
5.
J Evid Based Dent Pract ; 20(1): 101400, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32381409

RESUMO

OBJECTIVE: To evaluate if there is a connection between the causes of pulp necrosis (eg, caries, trauma, dental anomaly) and the success of regenerative endodontic treatment. METHODS: Electronic databases (PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, Embase) were searched for studies on regenerative endodontic treatment, which used both clinical and radiographic evaluation of root maturation after at least 6 months of follow-up. The search terms "necrotic pulp", "regenerative endodontic treatment", "revascularization", and "revitalization" were combined using Boolean operators. The main journals on endodontics and dental traumatology were additionally hand-searched. Studies were included if they specified the causes of pulp necrosis. The primary question under review was, "Does the cause of pulp necrosis affect the outcome of regenerative endodontic treatment?" Other factors such as tooth type, intracanal medicament, irrigation protocol, use of a collagen matrix, and the type of scaffold were evaluated for possible relation with the outcome. The risk-of-bias assessment for randomized and nonrandomized studies was performed separately, using a modified Cochrane Collaboration's tool and risk of bias in non-randomized studies of interventions-I tool, respectively. Meta-analysis was performed, when possible, between studies comparing treatment outcomes of teeth whose pulp necrosis had different etiology. The search strategy yielded 1197 items. After screening, 18 studies reporting 445 regenerative endodontic treatment cases were included. RESULTS: The overall success rate for 274 teeth with trauma etiology was 94.8%, for 95 teeth with dens evaginatus etiology was 93.1%, and for 24 teeth with caries etiology was 96%. No significant difference was found between the results of regenerative endodontic treatment among teeth with trauma, dens evaginatus, and caries etiology (P = .055). Meta-analysis of studies comparing teeth with caries vs dens evaginatus and those with trauma vs caries confirmed that there was no evidence for difference in outcomes. CONCLUSION: Further randomized studies specifically testing such hypothesis are needed to confirm the preliminary results of this review.


Assuntos
Cárie Dentária , Necrose da Polpa Dentária , Humanos , Endodontia Regenerativa , Resultado do Tratamento
7.
J Clin Pediatr Dent ; 44(2): 112-115, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32271657

RESUMO

The present case report describes a rare case of dens evaginatus on the labial surface of mandibular incisor and interdisciplinary management including endodontic and periodontal treatment. A 10-year-old girl presented unusual whitish tubercle-like structure penetrated through the buccal gingiva of mandibular later incisor. In cone-beam computed tomographic view, pulpal tissue was extended from the principal root to the tubercle. Following full thickness flap reflection, the tubercle was carefully removed, resulting in dentin and pin-point pulp exposure. In order to prevent pulp necrosis and facilitate periodontal attachment to this area, Biodentine and enamel matrix derivative were applied. Gingival defect was compensated using a collagen matrix. Up to 2 years, harmonious gingiva state and no loss of tooth vitality were observed. In summary, dens evaginatus on mandibular later incisor could be successfully treated by means of interdisciplinary approach.


Assuntos
Necrose da Polpa Dentária , Incisivo , Criança , Tomografia Computadorizada de Feixe Cônico , Esmalte Dentário , Dentina , Feminino , Humanos
8.
Int Endod J ; 53(7): 905-921, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32249441

RESUMO

AIM: To assess the outcomes of platelet-rich plasma as a scaffold in regenerative/revitalization endodontics (RET) using cone beam computed tomography (CBCT) and 2-dimensional radiographs. METHODOLOGY: Twenty-six healthy patients with mean age of 12.66 ± 4.47, and immature permanent anterior teeth with necrotic pulps, were randomly allocated to two groups, whereby RET was performed using platelet-rich plasma (PRP, test group) and blood clot (BLC, control group). Changes in root length (RL), root dentinal thickness (RDT), apical foramen width (AFW) and radiographic root area (RRA), were assessed using both radiographic methods, whilst changes in periapical area diameter (PAD) were assessed using CBCT, over a period of 12 months. T-test and chi-square/Fisher's exact tests were used to compare continuous and categorical data between BLC and PRP groups, respectively. Changes in RL, RDT, AFW, RRA and PAD were examined by comparing the two groups (PRP versus BLC) using multilevel modelling, considering the clustering effect of repeated measures of several teeth originating from the same participant. RESULTS: Changes in RL, RDT, AFW, RRA and PAD, over time, were found to be significant for both groups. There was, however, no difference between the RET techniques (PRP versus BLC), using both radiographic and CBCT methods. The results of both assessment techniques (CBCT and 2-dimensional radiographic methods) were highly consistent (overall ICC ranged between 0.80 and 0.94). In addition, a significant effect of baseline PAD was found on RL, RRA and AD at 12 months (RL effect = -0.68, P < 0.001; RRA effect = -1.91, P = 0.025; AD effect = 0.08, P = 0.024). CONCLUSION: The current study highlights successful and comparable clinical and radiographic outcomes of RET techniques using PRP and BLC. Standardized and calibrated 2-dimensional radiographic assessment was as effective as CBCT in assessing RET outcomes; therefore, the routine use of CBCT in RET is not recommended. Although an effect of baseline periapical lesion diameter on root development outcomes, at 12 months, were observed, more studies are recommended in order to assess such an effect.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Plasma Rico em Plaquetas , Necrose da Polpa Dentária , Dentição Permanente , Humanos , Regeneração
9.
J Indian Soc Pedod Prev Dent ; 38(1): 84-87, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32174634

RESUMO

Periostitis ossificans (PO) is a type of osteomyelitis stemming from an odontogenic infection, generally found in children and adolescents, and often leads to the loss of the involved tooth. This case presents a less invasive alternative for the treatment of PO. A 10-year-old patient presented with an asymmetrical increase in the left side of the mandible. Tooth 36 exhibited pulp necrosis and incomplete root formation. Radiographically, the bone in the region had the appearance of the layers of an onion. Computed tomography indicated periosteal bone proliferation in the region of the ramus and angle of the mandible adjacent to the vestibular cortical bone. Therapy involved root canal preparation and intracanal medication with calcium hydroxide in tooth 36. Complete remission of the condition occurred within 14 months. In conclusion, endodontic intervention is a less invasive alternative and should be considered to minimize the negative impact of tooth loss in children.


Assuntos
Doenças Mandibulares , Osteomielite , Periostite , Adolescente , Hidróxido de Cálcio , Criança , Necrose da Polpa Dentária , Humanos , Tratamento do Canal Radicular
10.
J Biol Regul Homeost Agents ; 34(1 Suppl. 1): 33-37, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32064833

RESUMO

An ideal scenario for a tooth in necrosis with immature root would be to continue root development after the regeneration of pulp tissue. We report a case, where the regenerative endodontic procedure (REP) was done using biodentine as a scaffold in an immature mandibular molar tooth.


Assuntos
Compostos de Cálcio/uso terapêutico , Necrose da Polpa Dentária/terapia , Dente Molar , Endodontia Regenerativa , Silicatos/uso terapêutico , Seguimentos , Humanos , Regeneração , Tratamento do Canal Radicular
11.
Niger J Clin Pract ; 23(2): 212-218, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32031096

RESUMO

Objectives: This single-blind, randomized clinical trial (RCT) aimed to compare the duration, intensity, and incidence of postoperative pain after foraminal enlargement (FE) with continuous rotary systems and reciprocating instruments. Materials and Methods: Sixty qualified patients were randomly divided into the following two groups: the ProTaper Next group and the WaveOne group. Participants were selected from patients who had both asymptomatic necrosis and asymptomatic apical periodontitis with a single root canal. Endodontic treatment was performed in one visit, and the patients were asked to record their pain severity and analgesic consumption during a 7-day follow-up period using a visual analog scale (VAS). The data were analyzed using the Mann-Whitney U-test and Chi-square test (P < 0.05). Results: A significant difference was observed between the two groups during the first two days of follow-up (P < 0.05). Pain experience was higher in FEs that had been created by reciprocating instruments than by continuous rotary systems. There were no significant differences in VAS pain scores over the other days (P > 0.05). None of the patients had severe postoperative pain during the follow-up period. No significant differences were observed in the prevalence of analgesic consumption between either group (P > 0.05). Conclusions: This RCT indicates that in the 2-day follow-up period after endodontic treatment, FEs created by reciprocated instruments associated more postoperative pain than continuous rotary systems.


Assuntos
Cavidade Pulpar/cirurgia , Necrose da Polpa Dentária/terapia , Dente Molar/cirurgia , Dor Pós-Operatória/epidemiologia , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Tratamento do Canal Radicular/instrumentação , Adulto , Analgésicos/uso terapêutico , Cavidade Pulpar/patologia , Feminino , Humanos , Incidência , Masculino , Dor Pós-Operatória/etiologia , Irrigantes do Canal Radicular/uso terapêutico , Método Simples-Cego , Resultado do Tratamento , Escala Visual Analógica
12.
BMC Oral Health ; 20(1): 29, 2020 01 30.
Artigo em Inglês | MEDLINE | ID: mdl-32000767

RESUMO

BACKGROUND: To report a case of type III dens invaginatus associated with peri-invagination periodontitis in an immature permanent mandibular central incisor with open apex, in which only the invagination area was treated and vitality was preserved. CASE PRESENTATION: A 9-year-old boy was referred complaining of pain in the mandibular left central incisor. After radiographic examination, an invagination into the pulp chamber of the tooth associated with periapical radiolucency was detected. Endodontic access was performed and the orifice was identified under a dental operating microscope. The invagination area was chemo-mechanically cleaned. After 1 week, the invagination was obturated with mineral trioxide aggregate. During the 2-year follow up period, the tooth was asymptomatic. Radiographic examination revealed significant progression of periapical healing and root development in the main root canal of the tooth. CONCLUSION: Non-surgical root canal treatment of the invagination may preserve pulp vitality, and continuous root development of the tooth.


Assuntos
Dens in Dente/terapia , Incisivo/anormalidades , Periodontite Periapical/terapia , Criança , Cavidade Pulpar/patologia , Necrose da Polpa Dentária/terapia , Humanos , Incisivo/diagnóstico por imagem , Masculino , Radiografia Interproximal , Reprodutibilidade dos Testes , Tratamento do Canal Radicular , Coroa do Dente/anormalidades , Coroa do Dente/diagnóstico por imagem , Raiz Dentária/anormalidades , Raiz Dentária/diagnóstico por imagem
13.
J Clin Pediatr Dent ; 44(1): 15-19, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31995420

RESUMO

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.


Assuntos
Periodontite Periapical , Fibrina Rica em Plaquetas , Necrose da Polpa Dentária , Humanos , Incisivo , Endodontia Regenerativa , Tratamento do Canal Radicular
14.
Clin Oral Investig ; 24(3): 1101-1111, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31953685

RESUMO

OBJECTIVE: Traumatic dental injuries often affect the dental hard tissues, periodontal tissues, and dental pulp. Root resorption (RR) is a significantly concerning phenomenon that could lead to loss of the traumatized tooth. The purpose of this systematic review was to analyze the incidences of different types of RR after concussion, subluxation, lateral luxation, intrusive luxation, and extrusive luxation. MATERIAL AND METHODS: Seven databases were electronically and manually searched for the identification of observational studies that evaluated the incidence of RR after luxation injuries. Following study selection, data extraction, and risk of bias assessment through MAStARI checklist, the GRADE quality of available evidence was assessed. RESULTS: In total, 14 studies were included in the present systematic review. Ten and four studies presented a moderate and low RoB, respectively, and the overall GRADE quality of evidence was "very low" for all outcomes. The highest incidence rates of RR were observed for teeth with intrusive luxation, followed by those with extrusive luxation, lateral luxation, subluxation, and concussion. In general, the most common type of RR documented for all injuries was inflammatory RR, followed by replacement RR, surface RR, and internal RR. CONCLUSIONS: Our findings suggest that RR most commonly occurs in association with intrusive luxation and by inflammatory RR. Awareness regarding the incidence of RR after injuries is useful for clinicians to minimize the risk and severity of its occurrence, because a late diagnosis of RR may limit treatment alternatives and result in tooth loss. CLINICAL RELEVANCE: Knowledge about the incidence of RR in teeth with concussion and different types of luxation injuries can ensure appropriate follow-up protocols and favorable outcomes.


Assuntos
Reabsorção da Raiz , Traumatismos Dentários/complicações , Necrose da Polpa Dentária , Humanos , Incidência , Estudos Observacionais como Assunto , Avulsão Dentária/complicações , Raiz Dentária
15.
Aust Endod J ; 46(1): 140-153, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31432612

RESUMO

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.


Assuntos
Periodontite Periapical , Endodontia Regenerativa , Necrose da Polpa Dentária , Dentição Permanente , Humanos , Tecido Periapical , Regeneração
16.
J Endod ; 46(1): 116-123, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31761331

RESUMO

The current American Association of Endodontists clinical considerations for a regenerative endodontic procedure state that a regenerative procedure is suitable for immature permanent teeth with necrotic pulp when the pulp space is not needed for a post/core in the final restoration. Therefore, many immature permanent teeth with necrotic pulp that have sustained a substantial loss of coronal tooth structure either from caries or trauma are treated by apexification or mineral trioxide aggregate/Biodentine (Septodent, Lancaster, PA) apical barrier techniques in which no further root maturation would occur. This case series presents 10 immature permanent teeth with necrotic pulp in which a post/core was likely required in the future for adequate coronal restoration because of loss of substantial coronal tooth structure and a modified apexification procedure was used. All 10 cases after the modified apexification procedure showed no clinical symptoms/signs and showed radiographic evidence of healed/healing of periapical lesion after a 2-year review. Eight cases showed increased thickness of the apical root canal walls, increased apical root length, and apical closure. The overall percentage change in root length was 7.52%, in root width at the apical one third it was 18.89%, and in radiographic root area it was 15.04% at the 24- to 72-month follow-up period. This modified apexification procedure allows for the tooth to be restored with a post/core if required for the final restoration in the future as well as continued root development.


Assuntos
Apexificação , Necrose da Polpa Dentária , Periodontite Periapical , Materiais Restauradores do Canal Radicular , Necrose da Polpa Dentária/terapia , Combinação de Medicamentos , Humanos , Óxidos , Periodontite Periapical/terapia , Tratamento do Canal Radicular , Silicatos , Ápice Dentário
17.
J Endod ; 46(2): 192-199, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31813579

RESUMO

INTRODUCTION: Regenerative endodontic procedures (REPs) are aimed to treat apical periodontitis and promote root maturation of immature necrotic teeth. However, REPs are not intended to be a primary indication for treating or arresting external root resorption (ERR). The purpose of this study was to describe REP treatment in the cessation of ERR. METHODS: Four cases (5 teeth) of posttraumatic immature teeth diagnosed with necrotic pulp and apical periodontitis or chronic apical abscess were treated with REPs using plasma-rich fibrin as a scaffold. All the teeth showed ERR and have been followed up to 3 years. RESULTS: This case series shows how REPs arrested ERR. In 3 of the cases, replacement resorption was arrested, thus avoiding complications of ankylosis and the need for decoronation. CONCLUSIONS: In addition to the known advantages of REPs, we show that REPs are a promising treatment modality for arresting ERR, warranting further clinical trials.


Assuntos
Periodontite Periapical , Endodontia Regenerativa , Reabsorção da Raiz , Anquilose Dental , Necrose da Polpa Dentária , Humanos
18.
J Endod ; 46(1): 44-50, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31740065

RESUMO

INTRODUCTION: The goal of regenerative endodontic treatment (RET) is to regenerate the pulp-dentin complex in immature teeth with pulp necrosis. There is no consensus in using RET in previously treated teeth. This article reports on long-term outcomes of RET in previously treated immature teeth. METHODS: Previously treated immature teeth with signs/symptoms of failure were included. After local anesthesia and rubber dam isolation, the root canal filling material was removed without the use of chemical solvents. The root canals were irrigated with 6% sodium hypochlorite using an EndoVac (Kerr Endodontics, Culver City, CA), and a creamy mix of metronidazole and ciprofloxacin was placed in the canals for 4 weeks. At the second visit, the antibiotic dressing was removed using 17% EDTA. Bleeding was induced into the root canal space, and SynOss Putty (Collagen Matrix Inc, Oakland, NJ) was placed. Bioceramic putty was placed over the SynOss Putty, and the teeth were restored at a subsequent visit. RESULTS: Five teeth in 4 patients were included. The patients' ages ranged from 14-46 years. Recall examinations were performed from 20 to 72 months with an average of 54.4 months. The apical openings of the teeth ranged from 1-3.7 mm. All teeth were functional and asymptomatic at the recall visits. All periapical lesions resolved with partial or complete mineralization of the root canals, and all teeth showed partial to complete apical closure at the follow-up visits. CONCLUSIONS: RET can be a viable option for nonsurgical retreatment of immature teeth. This article adds a new perspective to the field of regenerative endodontics.


Assuntos
Necrose da Polpa Dentária , Endodontia , Endodontia Regenerativa , Adolescente , Adulto , Necrose da Polpa Dentária/terapia , Humanos , Pessoa de Meia-Idade , Retratamento , Tratamento do Canal Radicular , Adulto Jovem
19.
Int Endod J ; 53(3): 298-307, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31587317

RESUMO

AIM: To evaluate the effect of intraorifice barriers and bases on the healing of apical periodontitis following root canal treatment in mandibular molars. METHODOLOGY: A total of 120 permanent mandibular molars with necrotic pulps and periapical radiolucencies (PAI score ≥ 3) were recruited. Root canal treatment was performed in all teeth using a standard protocol, following which they were randomly allocated to one of the three treatment groups: intraorifice barrier group: coronal 3-mm gutta-percha was removed and replaced with glass-ionomer cement (GIC) barrier. The floor of the pulp chamber was then sealed with 2-mm-thick GIC base followed by final composite resin restoration; base group: received 2-mm-thick GIC base before placement of composite resin restoration; and control group: had pulp chamber entirely filled with composite resin only. Follow-up was done at 3, 6, 9 and 12 months. Combination of clinical and radiographic parameters were used to assess treatment outcome. The data were analysed using Kruskal-Wallis, chi-square and Wilcoxon signed-rank tests and logistic regression analysis. RESULTS: At the end of 12 months, the base group had the most favourable healing (97.1%), whilst the control group had the least favourable healing (83.8%). The intraorifice barrier group had healing of 92.1%. However, there was no significant difference in healing between groups at the end of the follow-up period (P > 0.05). Additional subgroup analysis revealed a nonsignificant effect of periodontal status and root filling level on periapical healing. CONCLUSION: The use of an additional barrier under permanent restorations did not significantly improve the outcome of primary root canal treatment in posterior teeth after 12 months. However, its influence in the long term requires further evaluation.


Assuntos
Periodontite Periapical , Materiais Restauradores do Canal Radicular , Necrose da Polpa Dentária , Guta-Percha , Humanos , Tratamento do Canal Radicular
20.
J Endod ; 46(2): 209-215, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31859008

RESUMO

INTRODUCTION: SynOss Putty (Collagen Matrix, Oakland, NJ) has shown the formation of mineralized tissues when used as a scaffold in regenerative endodontic treatment (RET) in immature human teeth. The aim of this study was to compare the outcome of RET in immature ferret teeth using 2 scaffolds: a blood clot and SynOss Putty. METHODS: Thirty-two immature canine teeth in 8 ferrets (95-105 days old) were divided into 4 groups: group 1, no treatment (positive control, n = 8); group 2, full pulpectomy with no further treatment (negative control, n = 8); group 3, revascularization using a blood clot (n = 8); and group 4, revascularization using a SynOss Putty scaffold (n = 8). After 3 months, the animals were euthanized, and the newly formed tissues were examined histologically. The data were statistically analyzed using chi-square and Fisher exact tests. RESULTS: Normal pulps were found in group 1. No pulp tissue was found in teeth in group 2. In group 3, the pulp tissue and the odontoblastic layer were absent, and the root canal spaces were filled with a hard tissue characterized as bonelike and cementumlike tissues. All teeth except 1 in group 4 showed no hard tissue formation and intracanal/periapical inflammation. SynOss Putty was significantly associated with a lack of tissue formation and intracanal/periapical inflammation (P < .05). CONCLUSIONS: Intracanal hard tissue formation was observed in immature teeth after RET using a blood clot. No tissue regeneration was found in the majority of samples using SynOss Putty as a scaffold.


Assuntos
Necrose da Polpa Dentária , Furões , Endodontia Regenerativa , Trombose , Tecidos Suporte , Animais , Polpa Dentária , Humanos , Endodontia Regenerativa/métodos
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