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KONSANTRE BÜYÜME FAKTÖRÜ KULLANILARAK YAPILAN REJENERATİF ENDODONTİK TEDAVİLERİN ÜÇ YILLIK TAKİBİ: DOKUZ ADET OLGU

Year 2023, , 57 - 62, 25.12.2023
https://doi.org/10.34108/eujhs.1307531

Abstract

Bu olgu serisinin amacı, apeksi açık nekrotik daimi dişlerde konsantre büyüme faktörü kullanılarak gerçekleştirilen dokuz adet rejeneratif endodontik tedavi olgusunun 3 yıllık klinik ve radyografik takiplerini sunmaktır. Yaşları 8-21 arasında değişen 9 hasta kliniğimize başvurdu. Yapılan klinik ve radyografik muayeneler sonucunda rejeneratif endodontik tedavi yapılmasına karar verildi. Çalışma boyu tespitinden sonra dişler 20 mL %2.5 NaOCl ile irige edildi ve EndoActivator ile aktive edildi. Kök kanalları XP-endo Finisher-R eğesi ile enstrümante edildi. Final irrigasyonu olarak 20 mL %17 EDTA kullanıldı, ardından kalsiyum hidroksit ve geçici dolguları yerleştirildi. İki hafta sonra kökler 20 mL %17 EDTA ve 5 mL distile su ile irige edildi ve kağıt konlar ile kurutuldu. Kök kanallarının koronal kısmına kadar kanama gerçekleştirildi. Hastadan kan alınarak elde edilen konsantre büyüme faktörü kök kanallarına yerleştirildi. Oluşan kan pıhtısının üzerine Biodentine yerleştirildi ve rezin kompozit ile daimi restorasyonları yapıldı. 3 yıllık takipte 5 hastada klinik ve radyografik iyileşme gözlendi. Diğer 4 hastada farklı zaman dilimlerinde persiste enfeksiyon ve sinüs yolu oluşumu saptandı. Rejeneratif endodontik tedaviler dişleri canlı olarak korumayı amaçlayan ve gelecek vadeden tedaviler olsa da öngörülemeyen sonuçları nedeni ile daha fazla randomize klinik araştırmaya ihtiyaç vardır.

Project Number

-

References

  • Lin J, Zeng Q, Wei X, et al. Regenerative Endodontics Versus Apexification in Immature Permanent Teeth with Apical Periodontitis: A Prospective Randomized Controlled Study. J Endod. 2017;43(11):1821-1827. doi: 10.1016/j.joen.2017.06.023.
  • Wu J, Li X, Xu L, et al. Radiographic evaluation of immature traumatized incisors following different endodontic treatments. Dent Traumatol. 2021;37(2):330-337. doi: 10.1111/edt.12632.
  • American Association of Endodontists (AAE). AAE clinical considerations for a regenerative procedure. https://www.aae.org/specialty/wp-content/uploads/sites/2/2017/06/currentregenerativeendodonticconsiderations.pdf.; Available from: 17.05.2023.
  • Ulusoy AT, Turedi I, Cimen M and Cehreli ZC. Evaluation of Blood Clot, Platelet-rich Plasma, Platelet-rich Fibrin, and Platelet Pellet as Scaffolds in Regenerative Endodontic Treatment: A Prospective Randomized Trial. J Endod. 2019;45(5):560-566. doi: 10.1016/j.joen.2019.02.002.
  • Nagata JY, Gomes BP, Rocha Lima TF, et al. Traumatized immature teeth treated with 2 protocols of pulp revascularization. J Endod. 2014;40(5):606-612. doi: 10.1016/j.joen.2014.01.032.
  • Mittmann CW, Kostka E, Ballout H, et al. Outcome of revascularization therapy in traumatized immature incisors. BMC Oral Health. 2020;20(1):207. doi: 10.1186/s12903-020-01193-5.
  • Murray PE, Garcia-Godoy F and Hargreaves KM. Regenerative endodontics: a review of current status and a call for action. J Endod. 2007;33(4):377-390. doi: 10.1016/j.joen.2006.09.013.
  • Nosrat A, Homayounfar N and Oloomi K. Drawbacks and unfavorable outcomes of regenerative endodontic treatments of necrotic immature teeth: a literature review and report of a case. J Endod. 2012;38(10):1428-1434. doi: 10.1016/j.joen.2012.06.025.
  • Youssef A, Ali M, ElBolok A and Hassan R. Regenerative endodontic procedures for the treatment of necrotic mature teeth: A preliminary randomized clinical trial. Int Endod J. 2022;55(4):334-346. doi: 10.1111/iej.13681.
  • Panda S, Mishra L, Arbildo-Vega HI, et al. Effectiveness of Autologous Platelet Concentrates in Management of Young Immature Necrotic Permanent Teeth-A Systematic Review and Meta-Analysis. Cells. 2020;9(10):2241 doi: 10.3390/cells9102241.
  • Rodella LF, Favero G, Boninsegna R, et al. Growth factors, CD34 positive cells, and fibrin network analysis in concentrated growth factors fraction. Microsc Res Tech. 2011;74(8):772-777. doi: 10.1002/jemt.20968.
  • Li Z, Liu L, Wang L and Song D. The effects and potential applications of concentrated growth factor in dentin-pulp complex regeneration. Stem Cell Res Ther. 2021;12(1):357. doi: 10.1186/s13287-021-02446-y.
  • Masuki H, Okudera T, Watanebe T, et al. Growth factor and pro-inflammatory cytokine contents in platelet-rich plasma (PRP), plasma rich in growth factors (PRGF), advanced platelet-rich fibrin (A-PRF), and concentrated growth factors (CGF). Int J Implant Dent. 2016;2(1):19. doi: 10.1186/s40729-016-0052-4.
  • Nivedhitha MS, Jacob B and Ranganath A. Concentrated Growth Factor: A Novel Platelet Concentrate for Revascularization of Immature Permanent Teeth-A Report of Two Cases. Case Rep Dent. 2020;2020:1329145. doi: 10.1155/2020/1329145.
  • Yu LT, Zhou YJ, Li JH, Cheng J and Song GT. Revascularization of an Immature Permanent Tooth with Periapical Periodontitis Using Concentrated Growth Factor Assisted by Erbium Laser (2940 nm) Irrigation: A Case Report. Applied Sciences-Basel. 2022;12(9):4751. doi: 10.3390/app12094751.
  • Banchs F and Trope M. Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod. 2004;30(4):196-200. doi: 10.1097/00004770-200404000-00003.
  • Meschi N, Hilkens P, Van Gorp G, et al. Regenerative Endodontic Procedures Posttrauma: Immunohistologic Analysis of a Retrospective Series of Failed Cases. J Endod. 2019;45(4):427-434. doi: 10.1016/j.joen.2019.01.007.
  • Verma P, Nosrat A, Kim JR, et al. Effect of Residual Bacteria on the Outcome of Pulp Regeneration In Vivo. J Dent Res. 2017;96(1):100-106. doi: 10.1177/0022034516671499.
  • Fouad AF. Contemporary Microbial and Antimicrobial Considerations in Regenerative Endodontic Therapy. J Endod. 2020;46(9S):S105-S114. doi: 10.1016/j.joen.2020.06.030.
  • Kakoli P, Nandakumar R, Romberg E, Arola D and Fouad AF. The effect of age on bacterial penetration of radicular dentin. J Endod. 2009;35(1):78-81. doi: 10.1016/j.joen.2008.10.004.
  • Ricucci D, Lopes WSP, Loghin S, Rocas IN and Siqueira JF, Jr. Large Bacterial Floc Causing an Independent Extraradicular Infection and Posttreatment Apical Periodontitis: A Case Report. J Endod. 2018;44(8):1308-1316. doi: 10.1016/j.joen.2018.05.009.
  • Sasanakul P, Ampornaramveth RS and Chivatxaranukul P. Influence of Adjuncts to Irrigation in the Disinfection of Large Root Canals. J Endod. 2019;45(3):332-337. doi: 10.1016/j.joen.2018.11.015.
  • Zandi H, Rodrigues RC, Kristoffersen AK, et al. Antibacterial Effectiveness of 2 Root Canal Irrigants in Root-filled Teeth with Infection: A Randomized Clinical Trial. J Endod. 2016;42(9):1307-1313. doi: 10.1016/j.joen.2016.06.006.
  • Cameron R, Claudia E, Ping W, Erin S and Ruparel NB. Effect of a Residual Biofilm on Release of Transforming Growth Factor beta1 from Dentin. J Endod. 2019;45(9):1119-1125. doi: 10.1016/j.joen.2019.05.004.
  • Yang F, Yu L, Li J, et al. Evaluation of concentrated growth factor and blood clot as scaffolds in regenerative endodontic procedures: A retrospective study. Aust Endod J. 2023;49(2):332-343. doi: 10.1111/aej.12666.
  • Lin LM, Huang GT, Sigurdsson A and Kahler B. Clinical cell-based versus cell-free regenerative endodontics: clarification of concept and term. Int Endod J. 2021;54(6):887-901. doi: 10.1111/iej.13471.
  • Aksel H, Albanyan H, Bosaid F and Azim AA. Dentin conditioning protocol for regenerative endodontic procedures. J Endod. 2020;46(8),1099-1104. doi: 10.1016/j.joen.2020.05.010.
  • Wei X, Yang M, Yue L, Huang, D. et al. Expert consensus on regenerative endodontic procedures. Int J of Oral Sci. 2022;14.1:55. doi: 10.1038/s41368-022-00206-z

3-YEAR FOLLOW-UP OF REGENERATIVE ENDODONTIC TREATMENTS WITH THE APPLICATION OF CONCENTRATED GROWTH FACTOR AS SCAFFOLD: NINE CASES

Year 2023, , 57 - 62, 25.12.2023
https://doi.org/10.34108/eujhs.1307531

Abstract

The aim of this case series is to present 3-year clinical and radiographic follow-ups of nine regenerative endodontic treatment cases using concentrated growth factor in necrotic immature permanent teeth. Nine patients aged 8-21 years were referred to our clinic. According to clinical and radiographic examinations, it was decided to perform RET. After the working length determination, teeth were irrigated with 2.5% NaOCl and activated with EndoActivator. Root canals were instrumented with XP-endo Finisher-R file. 20 mL of 17% EDTA was used as final irrigation, and calcium hydroxide and temporary fillings were placed. Two weeks later, roots were irrigated with 17% EDTA and 5 mL distilled water and dried with paper points. Bleeding was induced into the coronal part of the root canal. Concentrated growth factor (obtained from the patient’s blood) was placed into the root canals. Biodentine was placed on the blood clot and permanent restorations were made with resin composite. At 3-year follow-up, clinical and radiographic healing was observed in 5 patients. In the other 4 patients, persistent infection and sinus-tract formation were detected at different time periods. Although RET is a promising treatment that aims to preserve teeth vitally, more randomized clinical research is needed due to its unpredictable results.

Supporting Institution

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Project Number

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Thanks

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References

  • Lin J, Zeng Q, Wei X, et al. Regenerative Endodontics Versus Apexification in Immature Permanent Teeth with Apical Periodontitis: A Prospective Randomized Controlled Study. J Endod. 2017;43(11):1821-1827. doi: 10.1016/j.joen.2017.06.023.
  • Wu J, Li X, Xu L, et al. Radiographic evaluation of immature traumatized incisors following different endodontic treatments. Dent Traumatol. 2021;37(2):330-337. doi: 10.1111/edt.12632.
  • American Association of Endodontists (AAE). AAE clinical considerations for a regenerative procedure. https://www.aae.org/specialty/wp-content/uploads/sites/2/2017/06/currentregenerativeendodonticconsiderations.pdf.; Available from: 17.05.2023.
  • Ulusoy AT, Turedi I, Cimen M and Cehreli ZC. Evaluation of Blood Clot, Platelet-rich Plasma, Platelet-rich Fibrin, and Platelet Pellet as Scaffolds in Regenerative Endodontic Treatment: A Prospective Randomized Trial. J Endod. 2019;45(5):560-566. doi: 10.1016/j.joen.2019.02.002.
  • Nagata JY, Gomes BP, Rocha Lima TF, et al. Traumatized immature teeth treated with 2 protocols of pulp revascularization. J Endod. 2014;40(5):606-612. doi: 10.1016/j.joen.2014.01.032.
  • Mittmann CW, Kostka E, Ballout H, et al. Outcome of revascularization therapy in traumatized immature incisors. BMC Oral Health. 2020;20(1):207. doi: 10.1186/s12903-020-01193-5.
  • Murray PE, Garcia-Godoy F and Hargreaves KM. Regenerative endodontics: a review of current status and a call for action. J Endod. 2007;33(4):377-390. doi: 10.1016/j.joen.2006.09.013.
  • Nosrat A, Homayounfar N and Oloomi K. Drawbacks and unfavorable outcomes of regenerative endodontic treatments of necrotic immature teeth: a literature review and report of a case. J Endod. 2012;38(10):1428-1434. doi: 10.1016/j.joen.2012.06.025.
  • Youssef A, Ali M, ElBolok A and Hassan R. Regenerative endodontic procedures for the treatment of necrotic mature teeth: A preliminary randomized clinical trial. Int Endod J. 2022;55(4):334-346. doi: 10.1111/iej.13681.
  • Panda S, Mishra L, Arbildo-Vega HI, et al. Effectiveness of Autologous Platelet Concentrates in Management of Young Immature Necrotic Permanent Teeth-A Systematic Review and Meta-Analysis. Cells. 2020;9(10):2241 doi: 10.3390/cells9102241.
  • Rodella LF, Favero G, Boninsegna R, et al. Growth factors, CD34 positive cells, and fibrin network analysis in concentrated growth factors fraction. Microsc Res Tech. 2011;74(8):772-777. doi: 10.1002/jemt.20968.
  • Li Z, Liu L, Wang L and Song D. The effects and potential applications of concentrated growth factor in dentin-pulp complex regeneration. Stem Cell Res Ther. 2021;12(1):357. doi: 10.1186/s13287-021-02446-y.
  • Masuki H, Okudera T, Watanebe T, et al. Growth factor and pro-inflammatory cytokine contents in platelet-rich plasma (PRP), plasma rich in growth factors (PRGF), advanced platelet-rich fibrin (A-PRF), and concentrated growth factors (CGF). Int J Implant Dent. 2016;2(1):19. doi: 10.1186/s40729-016-0052-4.
  • Nivedhitha MS, Jacob B and Ranganath A. Concentrated Growth Factor: A Novel Platelet Concentrate for Revascularization of Immature Permanent Teeth-A Report of Two Cases. Case Rep Dent. 2020;2020:1329145. doi: 10.1155/2020/1329145.
  • Yu LT, Zhou YJ, Li JH, Cheng J and Song GT. Revascularization of an Immature Permanent Tooth with Periapical Periodontitis Using Concentrated Growth Factor Assisted by Erbium Laser (2940 nm) Irrigation: A Case Report. Applied Sciences-Basel. 2022;12(9):4751. doi: 10.3390/app12094751.
  • Banchs F and Trope M. Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod. 2004;30(4):196-200. doi: 10.1097/00004770-200404000-00003.
  • Meschi N, Hilkens P, Van Gorp G, et al. Regenerative Endodontic Procedures Posttrauma: Immunohistologic Analysis of a Retrospective Series of Failed Cases. J Endod. 2019;45(4):427-434. doi: 10.1016/j.joen.2019.01.007.
  • Verma P, Nosrat A, Kim JR, et al. Effect of Residual Bacteria on the Outcome of Pulp Regeneration In Vivo. J Dent Res. 2017;96(1):100-106. doi: 10.1177/0022034516671499.
  • Fouad AF. Contemporary Microbial and Antimicrobial Considerations in Regenerative Endodontic Therapy. J Endod. 2020;46(9S):S105-S114. doi: 10.1016/j.joen.2020.06.030.
  • Kakoli P, Nandakumar R, Romberg E, Arola D and Fouad AF. The effect of age on bacterial penetration of radicular dentin. J Endod. 2009;35(1):78-81. doi: 10.1016/j.joen.2008.10.004.
  • Ricucci D, Lopes WSP, Loghin S, Rocas IN and Siqueira JF, Jr. Large Bacterial Floc Causing an Independent Extraradicular Infection and Posttreatment Apical Periodontitis: A Case Report. J Endod. 2018;44(8):1308-1316. doi: 10.1016/j.joen.2018.05.009.
  • Sasanakul P, Ampornaramveth RS and Chivatxaranukul P. Influence of Adjuncts to Irrigation in the Disinfection of Large Root Canals. J Endod. 2019;45(3):332-337. doi: 10.1016/j.joen.2018.11.015.
  • Zandi H, Rodrigues RC, Kristoffersen AK, et al. Antibacterial Effectiveness of 2 Root Canal Irrigants in Root-filled Teeth with Infection: A Randomized Clinical Trial. J Endod. 2016;42(9):1307-1313. doi: 10.1016/j.joen.2016.06.006.
  • Cameron R, Claudia E, Ping W, Erin S and Ruparel NB. Effect of a Residual Biofilm on Release of Transforming Growth Factor beta1 from Dentin. J Endod. 2019;45(9):1119-1125. doi: 10.1016/j.joen.2019.05.004.
  • Yang F, Yu L, Li J, et al. Evaluation of concentrated growth factor and blood clot as scaffolds in regenerative endodontic procedures: A retrospective study. Aust Endod J. 2023;49(2):332-343. doi: 10.1111/aej.12666.
  • Lin LM, Huang GT, Sigurdsson A and Kahler B. Clinical cell-based versus cell-free regenerative endodontics: clarification of concept and term. Int Endod J. 2021;54(6):887-901. doi: 10.1111/iej.13471.
  • Aksel H, Albanyan H, Bosaid F and Azim AA. Dentin conditioning protocol for regenerative endodontic procedures. J Endod. 2020;46(8),1099-1104. doi: 10.1016/j.joen.2020.05.010.
  • Wei X, Yang M, Yue L, Huang, D. et al. Expert consensus on regenerative endodontic procedures. Int J of Oral Sci. 2022;14.1:55. doi: 10.1038/s41368-022-00206-z
There are 28 citations in total.

Details

Primary Language English
Subjects Dentistry
Journal Section Case Reports
Authors

Tuba Gök 0000-0002-4116-8649

Project Number -
Early Pub Date December 25, 2023
Publication Date December 25, 2023
Submission Date May 31, 2023
Published in Issue Year 2023

Cite

APA Gök, T. (2023). 3-YEAR FOLLOW-UP OF REGENERATIVE ENDODONTIC TREATMENTS WITH THE APPLICATION OF CONCENTRATED GROWTH FACTOR AS SCAFFOLD: NINE CASES. Sağlık Bilimleri Dergisi, 32(Ek Sayı), 57-62. https://doi.org/10.34108/eujhs.1307531
AMA Gök T. 3-YEAR FOLLOW-UP OF REGENERATIVE ENDODONTIC TREATMENTS WITH THE APPLICATION OF CONCENTRATED GROWTH FACTOR AS SCAFFOLD: NINE CASES. JHS. December 2023;32(Ek Sayı):57-62. doi:10.34108/eujhs.1307531
Chicago Gök, Tuba. “3-YEAR FOLLOW-UP OF REGENERATIVE ENDODONTIC TREATMENTS WITH THE APPLICATION OF CONCENTRATED GROWTH FACTOR AS SCAFFOLD: NINE CASES”. Sağlık Bilimleri Dergisi 32, no. Ek Sayı (December 2023): 57-62. https://doi.org/10.34108/eujhs.1307531.
EndNote Gök T (December 1, 2023) 3-YEAR FOLLOW-UP OF REGENERATIVE ENDODONTIC TREATMENTS WITH THE APPLICATION OF CONCENTRATED GROWTH FACTOR AS SCAFFOLD: NINE CASES. Sağlık Bilimleri Dergisi 32 Ek Sayı 57–62.
IEEE T. Gök, “3-YEAR FOLLOW-UP OF REGENERATIVE ENDODONTIC TREATMENTS WITH THE APPLICATION OF CONCENTRATED GROWTH FACTOR AS SCAFFOLD: NINE CASES”, JHS, vol. 32, no. Ek Sayı, pp. 57–62, 2023, doi: 10.34108/eujhs.1307531.
ISNAD Gök, Tuba. “3-YEAR FOLLOW-UP OF REGENERATIVE ENDODONTIC TREATMENTS WITH THE APPLICATION OF CONCENTRATED GROWTH FACTOR AS SCAFFOLD: NINE CASES”. Sağlık Bilimleri Dergisi 32/Ek Sayı (December 2023), 57-62. https://doi.org/10.34108/eujhs.1307531.
JAMA Gök T. 3-YEAR FOLLOW-UP OF REGENERATIVE ENDODONTIC TREATMENTS WITH THE APPLICATION OF CONCENTRATED GROWTH FACTOR AS SCAFFOLD: NINE CASES. JHS. 2023;32:57–62.
MLA Gök, Tuba. “3-YEAR FOLLOW-UP OF REGENERATIVE ENDODONTIC TREATMENTS WITH THE APPLICATION OF CONCENTRATED GROWTH FACTOR AS SCAFFOLD: NINE CASES”. Sağlık Bilimleri Dergisi, vol. 32, no. Ek Sayı, 2023, pp. 57-62, doi:10.34108/eujhs.1307531.
Vancouver Gök T. 3-YEAR FOLLOW-UP OF REGENERATIVE ENDODONTIC TREATMENTS WITH THE APPLICATION OF CONCENTRATED GROWTH FACTOR AS SCAFFOLD: NINE CASES. JHS. 2023;32(Ek Sayı):57-62.