DAİMİ İMMATÜR DİŞLERDE REJENERATİF ENDODONTİK TEDAVİ: ÜÇ OLGU SUNUMU

Year 2023, , 164 - 167, 28.12.2023

Esra Şahin , Ebru Hazar Bodrumlu

https://doi.org/10.21306/dishekimligi.1369909

Abstract

Amaç: Rejeneratif endodontik tedavi, immatür nekrotik dişlerde, pulpa-dentin kompleksine fizyolojik işlevlerini yeniden kazandıran bir prosedür olarak tanımlanır ve kök gelişiminin devam etmesini sağlayarak kök kırıklarını potansiyel olarak önlemektedir. Bu vaka serisinin amacı, rejeneratif endodontik yaklaşım ile tedavi edilen üç vakayı 12 aylık takip dönemlerinde sunmaktır.
Olgu Sunumu: Bu vaka serisinde, bir premolar ve 2 molar diş olmak üzere 3 farklı olguya uygulanan rejeneratif endodontik tedavi sunulmuştur. Rejeneratif endodontik tedavi protokolü olarak NaOCl ve EDTA irrigasyon solüsyonları ve kanal içi medikament olarak kalsiyum hidroksit kullanımı uygulanan dişlerde koronal tıkama için mineral trioksit agregat kullanıldı. Ardından dişler kompozit ile restore edildi. Takip dönemlerinin sonunda, kök gelişimlerinin devam ettiği gözlendi. Tüm dişlerin 12. Ay kontrollerinde perküsyon veya palpasyona duyarlılığı saptanmadı ve kök gelişimleri tamamlandı.
Sonuç: Rejeneratif endodontik tedavi, immatür daimi dişlerin apeksinin kapanmasında ve kanal duvarlarının kalınlaşmasında geleneksel apeksifikasyon tedavisine iyi bir alternatif olarak düşünülmektedir.

Keywords

Apeksifikasyon, Rejenerasyon, Revaskularizasyon

Ethical Statement

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Supporting Institution

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Project Number

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Thanks

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REGENERATIVE ENDODONTIC TREATMENT OF PERMANENT IMMATURE TEETH: THREE CASE REPORT

Abstract

Objective: Regenerative endodontic treatment is defined as a procedure that restores physiologic function to the pulp-dentin complex in immature necrotic teeth, allowing continued root growth and potentially preventing root fractures. The aim of this case series is to present three cases treated with a regenerative endodontic approach during a 12-month follow-up period.
Case Report: In this case series, regenerative endodontic treatment of 3 different cases, one premolar and 2 molars, is presented. The regenerative endodontic treatment protocol consisted of NaOCl and EDTA irrigation solutions and calcium hydroxide as an intracanal medicament. Mineral trioxide aggregate was used for coronal occlusion. The teeth were then restored with composite. At the end of the follow-up periods, it was observed that root development continued. All teeth were not sensitive to percussion or palpation at the 12th month controls and root development was completed.
Conclusion: Regenerative endodontic treatment is considered a good alternative to traditional apexification therapy for the closure of the apex and thickening of the canal walls of immature permanent teeth.

Keywords

Apexification, Regeneration, Revascularization

Project Number

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References

• 1. Shabahang S. Treatment options: apexogenesis and apexification. J Endod. 2013;39(3 Suppl):26-9.
• 2. Huang GT. Apexification: the beginning of its end. Int Endod J. 2009;42(10):855-66.
• 3. 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. 2011; 37(4):562-67.
• 4. Galler KM, Krastl G, Simon S, Van Gorp G, Meschi N, Vahedi B, Lambrechts P. European Society of Endodontology position statement: Revitalization procedures. Int Endod J. 2016;49(8): 717-23.
• 5. Tzanetakis GN, Giannakoulas DG, Papanakou S, Gizani S, Lygidakis N. Regenerative endodontic therapy of immature permanent molars with pulp necrosis: a cases series and a literature review. Eur Arch Paediatr Dent. 2021;22(3):515-25.
• 6. Wang X, Thibodeau B, Trope M, Lin LM, Huang GT. Histologic characterization of regenerated tissues in canal space after the revitalization/revascularization procedure of immature dog teeth with apical periodontitis. J Endod. 2010;36(1):56-63.
• 7. Neha K, Kansal R, Garg P, Joshi R, Garg D, Grover HS. Management of immature teeth by dentin-pulp regeneration: a recent approach. Med Oral Patol Oral Cir Bucal. 2011;16(7):e997-1004.
• 8. Yamauchi N, Yamauchi S, Nagaoka H, Duggan D, Zhong S, Lee SM, Teixeira FB, Yamauchi M. Tissue engineering strategies for immature teeth with apical periodontitis. J Endod. 2011;37(3):390-7.
• 9. Mohammadi Z, Shalavi S, Yaripour S, Kinoshita JI, Manabe A, Kobayashi M, Giardino L, Palazzi F, Sharifi F, Jafarzadeh H. Smear Layer Removing Ability of Root Canal Irrigation Solutions: A Review. J Contemp Dent Pract. 2019;20(3):395-402.
• 10. Pang NS, Lee SJ, Kim E, Shin DM, Cho SW, Park W, Zhang X, Jung IY. Effect of EDTA on attachment and differentiation of dental pulp stem cells. J Endod. 2014;40(6):811-7.
• 11. Banchs F, Trope M. Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod. 2004;30(4):196-200.
• 12. Windley W 3rd, Teixeira F, Levin L, Sigurdsson A, Trope M. Disinfection of immature teeth with a triple antibiotic paste. J Endod. 2005;31(6):439-43.
• 13. da Silva LA, Nelson-Filho P, da Silva RA, Flores DS, Heilborn C, Johnson JD, Cohenca N. Revascularization and periapical repair after endodontic treatment using apical negative pressure irrigation versus conventional irrigation plus triantibiotic intracanal dressing in dogs' teeth with apical periodontitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 109(5):779-87.
• 14. Cehreli ZC, Isbitiren B, Sara S, Erbas G. Regenerative endodontic treatment (revascularization) of immature necrotic molars medicated with calcium hydroxide: a case series. J Endod. 2011; -37(9):1327-30.
• 15. Chueh LH, Ho YC, Kuo TC, Lai WH, Chen YH, Chiang CP. Regenerative endodontic treatment for necrotic immature permanent teeth. J Endod. 2009; 35(2):160-4.
• 16. Siqueira JF Jr. Strategies to treat infected root canals. J Calif Dent Assoc. 2001; 29(12): 825-37.
• 17. Torabinejad M, Turman M. Revitalization of tooth with necrotic pulp and open apex by using platelet-rich plasma: a case report. J Endod. 2011; 37(2):265-8.
• 18. Petrino JA, Boda KK, Shambarger S, Bowles WR, McClanahan SB. Challenges in regenerative endodontics: a case series. J Endod. 2010;36(3):536-41.
• 19. Thibodeau B, Trope M. Pulp revascularization of a necrotic infected immature permanent tooth: case report and review of the literature. Pediatr Dent. 2007;29(1):47-50.