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REJENERATİF ENDODONTİ KLİNİK UYGULAMALARINDA DİKKAT EDİLECEK NOKTALAR

Year 2020, Volume: 47 Issue: 1-3, 179 - 186, 31.12.2020

Esin Günal Tuğba Bezgin

Abstract

Devital genç sürekli dişlerin endodontik tedavisi, çocuk diş hekimliğinde klinisyenleri zorlayan prosedürlerden biridir. Genç sürekli dişler; çürük, dens invaginatus gibi dental anatomik varyasyonlar veya travma sebebiyle nekrotik hale gelebilmektedir. Nekrotik dişlerde kök gelişimi durmakta ve bu durum ince kök dentin duvarları ile diverjan, açık bir apeks ile sonuçlanmaktadır. Bu nedenle de endodontik tedaviler sırasında uygun mekanik preparasyon ve ardından hermetik bir dolum sağlanması güçleşmektedir. Kalsiyum hidroksit apeksifikasyonu ve tek seans apeksifikasyon teknikleri her ne kadar sıklıkla uygulansa da, bu teknikler kök gelişiminin devamını sağlayamamakta ve ince kalan kök kanal duvarları sebebiyle dişler kırılmaya yatkın olmaktadır. Bu nedenle tedavi sonrasında pulpa rejenerasyonu, dentin formasyonu ve kök gelişiminin devamını sağlayan rejeneratif endodontik tedaviler popüler hale gelmiştir. Bu makalede, rejeneratif endodontik tedaviler uygulanırken dikkat edilmesi gereken noktalar derlenmiştir.

Keywords

Apeksifikasyon Devital immatür diş Rejenerasyon

References

  • 1. Andreasen JO, Ravn JJ. Epidemiology of traumatic dental injuries to primary and permanent teeth in a Danish population sample. Int J Oral Surg 1972;1:235-239.
  • 2. Fuks AB, Heling I. Erken daimi dişlenme döneminde pulpa tedavisi. In: Çocuk diş hekimliği bebeklikten ergenliğe. Ed.: J.R. Pinkham, P.S. Casamassimo, D.J. McTigue, H.W. Fields, A.J. Nowak. 4. Baskı. Ankara: Atlas Kitapçılık, 2009;Bölüm 33.
  • 3. Feigin K, Shope B. Regenerative endodontics. J Veter Dent 2017;34:161-178.
  • 4. Wigler R, Kaufman AY, Lin S, Steinbock N, Hazan-Molina H, Torneck CD. Revascularization: A treatment for permanent teeth with necrotic pulp and incomplete root development. J Endod 2013;39:319–326.
  • 5. Moreno-Hidalgo MC, Caleza-Jimenez C, Mendoza-Mendoza A, Iglesias Linares A. Revascularization of immature permanent teeth with apical periodontitis. Int Endod J 2014;47:321-331.
  • 6. Cvek M. Prognosis of luxated non‐vital maxillary incisors treated with calcium hydroxide and filled with gutta‐percha. A retrospective clinical study. Dent Traumatol 1992;8:45-55.
  • 7. Huang GTJ. A paradigm shift in endodontic management of immature teeth: conservation of stem cells for regeneration. J Dent 2008;36:379–386.
  • 8. Kim SY, Kim HC, Shin SJ, Kim E. Comparison of gap volume after retrofilling using 4 different filling materials: evaluation by micro–computed tomography. J Endod 2018;44:635-638.
  • 9. Rosenberg B, Murray Pe, Namerow K. The effect of calcium hydroxide root filling on dentin fracture strength. Dent Traumatol 2007;23:26–29.
  • 10. Tuna EB, Dinçol ME, Gençay K, Aktören O. Fracture resistance of immature teeth filled with BioAggregate, mineral trioxide aggregate and calcium hydroxide. Dent traumatol: official publication of Int Assoc Dent Traumatol 2011;27:174–178.
  • 11. Naseri M, Eftekhar L, Gholami F, Atai M, Dianat O. The effect of calcium hydroxide and nano–calcium hydroxide on microhardness and superficial chemical structure of root canal dentin: an ex vivo study. J Endod 2019;45:1148-1154.
  • 12. Iwaya SI, Ikawa M, Kubota M. Revascularization of an immature permanent tooth with apical periodontitis and sinus tract. Dent Traumatol 2001;17:185–187.
  • 13. Galler KM. Clinical procedures for revitalization: current knowledge and considerations. Int Endod J 2016;49:926–936.
  • 14. American Academy of Endodontists. Clinical considerations for a regenerative procedure. 2018. Erişim Adresi: https://f3f142zs0k2w1kg84k5p9i1o-wpengine.netdna-ssl.com/specialty/wpcontent/uploads/sites/2/2018/06/ConsiderationsForRegEndo_AsOfApril2018.pdf. Erişim Tarihi: 17.08.2020.
  • 15. Diogenes A, Henry MA, Teixeira FB, Hargreaves KM. An update on clinical regenerative endodontics. Endod Top 2013;28:2–23.
  • 16. European Society Of Endodontology. European society of endodontology position statement: the use of antibiotics in endodontics. Int Endod J 2018;51:20–25.
  • 17. Ji YM, Jeon SH, Park JY, Chung JH, Choung YH, Choung PH. Dental stem cell therapy with calcium hydroxide in dental pulp capping. Tissue Eng Part A 2010;16:1823–1833.
  • 18. Galler KM, Buchalla W, Hiller KA, Federlin M, Eidt A, Schiefersteiner M, Schmalz G. Influence of root canal disinfectants on growth factor release from dentin. J Endod 2015;41:363–368.
  • 19. Kitikuson P, Srisuwan T. Attachment ability of human apical papilla cells to root dentin surfaces treated with either 3Mix or calcium hydroxide. J Endod 2016;42:89-94.
  • 20. Galler KM, D’souza RN, Federlin M, Cavender AC, Hartgerink JD, Hecker S, Schmalz G. Dentin conditioning codetermines cell fate in regenerative endodontics. J Endod 2011;37:1536–1541.
  • 21. Murray PE, Garcia-Godoy F, Hargreaves KM. Regenerative endodontics: a review of current status and a call for action. J Endod 2007;33:377–390.
  • 22. Bezgin T, Yılmaz AD, Çelik BN, Sönmez H. Concentrated platelet-rich plasma used in root canal revascularization: 2 case reports. Int Endod J 2014;47:41–49.
  • 23. Bezgin T, Yılmaz AD, Çelik BN, Kolsuz ME, Sönmez H. Efficacy of platelet-rich plasma as a scaffold in regenerative endodontic treatment. J Endod 2015;41:36-44.
  • 24. Neha K, Kansal R, Garg P, Joshi R, Garg D, Grover HS. Management of immature teeth by dentin-pulp regeneration: a recent approach. Med Oral Patol Oral Cir Bucal 2011;16:997–1004.
  • 25. Chen MY, Chen KL, Chen CA, Tayebaty F, Rosenberg PA, Lin LM. Responses of immature permanent teeth with infected necrotic pulp tissue and apical periodontitis/abscess to revascularization procedures. Int Endod J 2012;45: 294–305.
  • 26. Banchs F, Trope M. Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod 2004;30:196–200.
  • 27. Thibodeau B, Teixeira F, Yamauchi M, Caplan DJ, Trope M. Pulp revascularization of immature dog teeth with apical periodontitis. J Endod 2007;33:680–689.
  • 28. Becerra P, Ricucci D, Loghin S, Gibbs JL, Lin LM. Histologic study of a human immature permanent premolar with chronic apical abscess after revascularization/revitalization. J Endod 2014;40:133-139.
  • 29. Lin LM, Shimizu E, Gibbs JL, Loghin S, Ricucci D. Histologic and histobacteriologic observations of failed revascularization/revitalization therapy: a case report. J Endod 2014;40:291-295.
  • 30. Kim JH, Kim Y, Shin SJ, Park JW, Jung IY. Tooth discolouration of immature permanent incisor associated with triple antibiotic therapy: a case report. J Endod 2010;36:1086-1091.
  • 31. Lenherr P, Allgayer N, Weiger R, Filippi A, Attin T, Krastl G. Tooth discoloration induced by endodontic materials: a laboratory study. Int Endod 2012;45:942-949.
  • 32. Hargreaves KM, Giesler T, Henry M, Wang Y. Regeneration potential of the young permanent tooth: what does the future hold? J Endod 2008;34:51–56.
  • 33. Thibodeau B, Trope M. Pulp revascularization of a necrotic infected immature permanent tooth: case report and review of the literature. Pediatr Dent 2007,29:47–50.
  • 34. Petrino JA, Boda KK, Shambarger S, Bowles WR, Mcclanahan SB. Challenges in regenerative endodontics: a case series. J Endod 2010;36:536–541.
  • 35. Nosrat A, Homayounfar N, 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;38:1428-1434.
  • 36. Nosrat A, Seifi A, Asgary S. Regenerative endodontic treatment (revascularization) for necrotic immature permanent molars: a review and report of two cases with a new biomaterial. J Endod 2011;37:562-567.
  • 37. Yavari HR, Samiei M, Shahi S, Aghazadeh M, Jafari F, Abdolrahimi M, Asgary S. Microleakage comparison of four dental materials as intra-orifice barriers in endodontically treated teeth. Iran Endod J 2012;7:25-30.
  • 38. Asgary S, Ehsani S. Periradicular surgery of human permanent teeth with calcium-enriched mixture cement. Iran Endod J 2013;8:140-144.
  • 39. Moradi S, Disfani R, Ghazvini K, Lomee M. Sealing ability of orthograde MTA and cem cement in apically resected roots using bacterial leakage method. Iran Endod J 2013;8:109-113.
  • 40. Meschi N, Hilkens P, Van Gorp G, Strijbos O, Mavridou A, De Llano Perula MC, Lambrechts P. Regenerative endodontic procedures posttrauma: immunohistologic analysis of a retrospective series of failed cases. J Endod 2019;45:427-434.
  • 41. Hargreaves KM, Diogenes A, Teixeira FB. Treatment options: biological basis of regenerative endodontic procedures. J Endod 2013;39:30-43.
  • 42. Fouad AF. The microbial challenge to pulp regeneration. Adv Dent Res 2011;23:285-289.
  • 43. Kakoli P, Nandakumar R, Romberg F, Arola D, Fouad AF. The effect of age on bacterial penetration of radicular dentin. J Endod 2009;35:78-81.
  • 44. Lenzi R, Trope M. Revitalization procedures in two traumatized incisors with different biological outcomes. J Endod 2012;38:411–414.
  • 45. Ostby BN. The role of the blood clot in endodontic therapy: an experimental histologic study. Acta Odontol Scand 1961;19:324–353.
  • 46. Torneck CD, Smith J. Biologic effects of endodontic procedures on developing incisor teeth. I. effect of partial and total pulp removal. Oral Surg Oral Med Oral Pathol 1970;30:258-266.

Points of Consideration in Regenerative Endodontics Clinical Applications

Year 2020, Volume: 47 Issue: 1-3, 179 - 186, 31.12.2020

Esin Günal Tuğba Bezgin

Abstract

Endodontic treatment of devital young permanent teeth is one of the challenging procedures for clinicians in pediatric dentistry. Young permanent teeth can become necrotic due to caries, dental anatomical variations such as dens invaginatus or trauma. Root development stops in necrotic teeth, resulting in thin root dentin walls and a divergent, open apex. For this reason, it is difficult to provide appropriate mechanical preparation and subsequent hermetic filling during endodontic treatments. Although calcium hydroxide apexification and one-visit apexification techniques are used frequently, these techniques cannot ensure the continuity of root development and teeth are prone to fracture due to thin root canal walls. For this reason, regenerative endodontic treatments that provide the continuation of pulp regeneration, dentin formation and root development after treatment have become popular. In this article, the points to be considered when applying regenerative endodontic treatments are reviewed.

Keywords

Apexification Devital immature tooth Regeneration

References

  • 1. Andreasen JO, Ravn JJ. Epidemiology of traumatic dental injuries to primary and permanent teeth in a Danish population sample. Int J Oral Surg 1972;1:235-239.
  • 2. Fuks AB, Heling I. Erken daimi dişlenme döneminde pulpa tedavisi. In: Çocuk diş hekimliği bebeklikten ergenliğe. Ed.: J.R. Pinkham, P.S. Casamassimo, D.J. McTigue, H.W. Fields, A.J. Nowak. 4. Baskı. Ankara: Atlas Kitapçılık, 2009;Bölüm 33.
  • 3. Feigin K, Shope B. Regenerative endodontics. J Veter Dent 2017;34:161-178.
  • 4. Wigler R, Kaufman AY, Lin S, Steinbock N, Hazan-Molina H, Torneck CD. Revascularization: A treatment for permanent teeth with necrotic pulp and incomplete root development. J Endod 2013;39:319–326.
  • 5. Moreno-Hidalgo MC, Caleza-Jimenez C, Mendoza-Mendoza A, Iglesias Linares A. Revascularization of immature permanent teeth with apical periodontitis. Int Endod J 2014;47:321-331.
  • 6. Cvek M. Prognosis of luxated non‐vital maxillary incisors treated with calcium hydroxide and filled with gutta‐percha. A retrospective clinical study. Dent Traumatol 1992;8:45-55.
  • 7. Huang GTJ. A paradigm shift in endodontic management of immature teeth: conservation of stem cells for regeneration. J Dent 2008;36:379–386.
  • 8. Kim SY, Kim HC, Shin SJ, Kim E. Comparison of gap volume after retrofilling using 4 different filling materials: evaluation by micro–computed tomography. J Endod 2018;44:635-638.
  • 9. Rosenberg B, Murray Pe, Namerow K. The effect of calcium hydroxide root filling on dentin fracture strength. Dent Traumatol 2007;23:26–29.
  • 10. Tuna EB, Dinçol ME, Gençay K, Aktören O. Fracture resistance of immature teeth filled with BioAggregate, mineral trioxide aggregate and calcium hydroxide. Dent traumatol: official publication of Int Assoc Dent Traumatol 2011;27:174–178.
  • 11. Naseri M, Eftekhar L, Gholami F, Atai M, Dianat O. The effect of calcium hydroxide and nano–calcium hydroxide on microhardness and superficial chemical structure of root canal dentin: an ex vivo study. J Endod 2019;45:1148-1154.
  • 12. Iwaya SI, Ikawa M, Kubota M. Revascularization of an immature permanent tooth with apical periodontitis and sinus tract. Dent Traumatol 2001;17:185–187.
  • 13. Galler KM. Clinical procedures for revitalization: current knowledge and considerations. Int Endod J 2016;49:926–936.
  • 14. American Academy of Endodontists. Clinical considerations for a regenerative procedure. 2018. Erişim Adresi: https://f3f142zs0k2w1kg84k5p9i1o-wpengine.netdna-ssl.com/specialty/wpcontent/uploads/sites/2/2018/06/ConsiderationsForRegEndo_AsOfApril2018.pdf. Erişim Tarihi: 17.08.2020.
  • 15. Diogenes A, Henry MA, Teixeira FB, Hargreaves KM. An update on clinical regenerative endodontics. Endod Top 2013;28:2–23.
  • 16. European Society Of Endodontology. European society of endodontology position statement: the use of antibiotics in endodontics. Int Endod J 2018;51:20–25.
  • 17. Ji YM, Jeon SH, Park JY, Chung JH, Choung YH, Choung PH. Dental stem cell therapy with calcium hydroxide in dental pulp capping. Tissue Eng Part A 2010;16:1823–1833.
  • 18. Galler KM, Buchalla W, Hiller KA, Federlin M, Eidt A, Schiefersteiner M, Schmalz G. Influence of root canal disinfectants on growth factor release from dentin. J Endod 2015;41:363–368.
  • 19. Kitikuson P, Srisuwan T. Attachment ability of human apical papilla cells to root dentin surfaces treated with either 3Mix or calcium hydroxide. J Endod 2016;42:89-94.
  • 20. Galler KM, D’souza RN, Federlin M, Cavender AC, Hartgerink JD, Hecker S, Schmalz G. Dentin conditioning codetermines cell fate in regenerative endodontics. J Endod 2011;37:1536–1541.
  • 21. Murray PE, Garcia-Godoy F, Hargreaves KM. Regenerative endodontics: a review of current status and a call for action. J Endod 2007;33:377–390.
  • 22. Bezgin T, Yılmaz AD, Çelik BN, Sönmez H. Concentrated platelet-rich plasma used in root canal revascularization: 2 case reports. Int Endod J 2014;47:41–49.
  • 23. Bezgin T, Yılmaz AD, Çelik BN, Kolsuz ME, Sönmez H. Efficacy of platelet-rich plasma as a scaffold in regenerative endodontic treatment. J Endod 2015;41:36-44.
  • 24. Neha K, Kansal R, Garg P, Joshi R, Garg D, Grover HS. Management of immature teeth by dentin-pulp regeneration: a recent approach. Med Oral Patol Oral Cir Bucal 2011;16:997–1004.
  • 25. Chen MY, Chen KL, Chen CA, Tayebaty F, Rosenberg PA, Lin LM. Responses of immature permanent teeth with infected necrotic pulp tissue and apical periodontitis/abscess to revascularization procedures. Int Endod J 2012;45: 294–305.
  • 26. Banchs F, Trope M. Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod 2004;30:196–200.
  • 27. Thibodeau B, Teixeira F, Yamauchi M, Caplan DJ, Trope M. Pulp revascularization of immature dog teeth with apical periodontitis. J Endod 2007;33:680–689.
  • 28. Becerra P, Ricucci D, Loghin S, Gibbs JL, Lin LM. Histologic study of a human immature permanent premolar with chronic apical abscess after revascularization/revitalization. J Endod 2014;40:133-139.
  • 29. Lin LM, Shimizu E, Gibbs JL, Loghin S, Ricucci D. Histologic and histobacteriologic observations of failed revascularization/revitalization therapy: a case report. J Endod 2014;40:291-295.
  • 30. Kim JH, Kim Y, Shin SJ, Park JW, Jung IY. Tooth discolouration of immature permanent incisor associated with triple antibiotic therapy: a case report. J Endod 2010;36:1086-1091.
  • 31. Lenherr P, Allgayer N, Weiger R, Filippi A, Attin T, Krastl G. Tooth discoloration induced by endodontic materials: a laboratory study. Int Endod 2012;45:942-949.
  • 32. Hargreaves KM, Giesler T, Henry M, Wang Y. Regeneration potential of the young permanent tooth: what does the future hold? J Endod 2008;34:51–56.
  • 33. Thibodeau B, Trope M. Pulp revascularization of a necrotic infected immature permanent tooth: case report and review of the literature. Pediatr Dent 2007,29:47–50.
  • 34. Petrino JA, Boda KK, Shambarger S, Bowles WR, Mcclanahan SB. Challenges in regenerative endodontics: a case series. J Endod 2010;36:536–541.
  • 35. Nosrat A, Homayounfar N, 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;38:1428-1434.
  • 36. Nosrat A, Seifi A, Asgary S. Regenerative endodontic treatment (revascularization) for necrotic immature permanent molars: a review and report of two cases with a new biomaterial. J Endod 2011;37:562-567.
  • 37. Yavari HR, Samiei M, Shahi S, Aghazadeh M, Jafari F, Abdolrahimi M, Asgary S. Microleakage comparison of four dental materials as intra-orifice barriers in endodontically treated teeth. Iran Endod J 2012;7:25-30.
  • 38. Asgary S, Ehsani S. Periradicular surgery of human permanent teeth with calcium-enriched mixture cement. Iran Endod J 2013;8:140-144.
  • 39. Moradi S, Disfani R, Ghazvini K, Lomee M. Sealing ability of orthograde MTA and cem cement in apically resected roots using bacterial leakage method. Iran Endod J 2013;8:109-113.
  • 40. Meschi N, Hilkens P, Van Gorp G, Strijbos O, Mavridou A, De Llano Perula MC, Lambrechts P. Regenerative endodontic procedures posttrauma: immunohistologic analysis of a retrospective series of failed cases. J Endod 2019;45:427-434.
  • 41. Hargreaves KM, Diogenes A, Teixeira FB. Treatment options: biological basis of regenerative endodontic procedures. J Endod 2013;39:30-43.
  • 42. Fouad AF. The microbial challenge to pulp regeneration. Adv Dent Res 2011;23:285-289.
  • 43. Kakoli P, Nandakumar R, Romberg F, Arola D, Fouad AF. The effect of age on bacterial penetration of radicular dentin. J Endod 2009;35:78-81.
  • 44. Lenzi R, Trope M. Revitalization procedures in two traumatized incisors with different biological outcomes. J Endod 2012;38:411–414.
  • 45. Ostby BN. The role of the blood clot in endodontic therapy: an experimental histologic study. Acta Odontol Scand 1961;19:324–353.
  • 46. Torneck CD, Smith J. Biologic effects of endodontic procedures on developing incisor teeth. I. effect of partial and total pulp removal. Oral Surg Oral Med Oral Pathol 1970;30:258-266.
There are 46 citations in total.

Details

Primary Language Turkish
Subjects Dentistry
Journal Section Review Articles
Authors

Esin Günal

Tuğba Bezgin

Publication Date December 31, 2020
Published in Issue Year 2020 Volume: 47 Issue: 1-3

Cite

APA Günal, E., & Bezgin, T. (2020). REJENERATİF ENDODONTİ KLİNİK UYGULAMALARINDA DİKKAT EDİLECEK NOKTALAR. Ankara Üniversitesi Diş Hekimliği Fakültesi Dergisi, 47(1-3), 179-186.
AMA Günal E, Bezgin T. REJENERATİF ENDODONTİ KLİNİK UYGULAMALARINDA DİKKAT EDİLECEK NOKTALAR. AÜDHF dergisi. December 2020;47(1-3):179-186.
Chicago Günal, Esin, and Tuğba Bezgin. “REJENERATİF ENDODONTİ KLİNİK UYGULAMALARINDA DİKKAT EDİLECEK NOKTALAR”. Ankara Üniversitesi Diş Hekimliği Fakültesi Dergisi 47, no. 1-3 (December 2020): 179-86.
EndNote Günal E, Bezgin T (December 1, 2020) REJENERATİF ENDODONTİ KLİNİK UYGULAMALARINDA DİKKAT EDİLECEK NOKTALAR. Ankara Üniversitesi Diş Hekimliği Fakültesi Dergisi 47 1-3 179–186.
IEEE E. Günal and T. Bezgin, “REJENERATİF ENDODONTİ KLİNİK UYGULAMALARINDA DİKKAT EDİLECEK NOKTALAR”, AÜDHF dergisi, vol. 47, no. 1-3, pp. 179–186, 2020.
ISNAD Günal, Esin - Bezgin, Tuğba. “REJENERATİF ENDODONTİ KLİNİK UYGULAMALARINDA DİKKAT EDİLECEK NOKTALAR”. Ankara Üniversitesi Diş Hekimliği Fakültesi Dergisi 47/1-3 (December 2020), 179-186.
JAMA Günal E, Bezgin T. REJENERATİF ENDODONTİ KLİNİK UYGULAMALARINDA DİKKAT EDİLECEK NOKTALAR. AÜDHF dergisi. 2020;47:179–186.
MLA Günal, Esin and Tuğba Bezgin. “REJENERATİF ENDODONTİ KLİNİK UYGULAMALARINDA DİKKAT EDİLECEK NOKTALAR”. Ankara Üniversitesi Diş Hekimliği Fakültesi Dergisi, vol. 47, no. 1-3, 2020, pp. 179-86.
Vancouver Günal E, Bezgin T. REJENERATİF ENDODONTİ KLİNİK UYGULAMALARINDA DİKKAT EDİLECEK NOKTALAR. AÜDHF dergisi. 2020;47(1-3):179-86.