scholarly journals EFICÁCIA DA REVASCULARIZAÇÃO NA FORMAÇÃO DO ÁPICE RADICULAR EM PACIENTES COM RIZOGÊNESE INCOMPLETA: UMA REVISÃO INTEGRATIVA

2021 ◽  
Vol 4 (7) ◽  
pp. 1-10
Author(s):  
Verônica Caroline Brito REIA ◽  
Pedro MOLITOR ◽  
Fernanda Furtado PIRAS ◽  
Marcelo Ueti de CAMARGO ◽  
Miriam Graziele MAGRO
Keyword(s):  
Root Formation ◽  
Web Of Science ◽  
Root Apex ◽  
Permanent Teeth ◽  
Electronic Database ◽  
Periapical Lesion ◽  
X Ray ◽  
Searching Strategy ◽  
Tooth Apex

Objetivos: Verificar a eficácia da revascularização para induzir a continuidade de formação do ápice radicular em pacientes com rizogênese incompleta. Metodologia: A estratégia de busca foi aplicada nas bases de dados eletrônicas PubMed, Embase, Web of Science e LILACS, sendo selecionados quatro artigos publicados entre 2011 e 2021. Resultados: Um total de 27 pacientes diagnosticados com necrose pulpar foi incluído, de ambos os sexos. Os testes de percussão, térmico e elétrico no exame clínico foram realizados em 4 pacientes. Todos os pacientes fizeram radiografia periapical para análise inicial. O tratamento endodôntico foi realizado com indução do sangramento apical do canal radicular para revascularização em todos os estudos. No acompanhamento de até 4 anos, observou-se, radiograficamente, aumento do comprimento e espessura radicular, diminuição e posterior desaparecimento da radioluscência periapical, estreitamento do ápice radicular, desenvolvimento radicular e redução da lesão periapical. Conclusão: A revascularização permite que, mesmo após o estímulo para indução de sangramento, a região periapical continue a formação radicular por mais tempo quando comparada a outros materiais endodônticos.   THE EFFECTIVENESS OF REVASCULARIZATION ON ROOT APEX FORMATION IN PATIENTS WITH IMMATURE PERMANENT TEETH: AN INTEGRATIVE REVIEW   ABSTRACT Objectives: To verify the effectiveness of revascularization to induce further root apex formation in patients with immature permanent teeth. Method: A searching strategy was performed at PubMed, Embase, Web of Science, and LILACS electronic database, four articles issued between 2011 and 2021 were screened. Results:  A total of 27 patients diagnosed with pulp necrosis were included, both genders. Percussion, electric, and thermal pulp testing were performed for clinical examination in those 4 patients. All the patients had a periapical x-ray taken for initial analysis. The endodontic treatment was performed with the apex-induced bleeding into the root canal for the revascularization in all the studies. At a 4-year follow-up it was observed, radiographically, an increase in root length and thickness, and afterward the periapical radiolucency disappearance, the root apex narrowing, root growing, and the periapical lesion reduction. Conclusion: Revascularization enables, even after the stimulus for bleeding induction, the periapical region to further continue the root formation when compared to other endodontic materials.     Descriptors: Endodontics. Pulp Necrosis. Tooth Apex.

scholarly journals Case Report: Dilemma To Save Or Not To Save A Tooth

2017 ◽  
Vol 16 (2) ◽  
Author(s):  
Yee Woo Yap ◽  
Azillah Mohd Ali
Keyword(s):  
Case Report ◽  
Root Formation ◽  
Dentigerous Cyst ◽  
Permanent Teeth ◽  
Treatment Modalities ◽  
Successful Outcome ◽  
Odontogenic Cysts ◽  
Standard Assessment ◽  
Good Healing

Introduction: Dentigerous cyst is the most common odontogenic cysts that are associated with the crowns of permanent teeth. Treatment modalities normally include enucleation or marsupialization of the cyst. However, currently there are no standard assessment criteria to dictate which kind of treatment for certain cases. The purpose of this report is to describe the successful outcome of conservative surgical management of a large dentigerous cyst associated with an unerupted right maxillary permanent canine in an 8-year-old boy. The cyst was enucleated partially but leaving the cystic lining surrounding the unerupted canine in order to preserve the tooth. 3-year follow up revealed good healing with significant root formation and tooth eruption.

scholarly journals Management of non-vital immature root canal of right maxillary central incisor with Metapex-MTA Coating: A Case Report

2020 ◽  
Author(s):  
Vinay Kumar Srivastava
Keyword(s):  
Root Canal ◽  
Root Apex ◽  
Apical Region ◽  
Periapical Lesion ◽  
Maxillary Central Incisor ◽  
New Strategy ◽  
New Treatment ◽  
Root Apices ◽  
Sufficient Strength

Brief background: A tooth with Blunderbuss canal and periapical lesion is difficult to treat by traditional root canal procedures. The dentinal wall surrounding the Blunderbuss canal is very thin, fragile and prone to fracture with a slight blow/ trauma. Therefore, a new strategy is required to treat such a case. Materials and Methods: Canal was cleaned and irrigated with 5.25% NaOCl and 0.2% Chlorhexidine. It was temporized with Ca (OH) 2 for one week to obtain canal disinfection. After one week, Ca(OH) 2 was removed from the canal with a sterilized file and rinsed out with the help of saline. A 2-3mm thick Metapex layer was placed at the apical region of 11, followed by an MTA layer, once the apical MTA layer obtained sufficient strength; the rest of the canal was filled with MTA. Discussion: This new treatment procedure not only closes the open root apices but also provides strength to the dentinal wall. Metapex –MTA combination provides advantages of both the materials; like calcium hydroxide of Metapex stimulates odontoblast of residual apical pulp and MTA stimulates cementoblast cells to bring about root apex closure. Summery & Conclusion: Two year follow-up & a positive clinical outcome of this case were encouraging for the use of Metapex-MTA coating as an apical plug. The rest of the canal was filled with MTA to strengthen and supports the thin dentinal wall for better compliance with the occlusal forces. Key Words: Blunderbuss canal, MTA, Metapex

Application of Partial Pulpotomy in the Treatment of Chronic Pulpitis Caused by Carious in Mature Permanent Teeth: 3 Year-Follow-Up

2021 ◽  
Vol 7 (6) ◽  
pp. 6004-6008
Author(s):  
Lv Zhe ◽  
Zhu Jieying
Keyword(s):  
Informed Consent ◽  
Minimally Invasive ◽  
Clinical Effect ◽  
Clinical Signs ◽  
Permanent Teeth ◽  
Tooth Decay ◽  
Root Canal Therapy ◽  
X Ray ◽  
Dynamic Examination

Purpose: To observe the clinical effect of partial pulpotomy with I Root Bp Plus in cariously exposed mature permanent teeth. Methods: twenty-three cariously exposed mature permanent teeth were choosen by preoperative clinical signs, pulp dynamic examination and imaging examination. After informed consent, rubber barrier was placed. The tooth decay and the inflamed pulp were removed by round bur. After 5% sodium hypochlorite covered the section until sufficient hemostasis was achieved, I Root Bp Plus was used to tightly cover the pulp with a thickness of about 2mm, resin was filled to repaired the shape of the tooth. The capping pulp was examined by X-ray immediately after operation. Clinical and imaging examinations were performed 12 months and 36 months after treatment. Results: After 3 year, the success rate of partial pulpotomy was 86.96%, which is similar as root cannal therapy. Conclusions: The partial pulptomy for caries exposed mature permanent teeth may be an alternative to root canal therapy, and is more consistent with the current concept of minimally invasive and preservation of vital pulp.

scholarly journals Resolution of a large periapical lesion in an immature maxillary lateral incisor with the aid of triple antibiotic paste

2021 ◽  
Vol 76 (09) ◽  
pp. 560-564
Author(s):  
Nicoline Potgieter ◽  
Glynn Buchanan
Keyword(s):  
Root Canal ◽  
Root Formation ◽  
Surgical Intervention ◽  
Lateral Incisor ◽  
Permanent Teeth ◽  
Periapical Lesion ◽  
Periapical Lesions ◽  
Triple Antibiotic Paste ◽  
Maxillary Lateral Incisor ◽  
And Control

Apexification procedures are frequently performed on immature permanent teeth with incomplete root formation, open apices and necrotic pulp status with or without  periapical lesions in order to induce a calcific barrier prior to root canal therapy. The elimination and control of infection in the root canal space is critical to the success of these procedures. A healthy 21-year old male presented with pulpal necrosis, a large periapical lesion, incomplete root formation and an open apex on a maxillary right lateral incisor. Triple antibiotic paste was used to achieve antimicrobial control after traditional calcium hydroxide paste medicament failed to resolve the symptoms. Obturation was achieved using MTA and the conventional apexification technique. Excellent healing of the large periapical lesion was achieved without surgical intervention and the 4-year follow-up CBCT demonstrated complete bone fill of the lesion. Clinicians should be aware that alternative antimicrobial medicaments, such as triple antibiotic paste, may be beneficial in situations where conventional medicaments prove unsuccessful. The use of triple antibiotic paste may result in sufficient healing of the periapical lesion to justify placement of an MTA apical barrier without the need for surgical intervention

scholarly journals Single Sitting Revitalization of Nonvital Young Permanent Teeth

2020 ◽  
Vol 8 (03) ◽  
pp. 127-130
Author(s):  
Avninder Kaur ◽  
Anchal Soni ◽  
Harees Shabir
Keyword(s):  
Glass Ionomer Cement ◽  
Thick Layer ◽  
Permanent Teeth ◽  
Radiographic Examination ◽  
Radiographic Evaluation ◽  
Periapical Lesion ◽  
Immature Teeth ◽  
Pulp Revascularization ◽  
Ionomer Cement

AbstractA 9-year-old child reported with chief complaint of broken teeth (11 and 21) and discolored tooth (21). Diagnosis of pulp necrosis with apical periodontitis with regard to 11 and 21 was made based on clinical and radiographic examination. The canals were irrigated with sodium hypochlorite and then dried with paper points. Disinfection of canals was done using photoactivated disinfection (PAD). Platelet-rich fibrin (PRF) was placed as scaffold in canals till the cementoenamel junction (CEJ). A 2-mm thick layer of white MTA was placed, followed by dual seal using glass–ionomer cement (GIC) and composite resin. Follow-up examination was done for 1 year. Clinical examination showed no pain, tenderness on percussion, and no mobility and improvement in color of teeth. Radiographic evaluation revealed continued thickening of the dentinal walls, root lengthening, regression of the periapical lesion, and partial apical closure. This report of pulp revascularization shows that disinfection with photodynamic therapy combined with PRF resulted in satisfactory root development in necrotic immature teeth.

Stepwise Excavation Allows Apexogenesis in Permanent Molars with Deep Carious Lesions and Incomplete Root Formation

2015 ◽  
Vol 49 (6) ◽  
pp. 637-639 ◽  
Author(s):  
Patrícia Hernandéz-Gatón ◽  
César Ruiz Serrano ◽  
Paulo Nelson Filho ◽  
Esther Ruiz De Castañeda ◽  
Marília P. Lucisano ◽  
...  
Keyword(s):  
Root Formation ◽  
Permanent Teeth ◽  
Promising Technique ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Carious Lesions ◽  
Deep Carious Lesions ◽  
Stepwise Excavation ◽  
Permanent Molars

This study evaluated the stepwise excavation technique in 138 permanent molars with deep carious lesions and incomplete root formation within a 24-month clinical and radiographic follow-up period. In 96.7% of the cases, success was observed (no pain, integrity of restoration margins, absence of radiographic alterations and apexogenesis). The cases of failure (3.3%) were due to the loss of the temporary restoration. In conclusion, the stepwise excavation is a promising technique for permanent teeth with deep carious lesions and incomplete root formation as a minimally invasive approach because it allows the preservation of pulp vitality and occurrence of apexogenesis.

scholarly journals Importance of the diagnosis in the pulpotomy of immature permanent teeth

2007 ◽  
Vol 18 (3) ◽  
pp. 244-247 ◽  
Author(s):  
Ronaldo Araújo Souza ◽  
Suely Colombo Nelli Gomes ◽  
João da Costa Pinto Dantas ◽  
Yara Terezinha Silva-Sousa ◽  
Jesus Djalma Pécora
Keyword(s):  
Conservative Therapy ◽  
Root Formation ◽  
Correct Diagnosis ◽  
Clinical Signs ◽  
Permanent Teeth ◽  
New Bone Formation ◽  
Single Session ◽  
Radiographic Images ◽  
Pulp Vitality

Pulpotomy is a conservative therapy performed to remove the inflamed coronal portion of the pulp and preserve the vitality of the remaining radicular pulp. This article reports two cases of immature permanent mandibular molars with clinical signs of pulp vitality and radiographic images of periapical bone rarefaction, which were treated with calcium hydroxide pulpotomy. In Case 1, pulpotomy was performed in a single session, while in Case 2 two sessions were required to complete the treatment. Clinical and radiographic follow up within 13 and 9 months, respectively, showed hard tissue barrier and new bone formation as well as progression of root development. These outcomes are confirmatory that an accurate clinical/radiographic assessment of pulp vitality is of paramount importance for the correct diagnosis and indication of pulpotomy in cases of young permanent teeth with incomplete root formation.

scholarly journals Regenerative Endodontics as the Future Treatment of Immature Permanent Teeth

2021 ◽  
Vol 11 (13) ◽  
pp. 6211
Author(s):  
Justyna Zbańska ◽  
Katarzyna Herman ◽  
Piotr Kuropka ◽  
Maciej Dobrzyński
Keyword(s):  
Root Apex ◽  
Endodontic Treatment ◽  
Permanent Teeth ◽  
X Rays ◽  
Important Indicator ◽  
Regenerative Endodontics ◽  
Management Protocol ◽  
Essential Components ◽  
The Future

The regenerative endodontic procedure (REP) is an alternative solution for endodontic treatment of permanent teeth with incomplete root apex development. It results in angiogenesis, reinnervation, and further root formation. Indications for REP include immature permanent teeth with necrotic pulp and inflammatory lesions of the periapical tissues. The main contraindications comprise significant destruction of the tooth tissues and a lack of patient cooperation. We distinguish the following stages of this procedure: disinfection of the canal, delivery of the REP components, closure of the cavity, and follow-up appointments. For effective canal disinfection, the use of both rinsing agents and intracanal medicaments is suggested. Sodium hypochlorite and triple antibiotic paste are used most commonly. Light-activated disinfection is proposed as an alternative method. The prerequisite for the regeneration process of the pulp is the supply of its essential components: stem cells, growth factors, and scaffolds to the canal lumen. Blood clotting, platelet-rich plasma, and platelet-rich fibrin are used for this purpose. For a proper course of REP, it is also necessary to close the tooth canal tightly. For this purpose, mineral trioxide aggregate (MTA), tricalcium silicate (Biodentine), or types of glass ionomer cement are employed. The patient should attend regularly scheduled follow-up appointments and each time undergo a thorough interview, physical and radiological examination. The most important indicator of a successful REP is the continued growth of the root in length and thickness and the closure of the root apex visible on X-rays. Many different proposals for a management protocol have been published; the following paper proposes the authors’ original scheme. Regenerative endodontics is the future of the endodontic treatment of immature permanent teeth; however, it still requires a lot of research to refine and standardize the treatment protocol. The application of tissue engineering methods seems to be promising, also for mature teeth treatment.

Electron Microscopy of Human Gallstones

1971 ◽  
Vol 29 ◽  
pp. 296-297
Author(s):  
C. Wolpers ◽  
R. Blaschke
Keyword(s):  
Electron Microscopy ◽  
Room Temperature ◽  
Bile Pigment ◽  
X Ray Diffraction ◽  
Triclinic Crystal System ◽  
X Ray ◽  
Follow Up Study ◽  
Infra Red ◽  
Main Components

Scanning microscopy was used to study the surface of human gallstones and the surface of fractures. The specimens were obtained by operation, washed with water, dried at room temperature and shadowcasted with carbon and aluminum. Most of the specimens belong to patients from a series of X-ray follow-up study, examined during the last twenty years. So it was possible to evaluate approximately the age of these gallstones and to get information on the intensity of growing and solving.Cholesterol, a group of bile pigment substances and different salts of calcium, are the main components of human gallstones. By X-ray diffraction technique, infra-red spectroscopy and by chemical analysis it was demonstrated that all three components can be found in any gallstone. In the presence of water cholesterol crystallizes in pane-like plates of the triclinic crystal system.

Congenital Syphilis Simulating Bone Neoplasm in 2-Month Old Infant – Case Report

2017 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Case Report ◽  
Congenital Syphilis ◽  
Eosinophilic Granuloma ◽  
Osteolytic Lesion ◽  
Lower Limbs ◽  
Upper Body ◽  
Elective Cesarean Section ◽  
Distal Fibula ◽  
X Ray

Introduction: Congenital Syphilis (CS) occurs through the transplacental transmission of Treponema pallidum in inadequately treated or non-treated pregnant women, and is capable of severe consequences such as miscarriage, preterm birth, congenital disease and/or neonatal death. CS has been showing an increasing incidence worldwide, with an increase of 208% from 2009 to 2015 in Brazil. Case report: 2-month old infant receives care in emergency service due to edema of right lower limb with pain in mobilization. X-ray with osteolytic lesion in distal fibula. Infant was sent to the Pediatrics Oncology clinic. Perinatal data: 7 prenatal appointments, negative serology at 10 and 30 weeks of gestation. End of pregnancy tests were not examined and tests for mother’s hospital admission were not requested. Mother undergone elective cesarean section at 38 weeks without complications. During the pediatric oncologist appointment, patient showed erythematous-squamous lesions in neck and other scar-like lesions in upper body. A new X-ray of lower limbs showed lesions in right fibula with periosteal reaction associated with aggressive osteolytic lesion compromising distal diaphysis, with cortical bone rupture and signs of pathological fracture, suggestive of eosinophilic granuloma. She was hospitalized for a lesion biopsy. Laboratory tests: hematocrit: 23.1 / hemoglobin 7.7 / leukocytes 10,130 (without left deviation) / platelets 638,000 / Negative Cytomegalovirus IgG and IgM and Toxoplasmosis IgG and IgM / VDRL 1:128. Congenital syphilis diagnosis with skin lesions, bone alterations and anemia. Lumbar puncture: glucose 55 / total proteins 26 / VDRL non reagent / 13 leukocytes (8% neutrophils; 84% monomorphonuclear; 8% macrophages) and 160 erythrocytes / negative VDRL and culture. X-ray of other long bones, ophthalmological evaluation and abdominal ultrasound without alterations. Patient was hospitalized for 14 days for treatment with Ceftriaxone 100mg/kg/day, due to the lack of Crystalline Penicillin in the hospital. She is now under outpatient follow-up. Discussion: CS is responsible for high rates of morbidity and mortality. The ongoing increase of cases of this pathology reflects a severe health issue and indicates failures in policies for the prevention of sexually transmitted diseases, with inadequate follow-up of prenatal and maternity protocols.

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