Pulp revascularization as an alternative to apexification therapies commonly applied to young teeth with incomplete roots

Authors

DOI:

https://doi.org/10.33448/rsd-v11i15.36835

Keywords:

Endodontics; Apexification; Revascularization.

Abstract

The dentist has some alternatives for inducing apical closure in cases in which the dental element presents with the root in formation. The use of techniques for apexification with MTA and calcium hydroxide have been suggested for years, and the prognosis when performing this therapy is very promising. On the other hand, teeth that have fragile walls and an inadequate crown-root ratio, even when apical closure is induced, have a dubious prognosis, since they do not have enough structure to withstand the intrinsic forces of mastication. Therefore, this study aimed to present a literature review on the revascularization technique, as well as to cite a survey of clinical cases that prove the effectiveness of this therapy for the treatment of young teeth that do not present complete root development. For this, searches were carried out on PubMed for studies published from 2020 to 2022 using the terms: pulp, revascularization, case and report. In view of the results seen, pulp revascularization is a good alternative to conventional apexification treatments, and should be performed mainly in cases where there is no adequate thickness and length of the root.

References

AAE. (2016). Clinical Considerations for a Regenerative Procedure. https://www.aae.org/specialty/wp-content/uploads/sites/2/2017/06/currentregenerativeendodonticconsiderations.pdf

Altaii, M., Richards, L., & Rossi-Fedele, G. (2017). Histological assessment of regenerative endodontic treatment in animal studies with different scaffolds: A systematic review. Dental traumatology : official publication of International Association for Dental Traumatology, 33(4), 235–244. https://doi.org/10.1111/edt.12338

Andreasen, J. O., Farik, B., & Munksgaard, E. C. (2002). Long-term calcium hydroxide as a root canal dressing may increase risk of root fracture. Dental traumatology : official publication of International Association for Dental Traumatology, 18(3), 134–137. https://doi.org/10.1034/j.1600-9657.2002.00097.x

Araújo, P., Silva, L. B., Neto, A., Almeida de Arruda, J. A., Álvares, P. R., Sobral, A., Júnior, S. A., Leão, J. C., Braz da Silva, R., & Sampaio, G. C. (2017). Pulp Revascularization: A Literature Review. The open dentistry journal, 10, 48–56. https://doi.org/10.2174/1874210601711010048

Arshad, S., Tehreem, F., Rehab Khan, M., Ahmed, F., Marya, A., & Karobari, M. I. (2021). Platelet-Rich Fibrin Used in Regenerative Endodontics and Dentistry: Current Uses, Limitations, and Future Recommendations for Application. International journal of dentistry, 2021, 4514598. https://doi.org/10.1155/2021/4514598

Bastawala, D. S., Kapoor, S., & Nathani, P. (2020). A Comparison of Coronal Tooth Discoloration Elicited by Various Endodontic Reparative Materials MTA Plus, Bio MTA+, and Biodentine: An Ex Vivo Study. International journal of clinical pediatric dentistry, 13(5), 463–467. https://doi.org/10.5005/jp-journals-10005-1812

Brogni, J. K., Vitali, F. C., Cardoso, I. V., Dos Santos, J. D., Prado, M., Alves, A., & Duque, T. M. (2021). A second attempt at pulp revascularisation on an immature traumatised anterior tooth: a case report with two-year follow-up. Australian endodontic journal : the journal of the Australian Society of Endodontology Inc, 47(1), 90–96. https://doi.org/10.1111/aej.12466

Couto, A. M., Espaladori, M. C., Leite, A., Martins, C. C., de Aguiar, M., & Abreu, L. G. (2019). A Systematic Review of Pulp Revascularization Using a Triple Antibiotic Paste. Pediatric dentistry, 41(5), 341–353.

Cui, D., Yu, S., Zhou, X., Liu, Y., Gan, L., Pan, Y., Zheng, L., & Wan, M. (2021). Roles of Dental Mesenchymal Stem Cells in the Management of Immature Necrotic Permanent Teeth. Frontiers in cell and developmental biology, 9, 666186. https://doi.org/10.3389/fcell.2021.666186

Cvek M. (1992). Prognosis of luxated non-vital maxillary incisors treated with calcium hydroxide and filled with gutta-percha. A retrospective clinical study. Endodontics & dental traumatology, 8(2), 45–55. https://doi.org/10.1111/j.1600-9657.1992.tb00228.x

Diogenes, A., & Hargreaves, K. M. (2017). Microbial Modulation of Stem Cells and Future Directions in Regenerative Endodontics. Journal of endodontics, 43(9S), S95–S101. https://doi.org/10.1016/j.joen.2017.07.012

Eramo, S., Natali, A., Pinna, R., & Milia, E. (2018). Dental pulp regeneration via cell homing. International endodontic journal, 51(4), 405–419. https://doi.org/10.1111/iej.12868

Friedlander, L.T., Cullinan, M.P. and Love, R.M. (2009), Dental stem cells and their potential role in apexogenesis and apexification. International Endodontic Journal, 42: 955-962. https://doi.org/10.1111/j.1365-2591.2009.01622.x (Introdução)

Galler, K. M., Widbiller, M., Buchalla, W., Eidt, A., Hiller, K. A., Hoffer, P. C., & Schmalz, G. (2016). EDTA conditioning of dentine promotes adhesion, migration and differentiation of dental pulp stem cells. International endodontic journal, 49(6), 581–590. https://doi.org/10.1111/iej.12492

Kahler, S. L., Shetty, S., Andreasen, F. M., & Kahler, B. (2018). The Effect of Long-term Dressing with Calcium Hydroxide on the Fracture Susceptibility of Teeth. Journal of endodontics, 44(3), 464–469. https://doi.org/10.1016/j.joen.2017.09.018

Law A. S. (2013). Considerations for regeneration procedures. Journal of endodontics, 39(3 Suppl), S44–S56. https://doi.org/10.1016/j.joen.2012.11.019

Li, J., Parada, C., & Chai, Y. (2017). Cellular and molecular mechanisms of tooth root development. Development (Cambridge, England), 144(3), 374–384. https://doi.org/10.1242/dev.137216

Lin, J. C., Lu, J. X., Zeng, Q., Zhao, W., Li, W. Q., & Ling, J. Q. (2016). Comparison of mineral trioxide aggregate and calcium hydroxide for apexification of immature permanent teeth: A systematic review and meta-analysis. Journal of the Formosan Medical Association = Taiwan yi zhi, 115(7), 523–530. https://doi.org/10.1016/j.jfma.2016.01.010

Lin, L. M., & Kahler, B. (2017). A review of regenerative endodontics: current protocols and future directions. Journal of Istanbul University Faculty of Dentistry, 51(3 Suppl 1), S41–S51. https://doi.org/10.17096/jiufd.53911

Lin, L. M., Huang, G. T., Sigurdsson, A., & Kahler, B. (2021). Clinical cell-based versus cell-free regenerative endodontics: clarification of concept and term. International endodontic journal, 54(6), 887–901. https://doi.org/10.1111/iej.13471

Lopes, H. P., & Siqueira, J. F. (2020). Endodontia – Biologia e técnica (4ª ed.). Elsevier Brasil

Martin, D. E., De Almeida, J. F., Henry, M. A., Khaing, Z. Z., Schmidt, C. E., Teixeira, F. B., & Diogenes, A. (2014). Concentration-dependent effect of sodium hypochlorite on stem cells of apical papilla survival and differentiation. Journal of endodontics, 40(1), 51–55. https://doi.org/10.1016/j.joen.2013.07.026

Mayya, A., Bhandary, S., Kolakemar, A., & George, A. M. (2021). Management of necrotic immature permanent maxillary incisors using a modified technique of revascularisation. BMJ case reports, 14(3), e240203. https://doi.org/10.1136/bcr-2020-240203

Murray P. E. (2018). Platelet-Rich Plasma and Platelet-Rich Fibrin Can Induce Apical Closure More Frequently Than Blood-Clot Revascularization for the Regeneration of Immature Permanent Teeth: A Meta-Analysis of Clinical Efficacy. Frontiers in bioengineering and biotechnology, 6, 139. https://doi.org/10.3389/fbioe.2018.00139

Nagata, J. Y., Gomes, B. P., Rocha Lima, T. F., Murakami, L. S., de Faria, D. E., Campos, G. R., de Souza-Filho, F. J., & Soares, A. (2014). Traumatized immature teeth treated with 2 protocols of pulp revascularization. Journal of endodontics, 40(5), 606–612. https://doi.org/10.1016/j.joen.2014.01.032

Nagaveni, N. B., Poornima, P., Mathew, M. G., Soni, A. J., & Khan, M. M. (2020). A Comparative Evaluation of Revascularization Done in Traumatized Immature, Necrotic Anterior Teeth with and without Platelet-rich Fibrin: A Case Report. International journal of clinical pediatric dentistry, 13(1), 98–102. https://doi.org/10.5005/jp-journals-10005-1738

Neelamurthy, P. S., Kumar, R. A., Balakrishnan, V., Venkatesan, S. M., Narayan, G. S., & I, K. (2018). Revascularization in Immature and Mature Teeth with Necrotic Pulp: A Clinical Study. The journal of contemporary dental practice, 19(11), 1393–1399.

Ostby B. N. (1961). The role of the blood clot in endodontic therapy. An experimental histologic study. Acta odontologica Scandinavica, 19, 324–353.

Petel, R., & Noy, A. F. (2021). Regenerative endodontic treatment of an immature permanent canine - A case report of a 13-year follow-up. Journal of the Indian Society of Pedodontics and Preventive Dentistry, 39(1), 106–109. https://doi.org/10.4103/jisppd.jisppd_1_20

Rafter M. (2005). Apexification: a review. Dental traumatology : official publication of International Association for Dental Traumatology, 21(1), 1–8. https://doi.org/10.1111/j.1600-9657.2004.00284.x

Ramezani, M., Sanaei-Rad, P., & Hajihassani, N. (2020). Revascularization and vital pulp therapy in immature molars with necrotic pulp and irreversible pulpitis: A case report with two-year follow-up. Clinical case reports, 8(1), 206–210. https://doi.org/10.1002/ccr3.2614

Ravikumar, K., Chakravarthy, Y., Kumar, A., Samynathan, M., & Varshini, R. J. (2021). Foreign Body Removal and Revascularization of Teeth with Periapical Radiolucency: 18 Months' Follow-Up. Journal of pharmacy & bioallied sciences, 13(Suppl 1), S886–S889. https://doi.org/10.4103/jpbs.JPBS_536_20

Riaz, S., Azlina, A., Mahmood, Z., & Htun, A. T. (2022). Long-term treatment of dentine with triple antibiotic paste promotes stem cell viability and attachment. Journal of Taibah University Medical Sciences, 17(4), 630–639. https://doi.org/10.1016/j.jtumed.2022.01.007

Rother, E. T. (2007). Revisão sistemática X revisão narrativa. Acta Paulista de Enfermagem, 20(2), v–vi. https://doi.org/10.1590/s0103-21002007000200001

Sheehy, E. C., & Roberts, G. J. (1997). Use of calcium hydroxide for apical barrier formation and healing in non-vital immature permanent teeth: a review. British dental journal, 183(7), 241–246. https://doi.org/10.1038/sj.bdj.4809477

Tanase, S., Tsuchiya, H., Yao, J., Ohmoto, S., Takagi, N., & Yoshida, S. (1998). Reversed-phase ion-pair chromatographic analysis of tetracycline antibiotics. Application to discolored teeth. Journal of chromatography. B, Biomedical sciences and applications, 706(2), 279–285. https://doi.org/10.1016/s0378-4347(97)00563-x

Torabinejad, M., & Turman, M. (2011). Revitalization of tooth with necrotic pulp and open apex by using platelet-rich plasma: a case report. Journal of endodontics, 37(2), 265–268. https://doi.org/10.1016/j.joen.2010.11.004

Ulusoy, A. T., Turedi, I., Cimen, M., & Cehreli, Z. C. (2019). Evaluation of Blood Clot, Platelet-rich Plasma, Platelet-rich Fibrin, and Platelet Pellet as Scaffolds in Regenerative Endodontic Treatment: A Prospective Randomized Trial. Journal of endodontics, 45(5), 560–566. https://doi.org/10.1016/j.joen.2019.02.002

Xie, Z., Shen, Z., Zhan, P., Yang, J., Huang, Q., Huang, S., Chen, L., & Lin, Z. (2021). Functional Dental Pulp Regeneration: Basic Research and Clinical Translation. International journal of molecular sciences, 22(16), 8991. https://doi.org/10.3390/ijms22168991

Published

08/11/2022

How to Cite

SANTOS, P. H. O. dos .; AGUIAR, K. S. .; OGATA, L. I. .; RIBEIRO, A. L. R. . Pulp revascularization as an alternative to apexification therapies commonly applied to young teeth with incomplete roots. Research, Society and Development, [S. l.], v. 11, n. 15, p. e11111536835, 2022. DOI: 10.33448/rsd-v11i15.36835. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/36835. Acesso em: 29 nov. 2024.

Issue

Section

Teaching and Education Sciences