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Botero T, Chrepa V, Shrestha A, Gibbs J, Hezaimi KA, Law A, Sedgley C, Hargreaves KM. Web-Based Survey on Regenerative Endodontic Practices among Members of the American Association of Endodontists. J Endod 2024:S0099-2399(24)00340-6. [PMID: 38906528 DOI: 10.1016/j.joen.2024.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/23/2024] [Indexed: 06/23/2024]
Abstract
INTRODUCTION The American Association of Endodontics (AAE) Regenerative Endodontics Committee reports here the web-based survey data of regenerative endodontic procedures performed by the AAE members from 2008 to 2019. METHODS The web-based survey consisted of 2 questionnaires, a revascularization and a follow-up, including clinical and radiographic data at 3, 6, 12 or >12 months after treatment. Data from demographics, etiology, clinical protocols, radiographic, and clinical outcome as perceived by the clinicians were recorded. From 927 entries, 184 full cases were submitted and 126 were suitable for radiographic analysis. The data were divided into cases with 6-12 months and cases with >12 months recall time. Descriptive statistics and univariate analyses were performed. RESULTS Predominantly patients were male (63%), average 10 years-old with anterior teeth (77.2%) due to trauma (69.6%). A wide variation in regenerative endodontic procedures protocols was reported by the AAE members. The most common clinical protocols used minimal instrumentation (75.5%), 2.5% or higher concentrations of sodium hypochlorite (83.7%), and antibiotic paste as intracanal medication (58.7%). The majority reported blood clot formation (56%) and most common coronal capping material was white mineral trioxide aggregates (50.5%). Increases in radiographic root length, and radiographic root area were proportional to the time lapsed after treatment. Overall, case outcomes were categorized by clinicians as successful (54.3%), uncertain (23.9%), and unsuccessful (3.8%). CONCLUSIONS This web-based survey provides a valuable perspective on case selection, clinical protocols, and perceived outcomes for regenerative endodontic procedures and supports the need for future higher level evidence studies.
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Affiliation(s)
- Tatiana Botero
- Cariology, Restorative Sciences and Endodontics Department, School of Dentistry, University of Michigan, Ann Arbor, Michigan.
| | - Vanessa Chrepa
- Department of Endodontics, Rutgers School of Dental Medicine, Newark, New Jersey
| | - Annie Shrestha
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Gibbs
- Division of Endodontics in Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mississippi
| | - Khalid Al Hezaimi
- Department of Endodontics and Periodontics, University of Southern California, Los Angeles, California
| | - Alan Law
- Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota; Private Practice, Lake Elmo, Minnesota
| | - Christine Sedgley
- Department of Endodontology, School of Dentistry, Oregon Health and Science University, Portland, Oregon
| | - Kenneth M Hargreaves
- Department of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas
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Hatipoğlu FP, Hatipoğlu Ö, Taha N, Lehmann AP, Aldhelai TA, Madfa AA, Al-Haddad A, Jukić Krmek S, Javed MQ, Bhatti UA, Drobac M, Surendar S, Martín-Biedma B, Palma PJ, Martins JFB. Attitude and practice of regenerative endodontic procedures among endodontists and paediatric dentists: A multinational survey from 13 countries. Int J Paediatr Dent 2023; 33:521-534. [PMID: 37350350 DOI: 10.1111/ipd.13101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/26/2023] [Accepted: 06/15/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Regenerative endodontics (RET) refers to biologically based procedures that aim to restore damaged tooth structures and reinstate the pulp-dentine complex to its normal physiological state. AIM The purpose of this study was to examine the attitudes and practices of endodontists and paediatric dentists regarding RET. DESIGN A survey was conducted among endodontists and paediatric dentists from 13 countries. A number of factors were evaluated, including frequency of RET application, followed guidelines, disinfection techniques, intracanal medication type, scaffold type, preferred coronal seal material, and follow-up period. RESULTS Among the 1394 respondents, 853 (61.2%) and 541 (38.8%) were endodontists and paediatric dentists, respectively. Almost half (43%) of participants have not performed RET yet. The American Association of Endodontics guideline (47.3%) was selected as the primary source for the clinical protocol. The most frequently selected irrigant solution was 1.5%-3% NaOCl at the first (26.1%) and second (13.6%) sessions. A blood clot (68.7%) and MTA (61.9%) were the most frequently selected scaffold type and coronal barrier. Most participants preferred a 6-month follow-up period. CONCLUSION According to this survey, deviations exist from current RET guidelines regarding all aspects evaluated. Standardizing clinical protocols and adhering to available guidelines would help to ensure more predictable outcomes.
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Affiliation(s)
| | - Ömer Hatipoğlu
- Department of Restorative Dentistry, Nigde Omer Halisdemir University, Niğde, Turkey
| | - Nessrin Taha
- Department of Conservative Dentistry, Jordan University of science and Technology, Irbid, Jordan
| | - Anna Paulina Lehmann
- Poznan University of Medical Sciences Department of Conservative Dentistry and Endodontics, Poznan, Poland
| | - Thiyezen Abdullah Aldhelai
- Department of Orthodontic and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah, Saudi Arabia
| | - Ahmed A Madfa
- Department of Restorative Dental Science, College of Dentistry, University of Ha'il, Ha'il, Saudi Arabia
| | - Afaf Al-Haddad
- Department of Conservative Dentistry, Faculty of Dentistry, Mahsa University, Selangor, Malaysia
| | - Silvana Jukić Krmek
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Muhammad Qasim Javed
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Usman Anwer Bhatti
- Department of Operative Dentistry and Endodontics, Riphah International University, Islamabad, Pakistan
| | - Milan Drobac
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Sugumaran Surendar
- Department of conservative dentistry and Endodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Benjamín Martín-Biedma
- Department of Conservative Dentistry, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Paulo J Palma
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - João Filipe Brochado Martins
- Department of Endodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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da Silva Magalhães K, Kuerten Gil AC, Goulart TS, Schuldt DPV, Coelho BS, Figueiredo DDR, Garcia LDFR, de Almeida J. Efficacy of disinfection procedures performed prior to regenerative endodontic therapy: An integrative review. AUST ENDOD J 2023; 49:418-427. [PMID: 35932453 DOI: 10.1111/aej.12670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 07/17/2022] [Indexed: 11/30/2022]
Abstract
The aim of this integrative review was to identify whether the disinfection procedures performed prior to regenerative endodontic treatment were effective on biofilm removal from the root canals. The research was based on PubMed, Latin American and Caribbean Health Sciences Literature (Lilacs) and Scientific Electronic Library Online (SciELO) databases. Four articles were selected; one of the studies was in vivo and the others ex vivo. Different disinfection procedures were studied, characterised mainly by the use of intracanal medication, highlighting the double antibiotic paste, triple antibiotic paste and calcium hydroxide paste. Disinfection ability was evaluated against Enterococcus faecalis and multispecies biofilms by using the fluorescence technique and colony forming unit counting, for 7 to 21 days. Double antibiotic paste and triple antibiotic paste demonstrated excellent antibiofilm activity, unlike CH paste that showed limited disinfection, even when associated with different antimicrobial agents. Triple antibiotic paste was the most effective medication against biofilm.
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Affiliation(s)
| | - Ana Clara Kuerten Gil
- Department of Endodontics, University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil
| | - Taynara Santos Goulart
- Department of Endodontics, University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil
| | | | - Beatriz Serrato Coelho
- Department of Endodontics, University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil
| | | | | | - Josiane de Almeida
- Department of Endodontics, University of Southern Santa Catarina, Palhoça, Santa Catarina, Brazil
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Swaikat M, Faus-Matoses I, Zubizarreta-Macho Á, Ashkar I, Faus-Matoses V, Bellot-Arcís C, Iranzo-Cortés JE, Montiel-Company JM. Is Revascularization the Treatment of Choice for Traumatized Necrotic Immature Teeth? A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:jcm12072656. [PMID: 37048739 PMCID: PMC10095182 DOI: 10.3390/jcm12072656] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 03/25/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
Regenerative endodontic treatment (RET) has been considered a reliable procedure to treat immature necrotic teeth; however, the effect of dental trauma on the prognosis of RET is questionable. This systematic review aimed to evaluate the current level of evidence for revascularization techniques (the RET) in the management of traumatized necrotic immature permanent teeth with or without periapical radiolucent areas. Four electronic databases—PubMed, Web of Science, Scopus, and Embase—were searched until November 2022. Only randomized clinical trials, cohort studies, and case-control studies with a minimum of 10 cases and 12 months of follow-ups were included. The search identified 363 preliminary results. After discarding the duplicates and screening the titles, abstracts, and full texts, 13 articles were considered eligible. The results showed that RET techniques seemed to have high survival and success rates, 93.8% and 88.3%, respectively, in the treatment of traumatized necrotic immature permanent teeth. Root maturation with RET techniques seemed to be lower in traumatized teeth. Future studies are needed to evaluate root maturation in traumatized teeth using 3-dimensional radiographic evaluations. In addition, the lack of literature on the studies comparing RET and apexification (calcium hydroxide or an MTA) in the treatment of traumatized necrotic immature teeth highlights the necessity for high-level clinical studies comparing these treatment modalities.
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Affiliation(s)
- Mohamad Swaikat
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Ignacio Faus-Matoses
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Álvaro Zubizarreta-Macho
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain
| | - Israa Ashkar
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Vicente Faus-Matoses
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Carlos Bellot-Arcís
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - José Enrique Iranzo-Cortés
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - José María Montiel-Company
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
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Divya D, Naik SV, Raju OS, Shivani B, Basappa N, Betur AP. Conceptual combination of disinfection in regenerative endodontics: Conventional versus laser-assisted disinfection. J Conserv Dent 2021; 24:252-259. [PMID: 35035150 PMCID: PMC8717846 DOI: 10.4103/jcd.jcd_96_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/28/2021] [Accepted: 09/20/2021] [Indexed: 02/01/2023] Open
Abstract
Background: Successful regeneration depends on four key elements of tissue engineering such as stem cells, growth factors, scaffold and sterile environment. Therefore, regenerative endodontic therapy requires higher degree of disinfection for successful outcomes. Aims and Objective: To evaluate the clinical and radiographic outcome using conventional and laser assisted disinfection in regenerative endodontics at 1, 3 and 6 months. Materials and Methods: 18 children with necrotic young permanent teeth were selected for the study. In Group A, in the first appointment AAE (American Association of Endodontics, Clinical Consideration for Regenerative Endodontic Procedure - 2016) disinfection protocol was employed. In Group B laser assisted disinfection (810 nm diode laser, 1 W, 20 ms Pulse length and 20 ms interval duration) was performed. Microbial samples were obtained before and after disinfection to check the level of disinfection. The cases were followed up at 1 month, 3 months and 6 months interval and evaluated for clinical outcome, periapical healing and apical response. Data were statistically analyzed with level of significance set 1% or 5% accordingly (P<0.01 or P<0.05) Results: On intragroup comparison there was significant reduction in bacterial count before and after disinfection with respect to laser assisted disinfection group. (P value = 0.007) There was no significant change in the clinical outcome score in laser group at 1,3- and 6-months interval. Periapical healing score showed statistically significant results in laser group when followed from 3 months to 6 months (P value = 0.04). Conclusion: Along with AAE 2016 protocol, use of laser assisted disinfection resulted in improved quality of disinfection and an expeditious clinical outcome and periapical healing in necrotic young permanent teeth. Keywords: Disinfection; laser; regenerative endodontics; sodium hypochlorite; tooth apex
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Affiliation(s)
- D Divya
- Department of Pedodontics and Preventive Dentistry, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Saraswathi V Naik
- Department of Pedodontics and Preventive Dentistry, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - O S Raju
- Department of Pedodontics and Preventive Dentistry, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Bellal Shivani
- Department of Pedodontics and Preventive Dentistry, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - N Basappa
- Department of Pedodontics and Preventive Dentistry, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Archana P Betur
- Department of Pedodontics and Preventive Dentistry, Bapuji Dental College and Hospital, Davangere, Karnataka, India
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Tong HJ, Sim YF, Berdouses E, Al-Jundi S, El Shahawy O, Nazzal H. Regenerative endodontic therapy (RET) for managing immature non-vital teeth: experiences and opinions of paediatric dental practitioners in the European and Arabian regions. Eur Arch Paediatr Dent 2020; 22:145-155. [PMID: 32535749 DOI: 10.1007/s40368-020-00542-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 05/29/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE MTA apical plug approach is considered the gold standard in managing immature teeth with necrotic pulp tissues but does not increase root dimensions. Regenerative Endodontic Therapy (RET) has been advocated as an alternative technique for management of these teeth. This study aimed to assess the knowledge, experience and the opinions of dentists treating paediatric patients in the European and Arabian regions on RET. METHODS A cross-sectional, pre-piloted 23-item self-administered questionnaire survey was distributed electronically using the Bristol Online Survey tool through the mailing list of the European Academy of Paediatric Dentistry, the Arabian Academy of Paediatric Dentistry's and the Egyptian Society of Paediatric Dentistry. RESULTS 308 respondents completed the survey. Approximately half practised RET (N = 158; 51.3%), which was most frequently used to manage non-vital traumatized teeth. Majority of RET practitioners worked in university or dental institute practices. Protocol differences with deviation from the current published RET guidelines were observed. Half of the respondents reported discolouration as an undesirable outcome. Lack of training, materials, evidence and suitable cases were reasons for not using RET. CONCLUSIONS Although RET is being practised by European and Arabian paediatric dentists, different protocols are being used with clear deviations from the current evidence-based guidelines.
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Affiliation(s)
- H J Tong
- Faculty of Dentistry, National University of Singapore, National University Centre for Oral Health, 9 Lower Kent Ridge Road, #10-01, Singapore, 119085, Singapore.
| | - Y F Sim
- Faculty of Dentistry, National University of Singapore, National University Centre for Oral Health, 9 Lower Kent Ridge Road, #10-01, Singapore, 119085, Singapore
| | - E Berdouses
- , 22 Kodrou str, Halandri, 151 27, Athens, Greece
| | - S Al-Jundi
- Faculty of Dentistry, Jordan University of Science and Technology, Ar Ramtha 3030،, Ramtha, Jordan
| | - O El Shahawy
- Department of Pediatric Dentistry, Future University Egypt, 90th St, First New Cairo, Cairo Governorate, 11835, Egypt
| | - H Nazzal
- Hamad Medical Corporation, Doha, Qatar
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ElSheshtawy AS, Nazzal H, El Shahawy OI, El Baz AA, Ismail SM, Kang J, Ezzat KM. The effect of platelet-rich plasma as a scaffold in regeneration/revitalization endodontics of immature permanent teeth assessed using 2-dimensional radiographs and cone beam computed tomography: a randomized controlled trial. Int Endod J 2020; 53:905-921. [PMID: 32249441 DOI: 10.1111/iej.13303] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 03/26/2020] [Indexed: 12/20/2022]
Abstract
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.
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Affiliation(s)
- A S ElSheshtawy
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - H Nazzal
- Paediatric Dentistry Section, Hamad Dental Center, Hamad Medical Corporation, Doha, Qatar
| | - O I El Shahawy
- Department of Pediatric Dentistry, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - A A El Baz
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - S M Ismail
- Department of Endodontics, The National Research Center, Cairo, Egypt
| | - J Kang
- Department of Oral Biology, School of Dentistry, University of Leeds, Leeds, UK
| | - K M Ezzat
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Revitalisation endodontic treatment of traumatised immature teeth: a prospective long-term clinical study. Eur Arch Paediatr Dent 2019; 21:587-596. [PMID: 31808111 PMCID: PMC7518998 DOI: 10.1007/s40368-019-00501-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 11/28/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE Continuation of root development following revitalisation endodontics (RET) has been shown to be unpredictable with lower success rates in traumatised teeth. This study reports the outcomes for RET in traumatised teeth over a review period of 4 years. METHODS A prospective uncontrolled study, where RET was performed on traumatised upper immature anterior teeth with necrotic pulps in 15 children (mean age = 8.3 years), was conducted. Patients were reviewed at 3, 9, 12, 24, and 48 months, where clinical and radiographic assessments were performed. At the last review appointment, patients and parents answered questions assessing their perception and acceptance of tooth colour change over time. McNemar's Exact test and linear mixed model assessment were used to assess changes in pulpal electrical response and radiographic evidence of continuation of root development over time, respectively. RESULTS There was 83.3% healing with no significant changes in EPT responses, and no significant changes in root lengths, while significant changes in root widths (p < 0.05) and root apex widths (p < 0.001) were found over time. Twenty-five percent of patients and 33% of parents felt that there were changes in tooth colour following RET over time. CONCLUSION Within the limitations of this study, traumatised teeth treated using RET showed no significant root lengthening, however, acceptable periapical healing, slow thickening of root dentinal walls, and rapid development of apical closure were evident over a period of 43 months. Using Portland cement and omitting minocycline, did not eliminate crown colour change following RET.
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Antov H, Duggal MS, Nazzal H. Management of discolouration following revitalization endodontic procedures: A case series. Int Endod J 2019; 52:1660-1670. [PMID: 31127956 DOI: 10.1111/iej.13160] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 05/22/2019] [Indexed: 01/09/2023]
Abstract
AIM To discuss the causes and management of tooth crown discolouration following regenerative/revitalization endodontic therapy (RET) and to present the decision-making process affecting three RET-related cases of crown discolouration. SUMMARY This case series outlines several approaches used in the management of post-RET discolouration. The cases highlight the influence of the material used in creating a coronal seal on the choice and success of the management techniques provided. The first two cases highlight successful management of post-RET discolouration through the use of internal-external bleaching. The use of internal bleaching in the third case was not recommended; therefore, external bleaching followed by a direct composite veneer was carried out.
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Affiliation(s)
- H Antov
- Oral & Maxillofacial Surgery, Pinderfields Hospital, Wakefield, UK
| | - M S Duggal
- Department of Paediatric Dentistry, National University of Singapore, Singapore.,Department of Paediatric Dentistry, Leeds Dental Institute, University of Leeds, Leeds, UK
| | - H Nazzal
- Department of Paediatric Dentistry, Leeds Dental Institute, University of Leeds, Leeds, UK.,Department of Paediatric Dentistry, Hamad Medical Corporation, Doha, Qatar
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Jawad Z, Bates C, Duggal M, Nazzal H. Orthodontic management of a non-vital immature tooth treated with regenerative endodontics: a case report. J Orthod 2018; 45:289-295. [PMID: 30022713 DOI: 10.1080/14653125.2018.1501935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Management of non-vital immature permanent teeth in children remains a challenge in paediatric dentistry. The resulting short roots, thin root dentinal walls, and compromised crown root ratios, not only affect the long-term survival of these teeth but also complicate any intended orthodontic treatment. This case report shows a successful orthodontic movement of a traumatised non-vital immature tooth treated using regenerative endodontics.
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Affiliation(s)
- Zynab Jawad
- a Orthodontic Department , Leeds Dental Institute , Leeds , UK
| | - Claire Bates
- a Orthodontic Department , Leeds Dental Institute , Leeds , UK
| | - Mandeep Duggal
- b Paediatric Department , Leeds Dental Institute , Leeds , UK
| | - Hani Nazzal
- b Paediatric Department , Leeds Dental Institute , Leeds , UK
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