Pulp Revascularization: A treatment alternative for immature teeth with pulpal necrosis
DOI:
https://doi.org/10.33448/rsd-v13i10.47237Keywords:
Regenerative endodontics; Dental pulp necrosis; Dental pulp.Abstract
Introduction: The treatment of teeth with pulpal necrosis and incomplete root development presents a challenge in endodontic practice due to the fragility of the root walls and open apices. Techniques such as apexogenesis, apicoectomy, and pulp regeneration are treatment options for teeth with incomplete root development and pulp alterations, with pulp regeneration being a promising alternative. Objective: This study aims to evaluate the current knowledge on pulp revascularization and its success in endodontic practice. Methodology: A literature review was conducted by searching for studies in the following databases: PubMed, SciELO, Virtual Health Library (VHL), and ScienceDirect. The search included articles in English and Portuguese published between 2018 and 2024. Inclusion criteria consisted of case reports, clinical research, experimental research articles, and literature reviews available in full text. Exclusion criteria included abstracts, conference proceedings, dissertations, monographs, theses, and books that were not relevant to the topic. Results: After applying the criteria, 15 articles were selected for the study, with most of the included articles presenting a comparison between apicoectomy and pulp revascularization. Conclusion: It can be concluded that this treatment is viable in cases of incomplete root development; however, further studies are needed to standardize a single protocol to achieve effective clinical outcomes.
References
AAE. (2017). Clinical Considerations for a Regenerative Procedure Revised 6-8-16. https://www.aae.org/specialty/wp-content/uploads/sites/2/2017/06/currentregenerativeendodonticconsiderations.pdf.
AAE. (2021). Clinical Considerations for a Regenerative Procedure Revised 5/18/2021. https://www.aae.org/specialty/wp-content/uploads/sites/2/2021/08/ClinicalConsiderationsApprovedByREC062921.pdf.
Casarin, S. T. et al. (2020). Tipos de revisão de literatura: considerações das editoras do Journal of Nursing and Health. Journal of Nursing and Health. 10 (5). DOI: https://doi.org/10.15210/jonah.v10i5.19924.
Chrepa, V., Joon, R., Austah, O., Diogenes, A., Hargreaves, K. M., Ezeldeen, M. & Ruparel, N. B. (2020). Clinical outcomes of immature teeth treated with regenerative endodontic procedures—a San Antonio study. Journal of endodontics. 46 (8), 1074-84. https://doi.org/10.1016/j.joen.2020.04.008
Elfrink, M. E. C., Heijdra, J. S. C., Krikken, J. B., Kouwenberg-Bruring, W. H., Kouwenberg, H., Weerheijm, K. L., & Veerkamp, J. S. J. (2021). Regenerative endodontic therapy: a follow-up of 47 anterior traumatised teeth. European Archives of Paediatric Dentistry, 22, 469-477. https://doi.org/10.1007/s40368-020-00584-0
Gill, I., Mittal, S., Kumar, T., & Keshav, V. (2024). Open Apex and its Management. Journal of Pharmacy and Bioallied Sciences, 16(Suppl 1), S31-S34. https://doi.org/10.4103/jpbs.jpbs_615_23
Guerrero, F., Mendoza, A., Ribas, D., & Aspiazu, K. (2018). Apexification: A systematic review. Journal of Conservative Dentistry, 21(5), 462-465. https://doi.org/10.4103/JCD.JCD_96_18
Kim, S. G., Malek, M., Sigurdsson, A., Lin, L. M., & Kahler, B. (2018). Regenerative endodontics: a comprehensive review. International endodontic journal, 51(12), 1367–1388. https://doi.org/10.1111/iej.12954
Marques, I. V. et al. (2019). Estudo retrospectivo dos procedimentos clínicos e radiográficos em dentes traumatizados submetidos à apicificação. Dent. press endod, p. 29-35, 2019.
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. 11 (6), 139. Doi: 10.3389/fbioe.2018.00139.
Murray P. E. (2023). Review of guidance for the selection of regenerative endodontics, apexogenesis, apexification, pulpotomy, and other endodontic treatments for immature permanent teeth. International endodontic journal, 56 Suppl 2, 188–199. https://doi.org/10.1111/iej.13809
Ostby, B. N. (1961). The role of the blood clot in endodontic therapy. An experimental histologic study. Acta odontologica Scandinavica, 19, 324–353.
Pereira, A. C., Oliveira, M. L., Cerqueira-Neto, A. C. C. L., Gomes, B. P. F. A., Ferraz, C. C. R., Almeida, J. F. A., Marciano, M. A., & DE-Jesus-Soares, A. (2020). Treatment outcomes of pulp revascularization in traumatized immature teeth using calcium hydroxide and 2% chlorhexidine gel as intracanal medication. Journal of applied oral science: revista FOB, 28, e20200217. https://doi.org/10.1590/1678-7757-2020-0217
Pereira A. S. et al. (2018). Metodologia da pesquisa científica. [free e-book]. Santa Maria/RS. Ed. UAB/NTE/UFSM.
Priya B, L., Singh, N., Mangalam, K. K., Sachdev, R., P, A., Jain, H. N., & Nagi, P. K. (2023). Success and Complication Rates of Revascularization Procedures for Immature Necrotic Teeth: A Systematic Review. Cureus, 15(12), e51364. https://doi.org/10.7759/cureus.51364
Rother, E. T. (2007). Revisão sistemática x revisão narrativa. Acta Paulo. Enferm. 20(2), DOI.org/10.1590/S0103-21002007000200001.
Sales, S. Q., Silva, L. F. D. M., Evangelista, I. R. D. S., Santana, D. O., & Braitt, A. H. (2022). Revascularização pulpar, uma nova opção na terapêutica endodôntica: revisão da literatura e caso clínico em paciente adulto. Rev. Odontol. Araçatuba (Impr.), 40-47.
Santos, C. et al. (2007). The PICO strategy for the research question construction and evidence search. Revista latino-americana de enfermagem, 15, 508-511.
Shaik, I., Dasari, B., Kolichala, R., Doos, M., Qadri, F., Arokiyasamy, J. L., & Tiwari, R. V. C. (2021). Comparison of the Success Rate of Mineral Trioxide Aggregate, Endosequence Bioceramic Root Repair Material, and Calcium Hydroxide for Apexification of Immature Permanent Teeth: Systematic Review and Meta-Analysis. Journal of pharmacy & bioallied sciences, 13(Suppl 1), S43–S47. https://doi.org/10.4103/jpbs.JPBS_810_20
Vicente, C. A. B., Silva, J. P., Araújo, C. P., & Leite, M. F. (2019). Traumatismo em dente com rizogênese incompleta: caso clínico. Rev. Odontol. Araçatuba (Impr.), 9-13.
Wikström, A., Brundin, M., Romani Vestman, N., Rakhimova, O., & Tsilingaridis, G. (2022). Endodontic pulp revitalization in traumatized necrotic immature permanent incisors: Early failures and long-term outcomes-A longitudinal cohort study. International endodontic journal, 55(6), 630–645. https://doi.org/10.1111/iej.13735
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
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Copyright (c) 2024 Bianca Louise Pinheiro de Carvalho; Isabella Vitória Silva da Rocha; Helton Diego Dantas Linhares ; Giselle Maria Ferreira Lima Verde ; Marcílio Oliveira Melo

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