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Chauhan S, Chauhan R, Bhasin P, Sharaf BG. Present status and future directions: Apexification. World J Methodol 2025; 15:96923. [DOI: 10.5662/wjm.v15.i1.96923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Revised: 08/09/2024] [Accepted: 08/21/2024] [Indexed: 09/29/2024] Open
Abstract
The success rate of apexification is primarily determined by multiple factors, including the material used, the size of the open apex compared to the length of the root, and the technique used in each case. The main objective of this review was to provide an update on the present management of open apex to identify factors and circumstances that may influence the success of apexification using different materials and techniques. Future research on apexification should focus on how to treat open apices with wide periapical lesions without surgery. Previously, the predictability of these parameters with non-surgical procedures was uncertain, but now, with the use of a dental operating microscope, it has become more predictable. Another reason could be that extra visits are no longer required due to major advances in the armamentarium and materials used for apexification.
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Affiliation(s)
- Sachin Chauhan
- Department of Conservative Dentistry and Endodontics, Sudha Rustagi College of Dental Sciences and Research, Faridabad 121002, Haryana, India
| | - Radha Chauhan
- Department of Prosthodontics and Crown and Bridge and Oral Implantology, Mahatma Gandhi Dental College & Hospital, Jaipur 302022, Rajasthan, India
| | - Prashant Bhasin
- Department of Conservative Dentistry and Endodontics, Sudha Rustagi College of Dental Sciences and Research, Faridabad 121002, Haryana, India
| | - Bhavna G Sharaf
- Department of Pedodontics and Preventive Dentistry, Sudha Rustagi College of Dental Sciences and Research, Faridabad 121002, Haryana, India
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Roy M, Bailwad SA, Bhatnagar A, Singh S, Assiry AA, Mohamed RN, Basha S, Snigdha NT, Karobari MI. Evaluation of microleakage of mineral trioxide aggregate and biodentine as apical barriers in simulated young permanent teeth. BMC Oral Health 2024; 24:1100. [PMID: 39285402 PMCID: PMC11406731 DOI: 10.1186/s12903-024-04817-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Accepted: 08/27/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND Apexification is a procedure that promotes apical closure by forming mineralized tissue in the apex region of a nonvital young permanent tooth. Calcium silicate-based cement like Mineral trioxide aggregate (MTA) and Biodentine are commonly employed as apical barriers to facilitate this process. Microleakage, defined as the leakage along the junction between the canal wall and filling material, is a crucial aspect to assess in MTA and Biodentine applications as apical barriers, as it directly impacts the prevention of bacterial seepage and maintenance of structural integrity. The current study aims to assess the microleakage of MTA and Biodentine when used as apical barriers in simulated young permanent teeth. METHODS From a total of 128 extracted teeth, 114 were selected for the study and randomly allocated into three groups: G1 (MTA), G2 (Biodentine), and G3 (Control), with 38 teeth per group. After excluding 5 teeth from each group due to issues such as canal calcification, breakage during sectioning, and procedural errors, 33 teeth were analyzed to ensure equal distribution. To simulate young permanent teeth, samples were instrumented using a person-reamer with a diameter of 1.7 mm. A 4 mm thick apical plug of MTA and Biodentine was placed in G1 and G2, respectively, while G3 was the control group. Apical microleakage in all experimental groups was assessed using a dye penetration method. Specimens were longitudinally sectioned and examined under a stereomicroscope with graded eyepiece. RESULTS The Kruskal-Wallis test revealed variations in mean apical microleakage among the groups: G1 recorded 0.67, G2-0.16, and G3-1.62, with G2 showing the lowest value and G3 group exhibiting the highest. CONCLUSIONS Biodentine was found to excel in its ability to create a secure seal and function effectively as an apical barrier in simulated young permanent teeth. These results underscore its potential as a highly efficient material for dental applications, particularly in scenarios requiring reliable sealing and barrier formation in the root canal system of developing permanent teeth.
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Affiliation(s)
- Medha Roy
- Department of Pediatric and Preventive Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Sandeep A Bailwad
- Department of Pediatric and Preventive Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Akash Bhatnagar
- Department of Pediatric and Preventive Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Sushma Singh
- Department of Pediatric and Preventive Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Ali A Assiry
- Preventive Dental Science Department, Faculty of Dentistry, Najran University, Najran, 55461, Saudi Arabia
| | - Roshan Noor Mohamed
- Department of Pediatric Dentistry, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
| | - Sakeenabi Basha
- Preventive Dentistry Department (Community Dentistry Division), Faculty of Dentistry, Taif University, Taif, Saudi Arabia
| | - Niher Tabassum Snigdha
- Department of Dental Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, 602105, India
| | - Mohmed Isaqali Karobari
- Department of Conservative Dentistry & Endodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 600077, India.
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, 2211, Cambodia.
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Pham VK, Pham TLK, Pham AT, Le HLA, Tran TBV, Huynh KK, Tran NMH, Tran TL, Tran MH, Tran TAT, Nguyen TTD, Nguyen NP. Platelet-rich fibrin as an apical barrier for MTA placement in the treatment of teeth with open apices: a pilot study. J Transl Med 2024; 22:498. [PMID: 38796431 PMCID: PMC11128118 DOI: 10.1186/s12967-024-05318-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024] Open
Abstract
OBJECTIVE The aim of the present pilot study was to assess the effectiveness of the platelet-rich fibrin (PRF) apical barrier for the placement of MTA for the treatment of teeth with periapical lesions and open apices. METHODS A total of thirty teeth on twenty-eight patients with open apices and periapical periodontitis were enrolled and divided into two groups in the present pilot study. In the PRF group (fourteen teeth in thirteen patients), nonsurgical endodontic treatment was performed using PRF as an apical matrix, after which the apical plug of the MTA was created. For the non-PRF group (fourteen teeth in fourteen patients), nonsurgical endodontic therapy was performed using only the MTA for an apical plug with no further periapical intervention. Clinical findings and periapical digital radiographs were used for evaluating the healing progress after periodic follow-ups of 1, 3, 6, and 9 months. The horizontal dimension of the periapical lesion was gauged, and the changes in the dimensions were recorded each time. The Friedman test, Dunn-Bonferroni post hoc correction, and Mann-Whitney U test were used for statistical analysis, with P < 0.05 serving as the threshold for determining statistical significance. RESULTS All patients in both groups in the present pilot study had no clinical symptoms after 1 month, with a significant reduction in the periapical lesion after periodic appointments. The lesion width of the PRF group was significantly smaller than that of the non-PRF group in the sixth and ninth month after treatment. CONCLUSIONS PRF is a promising apical barrier matrix when combined with MTA for the treatment of teeth with open apices and periapical periodontitis. Small number of study subjects and the short time of follow-up period limit the generalizability of these results. TRIAL REGISTRATION TCTR, TCTR20221109006. Registered 09 November 2022 - Retrospectively registered, https://www.thaiclinicaltrials.org/show/TCTR20221109006 .
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Affiliation(s)
- Van-Khoa Pham
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
| | - Tran-Lan-Khue Pham
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - An-Tran Pham
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hoang-Lan-Anh Le
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Thi-Bich-Van Tran
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Kim-Khang Huynh
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | - Thuan-Loc Tran
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Minh-Hong Tran
- National Hospital of Odonto-Stomatology, Ho Chi Minh City, Vietnam
| | - Thi-Anh-Thu Tran
- National Hospital of Odonto-Stomatology, Ho Chi Minh City, Vietnam
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Cao L, Zhang Z, Yuan D, Yu M, Min J. Tissue engineering applications of recombinant human collagen: a review of recent progress. Front Bioeng Biotechnol 2024; 12:1358246. [PMID: 38419725 PMCID: PMC10900516 DOI: 10.3389/fbioe.2024.1358246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/31/2024] [Indexed: 03/02/2024] Open
Abstract
With the rapid development of synthetic biology, recombinant human collagen has emerged as a cutting-edge biological material globally. Its innovative applications in the fields of material science and medicine have opened new horizons in biomedical research. Recombinant human collagen stands out as a highly promising biomaterial, playing a pivotal role in crucial areas such as wound healing, stroma regeneration, and orthopedics. However, realizing its full potential by efficiently delivering it for optimal therapeutic outcomes remains a formidable challenge. This review provides a comprehensive overview of the applications of recombinant human collagen in biomedical systems, focusing on resolving this crucial issue. Additionally, it encompasses the exploration of 3D printing technologies incorporating recombinant collagen to address some urgent clinical challenges in regenerative repair in the future. The primary aim of this review also is to spotlight the advancements in the realm of biomaterials utilizing recombinant collagen, with the intention of fostering additional innovation and making significant contributions to the enhancement of regenerative biomaterials, therapeutic methodologies, and overall patient outcomes.
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Affiliation(s)
- Lili Cao
- Department of Plastic Surgery, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang, China
| | - Zhongfeng Zhang
- Department of Plastic Surgery, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang, China
| | - Dan Yuan
- Department of Plastic Surgery, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang, China
| | - Meiping Yu
- Department of Plastic Surgery, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang, China
| | - Jie Min
- General Surgery Department, Jiaxing No.1 Hospital, Jiaxing, Zhejiang, China
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Gill I, Mittal S, Kumar T, Keshav V. Open Apex and its Management: Review Article. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S31-S34. [PMID: 38595371 PMCID: PMC11000961 DOI: 10.4103/jpbs.jpbs_615_23] [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: 08/13/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 04/11/2024] Open
Abstract
During root development, the teeth are subjected to a variety of assaults. Due to this, the root stops forming and the closure of the apex does not take place. Root canal treatment becomes a major challenge in these cases because of the width of the canal and wide-open apices. Management of open apices includes apexogenesis in vital young permanent teeth and apexification, which is a method to induce a calcified barrier in the root. Newer concepts include regeneration and revascularization procedures, which still need to be experimented with further.
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Affiliation(s)
- Ikroop Gill
- Department of Conservative Dentistry and Endodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Sunandan Mittal
- Department of Conservative Dentistry and Endodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Tarun Kumar
- Department of Conservative Dentistry and Endodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Vanita Keshav
- Department of Conservative Dentistry and Endodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
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Van Pham K, Tran TA. Effectiveness of MTA apical plug in dens evaginatus with open apices. BMC Oral Health 2021; 21:566. [PMID: 34749689 PMCID: PMC8573861 DOI: 10.1186/s12903-021-01920-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/20/2021] [Indexed: 11/25/2022] Open
Abstract
Background The present study aims to evaluate the effectiveness of mineral trioxide aggregate (MTA) application in treating dens evaginatus affected teeth with apical lesions and open apices using haemostatic collagen membrane to prevent the apical extrusion of MTA. Methods Twelve patients with 14 dens evaginatus affected teeth with apical lesions and open apices were treated with MTA apical plug and haemostatic collagen membrane. Clinical symptoms of subjective pain, pain of palpation, percussion, sinus tract, and the apical lesions' radiographic parameter were recorded at every 3-month interval up to 9 months after treatment. Paired t-test or Wilcoxon signed-rank test was used for statistical analysis with P < 0.05 as the threshold for considering results to be statistically significant. Results No patient experienced clinical symptoms 3 months after endodontic treatment. In addition, there was a significant difference in the dimensions of the apical lesions' before compared to 3 months after endodontic treatment. Conclusions The combination of MTA apical plug and haemostatic collagen membrane effectively treated dens evaginatus affected teeth with apical lesions, and open apices.
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Affiliation(s)
- Khoa Van Pham
- Department of Operative Dentistry and Endodontics, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, 700000, Vietnam.
| | - Thu Anh Tran
- Department of Operative Dentistry and Endodontics, National Hospital of Odonto-Stomatology, Ho Chi Minh City, Vietnam
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Al-Nahlawi T, Ala Rachi M, Abu Hasna A. Endodontic Perforation Closure by Five Mineral Oxides Silicate-Based Cement with/without Collagen Sponge Matrix. Int J Dent 2021; 2021:4683689. [PMID: 34539787 PMCID: PMC8443381 DOI: 10.1155/2021/4683689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 08/26/2021] [Indexed: 02/07/2023] Open
Abstract
Endodontic perforations are common accidents that occasionally happen as a result of misuse or difficult anatomy of some teeth; it may lead to teeth loss unless a good management is provided. Bioceramic (silicate-based) cements like mineral trioxide aggregate have a big role in management of such accidents. This case report aimed to evaluate the ability of five mineral oxides cement "5MO" in sealing two root canal perforations (furcation and postdrill perforations) and inducing clinical and radiographic healing in the periodontal tissues with/without the use of collagen sponge matrix. A 58-year-old healthy female was referred to our dental office complaining of severe pain in the upper left premolars' region. Periapical radiographic examination revealed unsatisfactory root canal treatment of the teeth #24 and #25 with a furcation perforation and a postdrill perforation, respectively. Cone-beam computed tomography "CBCT" scans confirmed the findings of the periapical radiography and revealed the presence of radiolucent lesions surrounding the apex of both teeth #24 and #25. The treatment plan was a nonsurgical root canal retreatment by endodontic access through the full-ceramic crowns. After three years of follow-up, CBCT scans revealed a complete healing and bone formation on both premolars. This case report indicates the use of 5MO cement for endodontic perforations management.
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Affiliation(s)
- Talal Al-Nahlawi
- Operative Dentistry and Endodontics Department, Syrian Private University (S.P.U), Damascus, Syria
| | - Maisour Ala Rachi
- Operative Dentistry and Endodontics Department, Syrian Private University (S.P.U), Damascus, Syria
| | - Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, Sa˜o Paulo State University – UNESP, Sa˜o José Dos Campos, São Paulo, Brazil
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Camilo do Carmo Monteiro J, Rodrigues Tonetto M, Coêlho Bandeca M, Henrique Borges A, Cláudio Martins Segalla J, Cristina Fagundes Jordão-Basso K, Fernando Sanchez-Puetate C, Carlos Kuga M. Repair of Iatrogenic Furcal Perforation with Mineral Trioxide Aggregate: A Seven-Year Follow-up. IRANIAN ENDODONTIC JOURNAL 2017; 12:516-520. [PMID: 29225652 PMCID: PMC5722114 DOI: 10.22037/iej.v12i4.16888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Teeth with furcal perforation present difficult resolution and dubious prognosis. Several materials have been proposed and calcium silicate-based cements such as mineral trioxide aggregate (MTA) are the most recommended. However, its long-term clinical behavior still remains poorly understood. The present study reports a clinical case of furcal perforation repair using Angelus MTA, with a 7-year follow-up. Patient sought treatment 2 months after iatrogenic accident. First lower right molar presented clinical signs such as fistula and bone loss between mesial and distal roots. Firstly, all root canals were treated and then furcal perforation was sealed with MTA Angelus and the dental crown was restored with composite resin. Radiographic evaluation was immediately performed to analyze the furcal perforation filling. After 7 years, a new clinical and imaging evaluation using periapical radiography and cone-beam computed tomography (CBCT) showed absence of clinical signs and symptoms, and alveolar bone reconstitution with periodontal space reduction. Angelus MTA presented good clinical behavior in the iatrogenic furcal perforation resolution based on long-term clinical evidence.
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Affiliation(s)
| | - Mateus Rodrigues Tonetto
- Department of Postgraduate Program in Integrated Dental Science, University of Cuiaba-UNIC, Cuiabá, MT, Brazil;
| | - Matheus Coêlho Bandeca
- Department of Postgraduate Program in Dentistry, CEUMA University-UNICEUMA, São Luis, MA, Brazil,Corresponding author: Matheus Coelho Bandeca, Rua Josue Montello, número 01, 65075-120, São Luis, MA, Brasil. Tel: +55 32144127, E-mail:
| | - Alvaro Henrique Borges
- Department of Postgraduate Program in Integrated Dental Science, University of Cuiaba-UNIC, Cuiabá, MT, Brazil;
| | - José Cláudio Martins Segalla
- Department of Restorative Dentistry, Araraquara School of Dentistry, Univ Estadual Paulista, Araraquara, SP, Brazil
| | | | | | - Milton Carlos Kuga
- Department of Restorative Dentistry, Araraquara School of Dentistry, Univ Estadual Paulista, Araraquara, SP, Brazil
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