Response to Intracanal Medication in Immature Teeth with Pulp Necrosis: An Experimental Model in Rat Molars (original) (raw)
Related papers
Journal of Endodontics, 2012
Introduction: The aim of this study was to evaluate the enamel matrix derivative (EMD) biomaterial in nonvital immature teeth. Methods: To arrest root development, pulpectomies were performed in the lower first molars of 36 4-week-old rats; the cavities were left exposed to the oral environment for 3 weeks. Then, chemical disinfection was performed, and triple antibiotic paste (TAP) or EMD was applied in the root canals. A control group did not receive any treatment. Radiographic and histological data were evaluated after 3 and 6 weeks. Results: At 3 weeks, TAP promoted a milder inflammatory response and increased root lengths compared with the control group. At 6 weeks, root development and reduced periapical lesions could be observed in both test groups, mainly because of the deposition of a cementum-like tissue. EMD promoted narrower canals compared with TAP (P < .05). Conclusions: EMD deserves attention as a potential tool in the treatment of nonvital immature teeth. The ingrowth of cementum-like tissues into canal spaces favored dental wall thickness and may contribute to tooth resistance and support. (J Endod 2012;38:449-453)
Introduction: Several case reports on endodontic regeneration involving immature permanent teeth have recently been published. These case series have used varying treatments to achieve endodontic regeneration including triple antibiotic paste, Ca(OH) 2 , and formocresol. However, no study has analyzed the overall results. Methods: In this retrospective study, we collected radiographs from 54 published and unpublished endodontic regenerative cases and 40 control cases (20 apexification and 20 nonsurgical root canal treatments) and used a geometrical imaging program, NIH ImageJ with TurboReg plug-in, to minimize potential differences in angulations between the preoperative and recall images and to calculate continued development of root length and dentin wall thickness. Results: The comparison to the 2 control groups provided a validation test for this method. Forty-eight of the 54 regenerative cases (89%) had radiographs of sufficiently similar orientation to permit analysis. The results showed regenerative endodontic treatment with triple antibiotic paste (P < .001) and Ca(OH) 2 (P < .001) produced significantly greater increases in root length than either the MTA apexification or NSRCT control groups. The triple antibiotic paste produced significantly greater differences in root wall thickness than either the Ca(OH) 2 or formocresol groups (P < .05 for both). The position of Ca(OH) 2 also influenced the outcome. When Ca(OH) 2 was radiographically restricted to the coronal half of the root canal system, it produced better results than when it was placed beyond the coronal half. Conclusions: Ca(OH) 2 and triple antibiotic paste when used as an intracanal medicament in immature necrotic teeth can help promote further development of the pulpdentin complex. (J Endod 2009;35:1343-1349
Development of a root canal treatment model in the rat
Scientific Reports, 2017
Root canal treatment is performed to treat apical periodontitis, and various procedures and techniques are currently used. Although animal models have been used in the developmental research of root canal treatment, little of this research has used small animals such as rats, because of their small size. In this study, root canal treatment was performed on the rat mandibular first molar, which had four root canals, using a microscope, and the therapeutic effect was evaluated bacteriologically, radiologically and histopathologically. By performing root canal treatment, the level of bacteria in the mesial root of the treated teeth was reduced by 75% compared with the control. Additionally, the volume of the periapical lesions of the treated teeth as measured by micro-computed tomography decreased significantly 2 weeks after the root canal treatment when compared with the control. Histological evidence of healing was observed in the treatment group 8 weeks after root canal treatment. These results suggest that a root canal treatment model using rats can be used in developmental research for novel methods of root canal treatment.
Treatment of the immature tooth with a non-vital pulp and apical periodontitis
Dental clinics of North America, 2010
Traditional methods of treatment of immature root with necrotic pulp and apical periodontitis pose multiple challenges. These challenges include disinfection of the root canal with standard protocols that aggressively use endodontic files, filling the root canal with an open apex that provides no barrier for stopping the root filling material before impinging on the periodontal tissues, and the susceptibility of the teeth to fracture because of their thin roots. Disinfection using sodium hypochlorite, apical barrier formation using calcium hydroxide as well as mineral trioxide aggregate, and pulp revascularization of fractured tooth with the help of blood clot and collagen-enhanced matrix has been discussed in detail in this article.
Evolution of apical formation on immature necrotic permanent teeth
American journal of dentistry
Purpose: To evaluate the evolution of apical formation on 28 necrotic immature permanent teeth treated with calcium hydroxide at different stages of root development. Methods: Apical formation in 28 necrotic incisors was carried out (27 upper and one lower incisors), in children between the ages of 6 and 13 years old (11 males, 10 females). Following anesthesia and rubber dam isolation, the chamber was opened and the coronal and root pulp tissue was removed. Next, after measuring the canal, the root canal was irrigated with 5% sodium hypochlorite. Once the canal was dried, it was filled with the CaOH 2 powder mixed with physiologic saline solution to a dense consistency but malleable. This paste was compressed into the canal using a cotton pellet. The canal was completely filled up to the apex. Finally, the cavity opening was sealed with zinc oxide-eugenol (IRM) and glass-ionomer (Vitrebond). Follow-up appointments were made every 3 months in order to evaluate the evolution of the periapical radiolucency and the formation of the apical barrier. Results: The duration of the apical induction was 8.6 ± 5.36 months. Increase or lack of growth in the length of the root canal and the type of root end closing was as follows: cementoid tissue (85.72%); osseous tissue (14.28%), with a 100% overall success rate. The evolution of these teeth was monitored over a 2-year period with re-infections occurring in 7.1 percent of the cases. (Am J Dent 2010;23:269-274).
Dental Press Endodontics, 2011
Objectives: to evaluate the effect of instrumentation, irrigation with different substances and the use of calcium hydroxide on bacterial load and microbiota profile in dog's teeth with pulp necrosis and periapical lesion. Methods: Fifty five root canals were divided into groups: I) Saline (SSL) (n=11); II) natrosol gel (n=11); III) 2.5% NaOCl (n=11); IV) 2% CHX-gel (n=11); V) 2% CHX-solution (n=11). Endodontic samples were cultured, microorganisms counted and the microbiota analyzed at different sampling times-s1, s2 and s3. Results: At s1, the mean CFU counts ranged from 5.5 x10 5 to 1.5 x 10 6. These values dropped significantly at s2 (p<0.05). No statistical significant difference was found between s2 and s3. Changes in root canal microbiota were found at s2 and s3. Conclusion: Regardless the use of calcium hydroxide as a root canal medication, 2.5% NaOCl and 2% CHX-gel demonstrated a potent antimicrobial activity against endododontic pathogens in vivo.
Brazilian Oral Research
This study aimed to evaluate the role of photobiomodulation (PBM) in apexification and apexogenesis of necrotic rat molars with an open apex. Rat molars were exposed to the oral environment for 3 weeks. Canals were rinsed with 2.5% NaOCl and 17% EDTA, filled with antibiotic paste and sealed. After 7 days, canals were rinsed and divided into six groups (n=6): mineral trioxide aggregate (MTA); blood clot (BC); human dental pulp stem cells (hDPSC); MTA+PBM; BC+PBM; and hDPSC+PBM. In hDPSC groups, a 1% agarose gel scaffold was used. Two groups were not exposed: healthy tooth+PBM (n = 6), healthy tooth (n = 3); and one was exposed throughout the experiment: necrotic tooth (n = 3). In PBM groups, irradiation was performed with aluminum gallium indium phosphide (InGaAlP) diode laser for 30 days within 24-h intervals. After that, the specimens were processed for histological and immunohistochemical analyses. Necrotic tooth showed greater neutrophil infiltrate (p < 0.05). Necrotic tooth, healthy tooth, and healthy tooth+PBM groups showed absence of a thin layer of fibrous condensation in the periapical area. All the other groups stimulated the formation of a thicker layer of fibers (p < 0.05). All groups formed more mineralized tissue than necrotic tooth (p < 0.05). PBM associated with MTA, BC, or hDPSC formed more mineralized tissue (p < 0.05). MTA+PBM induced apexification (p < 0.05). Rabbit polyclonal anti-bone sialoprotein (BSP) antibody confirmed the histological findings of mineralized tissue formation, and hDPSC groups exhibited higher percentage of BSP-positive cells. It can be concluded that PBM improved apexification and favored apexogenesis in necrotic rat molars with an open apex.
Regenerative potential following revascularization of immature permanent teeth with necrotic pulps
Aim To assess the regenerative potential of immature teeth with necrotic pulps following revascularization procedure in dogs. Methodology Necrotic pulps and periapical pathosis were created by infecting 108 immature teeth, with 216 root canals in nine mongrel dogs. Teeth were divided into three equal groups according to the evaluation period. Each group was further subdivided into six subgroups according to the treatment protocol including MTA apical plug, revascularization protocol, revascularization enhanced with injectable scaffold, MTA over empty canal. All root canals were disinfected with a triple antibiotic paste prior to revascularization with the exception of control subgroups. After disinfection, the root length, thickness and apical diameter were measured from radiographs. Histological evaluation was used to assess the inflammatory reaction, soft and hard tissue formation. Results In the absence of revascularization, the length and thickness of the root canals did not change over time. The injectable scaffold and growth factor was no more effective than a revascularization procedure to promote tooth development following root canal revascularization. The tissues formed in the root canals resembled periodontal tissues. Conclusion The revascularization procedure allowed the continued development of roots in teeth with necrotic pulps.
Al-Azhar Dental Journal for Girls
Purpose: This study was carried out to evaluate the effect of biostimulation on the regenerative response of immature teeth with necrotic pulp and apical periodontitis in dogs. Materials and Methods: Seventy-two root canals were employed in the present study as follows: Sixty root canals for experimental groups and twelve as positive and negative controls. After the induction of pulp necrosis and apical periodontitis, roots were divided into two groups, group I: Regenerative Endodontic Therapy (RET) with subsequent biostimulation (seven sessions at 808 nm diode laser at output power of 300 mW for 90 seconds) and group II: RET without biostimulation. The groups were followed up for 1, 2 and 3 months (subgroups A, B&C). The maturation of the roots was assessed both radiographically and histologically. All data were statistically analyzed. Results: the application of biostimulation in group I demonstrated marked increase in root length, thickness and decrease in apical diameter compared to group II however, it was statistically significant only in subgroup C (12.43% versus 7.66%, 33.09% versus 17.81% and 38.12% versus 23.35 % at third month) respectively (p<0.05). Furthermore, it showed histologically the highest score of vital tissue infiltration and least inflammatory scores which was statistically significant. Conclusion: Biostimulation enhanced the response of immature teeth with necrotic pulp and apical periodontitis to regenerative endodontic therapy improving root maturation.