A natural meliorate: revolutionary tissue engineering in endodontics

Treatment of apicomarginal defect with periapical surgery: A case report

An apicomarginal defect can be explained as a total loss of buccal alveolus extending from the original crestal bone to the apex of the tooth. This study presents a case of an apicomarginal defect in a first left molar subjected to periapical surgery with vestibular cortex block replacement and A-PRF + membrane coating approximately one year ago. One-year clinical follow-up was performed, with no evidence of recurrence. This case report discusses periapical surgical treatment and the importance of an interdisciplinary approach to the management of teeth with apicomarginal defects.

Key words:Periapical surgery, apicomarginal defect, A-PRF+, bone graft.

A Comparative Evaluation of Revascularization Done in Traumatized Immature, Necrotic Anterior Teeth with and without Platelet-rich Fibrin: A Case Report

The aim of this paper is to present two methods of revascularization done in traumatized immature, nonvital anterior teeth using platelet-rich fibrin (PRF) and natural blood clot as a scaffold material. This was performed after disinfection of the root canal space using tri-antibacterial paste. In one tooth, PRF prepared from autologous blood was placed in the canal and in the other tooth, natural bleeding was induced to obtain a fresh blood clot. The patient was recalled regularly at 1, 3, 6, 9, and 12 months’ interval for evaluation. After 12 months, on clinical examination, both teeth showed negative response to percussion and palpation tests but positive response to cold and electric pulp tests. On radiographic examination, the tooth treated with PRF exhibited comparatively faster root lengthening, complete closure of the root apex, more thickening of the root dentinal walls, and narrowing of root canal space compared to conventionally revascularized tooth.

How to cite this article: Nagaveni NB, Poornima P, Mathew MG, et al. A Comparative Evaluation of Revascularization Done in Traumatized Immature, Necrotic Anterior Teeth with and without Platelet-rich Fibrin: A Case Report. Int J Clin Pediatr Dent 2020;13(1):98–102.

Materials for pulpotomy in immature permanent teeth: a systematic review and meta-analysis

BACKGROUND

Pulpotomy is one of the most widely used methods in preserving vital pulp in teeth, which is of great significance in achieving continue root formation in immature permanent teeth suffering from dental caries or trauma. The aim of this meta-analysis and systemic review is to synthesize the available evidences to compare different pulpotomy dressing agents for pulpotomy treatment in immature permanent teeth.

METHODS

Electronic databases including MEDLINE (via Pubmed), EMBASE, the Cochrane library (CENTRAL) and the clinicaltrials.gov database were searched. The references of all included articles or relevant reviews were cross-checked. Only randomized controlled trials (RCTs) comparing two or more pulp dressing agent in permanent teeth with open apex would be included. Also, the studies should have at least 6 months of follow-up, report clinical and radiographic success in detail and publish in English.

RESULTS

Five RCTs were included for a systematic review, and all of them had a high risk of bias. There is little difference in success rate between mineral trioxide aggregate (MTA) and calcium hydroxide (CH) at 6-month follow-up (risk ratio (RR) 1; 95% confidence interval (CI) 0.94 to 1.06) and 12-month follow-up (RR 1.04; 95% CI 0.96 to 1.13). There is no difference between MTA versus platelet-rich fibrin and MTA versus calcium-enriched mixture (CEM). There is only weak evidence of increased success rate in using MTA and triple antibiotic paste (TAP) rather than abscess remedy.

CONCLUSIONS

Based on the present evidence, similar success rates with MTA were found between the dressing agents CH, CEM, RPF and TAP as pulpotomy-dressing agents in the treatment of immature permanent teeth. More high-quality RCTs are needed in this field in future studies.

Revascularization of a Nonvital, Immature Permanent Tooth Using Amniotic Membrane: A Novel Approach

Aim

To evaluate the clinical and radiological results of a revascularization treatment done in a nonvital, immature permanent tooth using the amniotic membrane.

Case description

A 12-year-old boy reported with a complaint of pain in the lower left back tooth since 1 month due to dental caries. On clinical examination, the mandibular left second premolar was tender on percussion and discolored due to dental caries. Radiographic examination of the same tooth revealed open apex, thin root dentinal walls, and periodontal ligament widening. An access opening was prepared, necrotic pulp extirpated completely followed by thorough irrigation. After drying the canal, closed dressing with the 3-mix antibacterial paste was given for 15 days. After 15 days, the paste was removed and the amniotic membrane was placed inside the canal extending 1 mm beyond the apex and mineral tri-oxide aggregate was placed over this followed by sealing of the cavity. The patient was followed up at 1, 3, and 6 months for clinical and radiographic evaluation.

Conclusion

After 6 months, clinically the tooth found asymptomatic. Radiographic examination showed continued root elongation, closure in the periapical opening, thick root dentinal walls with narrowing of the canal space, and normal periradicular architecture.

Clinical significance

Amniotic membrane can be used as a scaffold for revascularization in nonvital immature teeth.

How to cite this article

NB Nagaveni, P Poornima, et al. Revascularization of a Nonvital, Immature Permanent Tooth Using Amniotic Membrane: A Novel Approach. Int J Clin Pediatr Dent 2019;12(2):150–152.