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Hu X, Wang Q, Ma C, Li Q, Zhao C, Xiang K. Is Etiology a Key Factor for Regenerative Endodontic Treatment Outcomes? J Endod 2023:S0099-2399(23)00293-5. [PMID: 37285935 DOI: 10.1016/j.joen.2023.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/29/2023] [Accepted: 05/29/2023] [Indexed: 06/09/2023]
Abstract
INTRODUCTION This study aimed to evaluate treatment outcomes of regenerative endodontic treatment (RET) in nonvital immature permanent teeth due to developmental malformation and trauma, and to analyze the influence of etiology on the prognosis. METHODS Fifty-five cases were included and divided into a malformation group (n=33) and a trauma group (n=22). Treatment outcomes were classified as healed, healing and failure. Root development was evaluated in terms of root morphology and the percentage changes in root length, root width and apical diameter during a follow-up period of 12 to 85 months (mean 30.8 months). RESULTS The mean age and the mean degree of root development in the trauma group were significantly younger than that in the malformation group. The success rate of RET was 93.9% (81.8% healed, 12.1% healing) in the malformation group and 90.9% (68.2% healed, 22.7% healing) in the trauma group, showing no statistically significant difference. The proportion of type I-III root morphology in the malformation group (97%, 32/33) was significantly higher than that in the trauma group (77.3%, 17/22) (P<0.05), whereas there was no significant difference in the percentage changes of root length, root width and apical diameter between the two groups. Six cases (6/55, 10.9%) showed no significant root development (type IV-V) (1 in the malformation group and 5 in the trauma group). Six cases (6/55, 10.9%) revealed intracanal calcification. CONCLUSIONS RET achieved reliable outcomes regarding the healing of apical periodontitis and continued root development. The etiology seems to influence the outcome of RET. Malformation cases presented with a better prognosis than trauma cases after RET.
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Affiliation(s)
- Xiaoyan Hu
- Stomatologic Hospital & College, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China.
| | - Qingtong Wang
- Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Collaborative Innovation Center of Anti-inflammatory and Immune Medicine, Hefei, 230032, China
| | - Chenxue Ma
- Stomatologic Hospital & College, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
| | - Quanli Li
- Stomatologic Hospital & College, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
| | - Chunhui Zhao
- Stomatologic Hospital & College, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
| | - Kun Xiang
- Stomatologic Hospital & College, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
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Evaluation of the Effectiveness of Laser-Assisted Bleaching of the Teeth Discolored due to Regenerative Endodontic Treatment. Int J Dent 2022; 2022:3589609. [PMID: 35847349 PMCID: PMC9279097 DOI: 10.1155/2022/3589609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/04/2022] [Accepted: 06/20/2022] [Indexed: 11/18/2022] Open
Abstract
Regenerative endodontic treatments (RETs) as a valuable treatment option to save the immature necrotic teeth, have been reported to be associated with discoloration which is an inevitable unfavorable outcome. The present study aimed to compare three laser-assisted protocols with conventional walking bleaching in terms of bleaching efficacy. Seventy-two human incisor teeth underwent regenerative treatment. A triple antibiotic paste containing minocycline, ciprofloxacin, and metronidazole was used as an intracanal medicament. A human blood clot was applied as a scaffold and capped by a hydraulic calcium silicate-based cement. Ten weeks after the RET procedure, a four-session bleaching course started. Teeth were assigned to four groups: (1) 35% hydrogen peroxide gel, (2) 35% hydrogen peroxide gel + Nd: YAG laser, (3) 35% hydrogen peroxide gel + 980 nm diode laser, and (4) 35% hydrogen peroxide gel + 810 nm diode laser. The color changes (ΔE) were measured before and after bleaching sessions. The data were analyzed using Kruskal-Wallis nonparametric test. The statistical significance level was set at 0.05. Significant discoloration, exceeding the perceptibility threshold (ΔE > 3.7) was observed in all of the samples ten weeks after RET. There was no significant difference between groups in terms of RET-induced discoloration values (p > 0.05). Bleaching either by using 35% hydrogen peroxide or 35% hydrogen peroxide activated by different lasers used in this study resulted in significant tooth whitening (p < 0.05). There was no statistically significant difference among the groups in terms of bleaching efficacy (p > 0.05). Internal bleaching by using 35% hydrogen peroxide is as effective as laser-assisted protocols for correction of crown discoloration in teeth that have undergone RET.
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Almutairi W, Al-Dahman Y, Alnassar F, Albalawi O. Intracanal calcification following regenerative endodontic treatment: a systematic review and meta-analysis. Clin Oral Investig 2022; 26:3333-3342. [PMID: 35243550 DOI: 10.1007/s00784-021-04333-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 12/01/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Calcification is a common finding in endodontic cases after regenerative endodontic therapy (RET). We aimed to identify the prevalence of intracanal calcification after RET and to compare intracanal calcification outcomes in RET using either calcium hydroxide [Ca(OH)2] or antibiotics. MATERIALS AND METHODS We searched PubMed, Web of Science, ProQuest Dissertations & Theses, and Scopus databases for clinical, cross-sectional, case-control, and cohort RET studies published until May 2020 in the English language and reporting a calcified case after RET. The Cochrane risk-of-bias tool for randomized trials and Risk of Bias In Non-randomized Studies of Interventions were used for bias assessment. Meta-analyses were performed, overall and separately, for intracanal medicaments using a random-effects model with weighted inverse variance methods. Subgroup analysis was performed according to the calcification type. RESULTS Eight studies were included. The overall prevalence of intracanal calcification after RET was 30.7% (95% confidence interval [CI]: 0.15-0.45,[Formula: see text]=92.6%), 46.5% with Ca(OH)2 vs. 25.8% with antibiotic-based intracanal medicaments. Subgroup analyses for complete calcification outcome showed a higher prevalence of complete calcification in the Ca(OH)2 group (46.5%, 95% CI: 0.17-0.68,[Formula: see text]%) than in the antibiotic group (10%, 95% CI: - 0.04-0.43,[Formula: see text]%). CONCLUSIONS Based on the studies included, available evidence shows a statistically significant association between complete calcification and Ca(OH)2 paste as an intracanal medicament. Other contributing factors, such as blood clot formation and follow-up time, might also play an essential role in forming intracanal calcification. CLINICAL RELEVANCE This study highlights the significant association between complete calcification and Ca(OH)2 paste.
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Affiliation(s)
- Waleed Almutairi
- Department of Endodontics, College of Dentistry, Qassim University, Qassim, P. O. Box: 1162, Saudi Arabia.
| | - Yousef Al-Dahman
- Department of Endodontics, Eastern Riyadh Dental Center, Second Health Cluster in Riyadh, Ministry of Health, Riyadh, Saudi Arabia
| | - Faisal Alnassar
- Department of Restorative Dental Sciences, College of Dentistry, Majmaah University, Al Majmaah, Saudi Arabia
| | - Olayan Albalawi
- Department of Statistic, Faculty of Science, Tabuk University, Tabuk, Saudi Arabia
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Markandey S, Das Adhikari H. Evaluation of blood clot, platelet-rich plasma, and platelet-rich fibrin–mediated regenerative endodontic procedures in teeth with periapical pathology: a CBCT study. Restor Dent Endod 2022; 47:e41. [DOI: 10.5395/rde.2022.47.e41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/19/2021] [Accepted: 01/03/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Swati Markandey
- Department of Conservative Dentistry and Endodontics, Dr. R. Ahmed Dental College and Hospital, Kolkata, India
| | - Haridas Das Adhikari
- Department of Conservative Dentistry and Endodontics, Dr. R. Ahmed Dental College and Hospital, Kolkata, India
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Srisuwan T, Srisathian A. Improvement of apical papilla cell attachment after erbium, chromium-doped yttrium, scandium, gallium, and garnet laser application: a study in an ex vivo immature tooth model. Lasers Med Sci 2021; 37:1167-1174. [PMID: 34227042 DOI: 10.1007/s10103-021-03368-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/28/2021] [Indexed: 10/20/2022]
Abstract
The purposes of this study were (1) to investigate the direct effect of an Er,Cr:YSGG laser on human apical papilla cell (APC) proliferation and mineralization and (2) to examine the effect of Er,Cr:YSGG laser, when applied to an ex vivo immature tooth model, on APC attachment. An Er,Cr:YSGG laser at various power outputs (0.1, 0.5, and 1 W) was used at different positions (2, 5, or 8 mm from the cells) to irradiate cultured APCs. APC proliferation and mineralization were assessed at various intervals. For the cell attachment evaluation, ex vivo tooth models containing dentin samples were irrigated with either EDTA or normal saline solution (NSS) and supplemented with laser activation. Fibronectin-positive-staining cells were counted and analyzed. The number of APCs was significantly greater when power outputs of 0.1 W and 0.5 W were used than when 1 W was used (P < 0.05). The close contact of laser application, at 2 and 5 mm, exerted a negative effect on cell proliferation at 24 and 48 h. The application at 8 mm did not show the deterioration effect. APC mineralization was reduced after laser irradiation, regardless of the power and the tip positioning, at 21 days. APC attachment in all laser-activated groups was significantly greater than in the groups without laser. The use of Er,Cr:YSGG laser significantly promoted APC attachment on the root canal dentin.
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Affiliation(s)
- Tanida Srisuwan
- Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Suthep Road, Muang, 50200, Chiang Mai, Thailand.
| | - Apichaya Srisathian
- McCormick Hospital, 133 Kaew-nawarat Road, Muang, 50000, Chiang Mai, Thailand
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Fagogeni I, Falgowski T, Metlerska J, Lipski M, Górski M, Nowicka A. Efficiency of Teeth Bleaching after Regenerative Endodontic Treatment: A Systematic Review. J Clin Med 2021; 10:jcm10020316. [PMID: 33467092 PMCID: PMC7829849 DOI: 10.3390/jcm10020316] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/11/2020] [Accepted: 01/13/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this review is to evaluate of effectiveness of bleaching procedures used to treat discolored teeth subsequent to regenerative endodontic procedures (REPs) based on the review of in vitro and in vivo studies. This literature review was carried out according to the PRISMA guidelines. Four databases (PubMed, Scopus, the Cochrane Library, and Web of Science databases) were searched electronically, until 30 January 2020 without a year limit. The quality of studies was assessed using a modified methodological index for non-randomized studies. After analyzing 1405 studies, 6 in vitro and 9 in vivo studies were eligible for this review. In in vitro studies, effectiveness of bleaching was assessed in teeth discolored by antibiotic pastes, blood, and barrier materials in various combinations. In all analyzed studies, bleaching was effective in teeth discolored by antibiotic pastes as well as by blood and barrier materials. Of 26 treated teeth in the in vivo studies, 17 teeth were bleached successfully. In six cases, there was improvement of the shade. In three cases, bleaching was not sufficient. Bleaching material, techniques, and times differed between studies. Whitening of discolored teeth after REPs is achievable. However, to establish precise guidelines, further long-term clinical studies should be performed.
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Affiliation(s)
- Irini Fagogeni
- Doctoral Studies of the Faculty of Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland; (I.F.); (J.M.)
| | - Tomasz Falgowski
- General, Minimally Invasive and Gastrointestinal Surgery Department, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
| | - Joanna Metlerska
- Doctoral Studies of the Faculty of Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland; (I.F.); (J.M.)
| | - Mariusz Lipski
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
| | - Maciej Górski
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
| | - Alicja Nowicka
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
- Correspondence: ; Tel.: +48-91-466-16-48
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Ong TK, Lim GS, Singh M, Fial AV. Quantitative Assessment of Root Development after Regenerative Endodontic Therapy: A Systematic Review and Meta-Analysis. J Endod 2020; 46:1856-1866.e2. [DOI: 10.1016/j.joen.2020.08.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/07/2020] [Accepted: 08/13/2020] [Indexed: 12/15/2022]
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Maniglia-Ferreira C, Gurgel Filho ED, Gomes FDA, Reis SA, Pappen FG. 12-Year Follow-Up of Regenerative Endodontic Treatment of Immature Permanent Upper Incisors with Acute Abscess. Braz Dent J 2020; 31:680-684. [PMID: 33237241 DOI: 10.1590/0103-6440202003663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/23/2020] [Indexed: 11/21/2022] Open
Abstract
This case report discusses the endodontic treatment of a 7-year-old girl who suffered trauma (intrusion) to the immature upper central incisors secondary to a fall from a bicycle. Thirty days after the accident the patient was brought by her mother for clinical and radiographic assessment with a chief complaint of swelling and tenderness to percussion and palpation. Acute apical abscess associated with immature teeth were diagnosed. A decision was made to perform regenerative endodontic treatment. Access cavities were made and the root canals were disinfected by irrigation with 2.5% sodium hypochlorite. Final irrigation was performed with 17% EDTA. Due to pain and presence of secretions, 2% chlorhexidine gel was applied as an intracanal medicament. Seven days later, at the second visit, the root canals were once again disinfected and the canals of the right and left permanent upper central incisors were filled with double antibiotic paste (metronidazole/ciprofloxacin) and calcium hydroxide paste, respectively. Zinc oxide was mixed in both pastes. At the third visit, after 21 more days, the pastes were removed and the periapical areas were stimulated with a #80 K-file to encourage clot formation within the pulp cavities. A mineral trioxide aggregate (MTA) paste cervical plug was placed and the teeth were restored with glass ionomer cement. Radiographs and CBCT scans demonstrated complete root formations. The patient has been followed for 12 years, with evidence of clinical success throughout.
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Affiliation(s)
- Claudio Maniglia-Ferreira
- Department of Endodontics, School of Dentistry, UNIFOR - Universidade de Fortaleza, Fortaleza, CE, Brazil
| | - Eduardo Diogo Gurgel Filho
- Department of Endodontics, School of Dentistry, UNIFOR - Universidade de Fortaleza, Fortaleza, CE, Brazil
| | - Fabio de Almeida Gomes
- Department of Endodontics, School of Dentistry, UNIFOR - Universidade de Fortaleza, Fortaleza, CE, Brazil
| | - Sthefanny Amaral Reis
- Department of Endodontics, School of Dentistry, UNIFOR - Universidade de Fortaleza, Fortaleza, CE, Brazil
| | - Fernanda Geraldo Pappen
- Department of Semiology and Clinics, Diagnostic Center for Oral Diseases, School of Dentistry, UFPEL - Universidade Federal de Pelotas, Pelotas, RS, Brazil
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Effects of cold atmospheric pressure plasma jet on human apical papilla cell proliferation, mineralization, and attachment. Clin Oral Investig 2020; 25:3275-3283. [PMID: 33104928 DOI: 10.1007/s00784-020-03659-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/22/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To investigate the direct effects of cold atmospheric pressure plasma jet on cell proliferation and mineralization on human apical papilla cells and its indirect effect on cell attachment on plasma-treated dentin. MATERIALS AND METHODS Plasma was directly applied to cell culture for various durations. Cell proliferation was evaluated using AlamarBlue® assay. Mineralization was assessed using Alizarin Red S staining after 14 and 21 days. The cell attachment to plasma-treated dentin surface was evaluated using an ex vivo immature tooth model, and the protocols varied based on root canal irrigants (NSS or 17% EDTA), the durations of plasma application (0, 30, or 60 s), and the different positions of the plasma needle (coronal or middle). The attached cells were visualized using the immunofluorescence staining and the positive-staining cells were counted. RESULTS There was no difference in the cell proliferation between the untreated and plasma-treated cells. However, the plasma-treated cells tended to have lower levels of calcium deposition, especially after the 60-s plasma application (p < 0.05). Finally, significantly greater numbers of attached cells were shown when NSS was combined with plasma treatment when compared to the untreated cells (p < 0.05), whereas no difference was observed when EDTA was used as the irrigant. CONCLUSIONS Plasma might disturb the mineralization of the cells. Interestingly, the dentin conditioning process using a plasma jet with NSS irrigation may enhance cell attachment. CLINICAL RELEVANCE Cold atmospheric pressure plasma jet may be an alternative treatment in regenerative endodontic procedures in order to improve cell attachment in the root canal system.
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Berlin-Broner Y, Levin L. Retrospective evaluation of endodontic case reports published in the International Endodontic Journal and the Journal of Endodontics for their compliance with the PRICE 2020 guidelines. Int Endod J 2020; 54:210-219. [PMID: 32961626 DOI: 10.1111/iej.13415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/15/2020] [Indexed: 01/25/2023]
Abstract
AIM To evaluate, retrospectively, the quality of previously published case reports in Endodontics according to the PRICE 2020 guidelines. METHODOLOGY An electronic literature search was conducted in PubMed database on 12 March 2020, to identify case reports published during the last five years in the International Endodontic Journal and the Journal of Endodontics. For each of the included case reports, information regarding fulfilment of each of the items of the PRICE 2020 guidelines was extracted as '0' (not present in the manuscript), '1' (present in the manuscript) and 'NA' (not applicable) and translated into a score (percentage of items fulfilled). Additionally, the percentage of papers fulfilling each item was calculated. RESULTS Overall, 70 endodontic case reports were identified. The scores of the papers ranged between 56.41% and 79.55%, with a mean score of 70.26 ± 4.36% (SD). The percentage of papers fulfilling each item of the applicable PRICE 2020 items ranged widely, between 0% and 100%. The median of the percentage of all the items (n = 47) was 97.01% and mean 73.33 ± 36.28% (SD). The lowest scores were recorded for specific items in the following domains: 'Case Report Information'-Items 6c, 6g-i, 'Patient Perspective'-Item 8a and 'Quality of Images'-Items 12c-d. CONCLUSIONS Several areas with low reporting rates were identified in case reports published over the last 5 years in Endodontics. Authors should be encouraged to follow the PRICE 2020 guidelines in order to increase the quality and improve reproducibility of their case reports.
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Affiliation(s)
- Y Berlin-Broner
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - L Levin
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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Wattanapakkavong K, Srisuwan T. Release of Transforming Growth Factor Beta 1 from Human Tooth Dentin after Application of Either ProRoot MTA or Biodentine as a Coronal Barrier. J Endod 2019; 45:701-705. [DOI: 10.1016/j.joen.2019.03.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/08/2019] [Accepted: 03/16/2019] [Indexed: 12/28/2022]
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Ulusoy AT, Turedi I, Cimen M, Cehreli ZC. Evaluation of Blood Clot, Platelet-rich Plasma, Platelet-rich Fibrin, and Platelet Pellet as Scaffolds in Regenerative Endodontic Treatment: A Prospective Randomized Trial. J Endod 2019; 45:560-566. [PMID: 30935618 DOI: 10.1016/j.joen.2019.02.002] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 01/28/2019] [Accepted: 02/01/2019] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Regenerative endodontic procedures (REPs) using autologous platelet concentrates as scaffolds can improve the biologic outcome of treatment. This prospective, randomized trial compared the clinical and radiographic performance of REPs using platelet-rich plasma (PRP), platelet-rich fibrin (PRF), a platelet pellet (PP), and an induced blot clot (BC). METHODS Sixty-seven healthy children (aged 8-11 years) with 88 immature necrotic incisors were included. After the root canal disinfection step, the teeth were randomly assigned into 1 of the following groups (n = 22/group) according to the scaffold used: PRP, PRF, PP, and BC. In the PRP, PRF, and PP groups, the platelet concentrates were introduced into the root canal without prior induction of apical bleeding. Treatment outcomes were assessed using a combined clinical and radiographic scoring system, whereas the changes in root dimensions were compared using linear measurements of root length and width with ImageJ (National Institutes of Health, Bethesda, MD) and Turboreg (Biomedical Imaging Group, Swiss Federal Institute of Technology, Lausanne, Switzerland) and planar measurements using the radiographic root area (RRA) and radiographic canal area (RCA) techniques. One-way analysis of variance, the Duncan multiple range test, the Kruskal-Wallis test, the Mann-Whitney U test, and chi-square dependency tests were used for statistical analysis of data (all P = .05). RESULTS Except for 2 teeth in the PRF and BC groups, all teeth showed similar and high success scores (periapical healing, radiographic root development, and positive response to sensitivity tests) after an average follow-up time of 28.25 ± 1.2 months. Of all teeth, 73.9% showed complete apical closure with similar closure rates among groups (P > .05) and a greater tendency for conical-shaped apical closure than a blunt apex. Although linear measurements indicated a similar increase in root length and width among all groups (P > .05), the RRA of the BC group was significantly greater than those of the PRF and PP groups, and the RCA of the BC group was significantly greater than PRP, PRF, and PP (all P < .05) when the follow-up time was not used as a factor. Eighty-six percent of the teeth showed a positive response to sensitivity tests with similar initial response times (P > .05). CONCLUSIONS PRP, PRF, and PP can yield similar clinical and radiographic outcomes to BC without the need for prior apical bleeding and with significantly less tendency for root canal obliteration. RRA and RCA may reveal minor differences that cannot be determined by linear measurements.
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Affiliation(s)
- Ayca Tuba Ulusoy
- Department of Pediatric Dentistry, Ondokuz Mayis Univesity, Faculty of Dentistry, Samsun, Turkey.
| | - Irem Turedi
- Rize Oral and Dental Health Center, Rize, Turkey
| | - Muge Cimen
- Department of Pediatric Dentistry, Istanbul Okan University, Faculty of Dentistry, Istanbul, Turkey
| | - Zafer C Cehreli
- Department of Pediatric Dentistry, Hacettepe Univesity, Faculty of Dentistry, Ankara, Turkey; Department of Pediatric Dentistry, Louisiana State University Health Sciences Center, New Orleans, Louisiana
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