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Ok E, Altunsoy M, Nur BG, Kalkan A. Effectiveness of different irrigation solutions on triple antibiotic paste removal from simulated immature root canal. SCANNING 2015; 37:409-413. [PMID: 26061777 DOI: 10.1002/sca.21229] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 05/21/2015] [Indexed: 06/04/2023]
Abstract
To evaluate the effectiveness of different irrigation solutions and ultrasonic activation of irrigation solutions on removal of triple antibiotic paste (TAP) from root canals of the simulated immature teeth. Fifty single-rooted teeth were used. TAP was placed into each root canal, and specimens were stored in distilled water for 4 weeks at 37°C. After 4 weeks, the temporary coronal seal was removed and the samples were randomly divided into five groups as follows: (i) saline; (ii) ultrasonic activation of saline; (iii) NaOCl; (iv) ultrasonic activation of NaOCl; (v) chlorhexidine digluconate (CHX). The amount of remaining TAP on the canal walls was measured under stereomicroscope with 30× magnification. The data were analyzed using a one-way ANOVA and post-hoc Tukey test at a significance level of 0.05. There were statistically differences among CHX and ultrasonic activation of NaOCl and other groups (p < 0.05). There were no significant differences among the ultrasonic activation of saline, NaOCl, and saline groups (p > 0.05). Irrigation solutions and ultrasonic activation of the irrigation solutions could not completely remove the triple antibiotic paste from simulated immature root canals. Ultrasonic activation of the NaOCl gave the best and CHX was the worst results.
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Affiliation(s)
- Evren Ok
- Department of Endodontics, Faculty of Dentistry, Şifa University, Izmir, Turkey
| | - Mustafa Altunsoy
- Department of Pedodontics, Faculty of Dentistry, Şifa University, Izmir, Turkey
| | - Bilge Gülsüm Nur
- Department of Pedodontics, Faculty of Dentistry, Şifa University, Izmir, Turkey
| | - Abdussamed Kalkan
- Department of Endodontics, Faculty of Dentistry, Şifa University, Izmir, Turkey
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Chalakkal P, Akkara F, Ataide IDND, Pavaskar R. Apicoectomy versus apexification. J Clin Diagn Res 2015; 9:ZD01-3. [PMID: 25859529 DOI: 10.7860/jcdr/2015/10078.5516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 09/09/2014] [Indexed: 11/24/2022]
Abstract
The aim was to evaluate treatment outcomes after apicoectomy and apexification in adjacent non-vital maxillary central incisors with large periapical radiolucencies, in a 10-year-old boy. The patient had complained of tenderness in the upper central incisors on mastication and gave a history of trauma to those teeth three years ago. On examination, there were found to be non-vital. Apexification (using Metapex) and apicoectomy (obturation with gutta percha) were performed on 11 and 21, respectively. Radiographical observations were made six months, one year and two years, post-operatively. Apical repair was found to be more favorable after apicoectomy than apexification, for a non-vital maxillary central incisor with an open apex and large periapical radiolucency.
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Affiliation(s)
- Paul Chalakkal
- Lecturer, Department of Pedodontics & Preventive Dentistry, Goa Dental College & Hospital , Bambolim, Goa, India
| | - Francis Akkara
- Professor, Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital , Bambolim, Goa, India
| | - Ida De Noronha De Ataide
- Professor and Head, Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital , Bambolim, Goa, India
| | - Rajdeep Pavaskar
- Lecturer, Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital , Bambolim, Goa, India
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Ok E, Altunsoy M, Tanriver M, Çapar İD. Effectiveness of different irrigation protocols on calcium hydroxide removal from simulated immature teeth after apexification. ACTA BIOMATERIALIA ODONTOLOGICA SCANDINAVICA 2015. [PMID: 28642893 PMCID: PMC5433195 DOI: 10.3109/23337931.2015.1015132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Aim: To evaluate the effectiveness of different irrigation solutions and ultrasonic activation of the irrigation solutions on the removal of calcium hydroxide (Ca(OH)2) from the simulated immature root canals after apexification. Materials and methods: One-hundred and one single-rooted teeth were used. The root canals were shaped with ProTaper rotary files up to F5. Simulation of roots with immature apices was carried out using size 4 Unicore drills. An injectable Ca(OH)2 was injected into each root canal, and packed to the working length. Then, cotton pellets were placed over canal orifices, and apical and coronal parts of the roots were sealed with resin-modified glass ionomer cement, and light cured. Specimens were stored in distilled water for 3 months at 37°C. After 3 months, the temporary coronal seal was removed and the samples were randomly divided into: (a) saline (n = 20), (b) ultrasonic activation of saline (n = 20), (c) sodium hypochlorite (NaOCl) (n = 20), (d) ultrasonic activation of NaOCl (n = 15), (e) chlorhexidine digluconate (CHX) (n = 20) and one positive control group (n = 3) and one negative control group (n = 3). The amount of remaining Ca(OH)2 on the canal walls was measured under stereomicroscope with 30× magnification. Comparisons between groups were made by the non-parametric Kruskal-Wallis test and Dunn post-test at a significance level of p < 0.05. Results: There were no significant differences among the saline, ultrasonic activation of saline, NaOCl, ultrasonic activation of NaOCl and CHX (p > 0.05) groups. Conclusions: Irrigation solutions and ultrasonic activation of the irrigation solutions could not completely remove Ca(OH)2 from the simulated immature root canals.
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Affiliation(s)
| | - Mustafa Altunsoy
- Department of Pedodontics, Faculty of Dentistry, Sifa UniversityIzmirTurkey
| | - Mehmet Tanriver
- Department of Pedodontics, Faculty of Dentistry, Sifa UniversityIzmirTurkey
| | - İsmail Davut Çapar
- Department of Endodontics, Faculty of Dentistry, İzmir Katip Çelebi UniversityIzmirTurkey
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Güven Polat G, Yıldırım C, Akgün OM, Altun C, Dinçer D, Ozkan CK. The use of platelet rich plasma in the treatment of immature tooth with periapical lesion: a case report. Restor Dent Endod 2014; 39:230-4. [PMID: 25110649 PMCID: PMC4125589 DOI: 10.5395/rde.2014.39.3.230] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 04/23/2014] [Indexed: 01/08/2023] Open
Abstract
This study describes the treatment of an immature permanent tooth with periapical lesion which was treated with regenerative approach using platelet rich plasma (PRP). The root canal of immature human permanent tooth with periapical lesion was gently debrided of necrotic tissue and disinfected with 2.5% NaOCl, and then medicated with triple antibiotic paste comprised of ciprofloxacin, metronidazole, and tetracycline. When the tooth was asymptomatic, PRP and mineral trioxide aggregate (MTA) were placed into the root canal. Six months after PRP treatment, radiographical examination revealed resolution of the radiolucency and progressive thickening of the root wall and apical closure. Our findings suggest that PRP can be used for the treatment of immature permanent teeth with periapical lesion, as part of a regenerative endodontic treatment procedure.
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Affiliation(s)
- Günseli Güven Polat
- Department of Pediatric Dentistry, Center for Dental Sciences, Gulhane Medical Academy, Ankara, Turkey
| | - Ceren Yıldırım
- Department of Pediatric Dentistry, Center for Dental Sciences, Gulhane Medical Academy, Ankara, Turkey
| | - Ozlem Martı Akgün
- Department of Pediatric Dentistry, Center for Dental Sciences, Gulhane Medical Academy, Ankara, Turkey
| | - Ceyhan Altun
- Department of Pediatric Dentistry, Center for Dental Sciences, Gulhane Medical Academy, Ankara, Turkey
| | - Didem Dinçer
- Department of Dermatology, Gulhane Medical Academy, Ankara, Turkey
| | - Cansel Köse Ozkan
- Center for Pharmaceutical Sciences, Gulhane Medical Academy, Ankara, Turkey
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Ghosh S, Mazumdar D, Ray PK, Bhattacharya B. Comparative evaluation of different forms of calcium hydroxide in apexification. Contemp Clin Dent 2014; 5:6-12. [PMID: 24808688 PMCID: PMC4012120 DOI: 10.4103/0976-237x.128652] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: One out of every two children sustains a dental injury most often between 8 and 10 years of age. Majority of these teeth subsequently become non-vital and most often with immature apex. Management of these teeth is an enormous challenge for lack of apical stop. Calcium hydroxide in various formulations has maximum literature support in favor of successful apexification or induced apical closure. Aim: The aim of the following study is to determine the efficacy of calcium hydroxide in a different formulation to induce apexification. Materials and Methods: The present study was undertaken on 51 children of 8-10 years of age (both sexes) at Dr. R Ahmed Dental College and Hospital from April 2006 to March 2007. All children had one or two maxillary permanent central incisor (s), non-vital and apices open. In all the cases, apexification was attempted with either calcium hydroxide mixed with sterile distilled water, or calcium hydroxide plus iodoform in methyl cellulose base, or calcium hydroxide plus iodoform in polysilicone oil base. The success of apexification was determined on the basis of clinical and radiographic criteria. Results: In the pre-operative asymptomatic cases (72.55%), failure occurred in only 5.45% cases and pre-operative symptomatic cases failure rate was as high as 35.71%. Success rate was 94.6% in cases with narrow open apices, whereas 64.28% in wide open apices. In cases with pre-existing apical radiolucencies, successful apexification occurred in 63.63% and success rate was 92.5% in the cases without pre-existing apical radiolucencies. Average time consumed for apexification was minimum with calcium hydroxide plus iodoform in polysilicone oil base. Conclusion: The overall success rate observed to be 86.27%, which is in close proximity to the findings of most of the previous studies across the globe.
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Affiliation(s)
- Subhankar Ghosh
- Department of Pedodontics, North Bengal Dental College and Hospital, Darjeeling, West Bengal, India
| | - Dibyendu Mazumdar
- Department of Dentistry, Kolkata Medical College and Hospital, Kolkata, West Bengal, India
| | - Pradip Kumar Ray
- Department of Dentistry, North Bengal Medical College and Hospital, Darjeeling, West Bengal, India
| | - Bhaswar Bhattacharya
- Department of Dentistry, Mednipur Medical College and Hospital, West Bengal, India
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Tate AR. Calcium hydroxide or mineral trioxide aggregate may be used for the apexification of immature teeth. J Evid Based Dent Pract 2012; 12:24-5. [PMID: 22326154 DOI: 10.1016/j.jebdp.2011.12.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
PURPOSE/QUESTION To compare the efficacy of mineral trioxide aggregate (MTA) and calcium hydroxide (CH) for the root-end induction of immature teeth. SOURCE OF FUNDING Information not available. TYPE OF STUDY/DESIGN Systematic review and meta-analysis of data. LEVEL OF EVIDENCE Level 2: Limited-quality, patient-oriented evidence. STRENGTH OF RECOMMENDATION GRADE Grade B: Limited-quality patient-oriented evidence.
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Affiliation(s)
- Anupama Rao Tate
- Oral Health Advocacy & Research, Department of Oral Health, Children's National Medical Center, 111 Michigan Ave. NW, Washington, DC 20010, USA.
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Tissue Reaction to a Triantibiotic Paste Used for Endodontic Tissue Self-regeneration of Nonvital Immature Permanent Teeth. J Endod 2012; 38:91-4. [DOI: 10.1016/j.joen.2011.09.020] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 09/21/2011] [Accepted: 09/22/2011] [Indexed: 11/21/2022]
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Yassen GH, Chin J, Mohammedsharif AG, Alsoufy SS, Othman SS, Eckert G. The effect of frequency of calcium hydroxide dressing change and various pre- and inter-operative factors on the endodontic treatment of traumatized immature permanent incisors. Dent Traumatol 2011; 28:296-301. [DOI: 10.1111/j.1600-9657.2011.01089.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Kahler B. Endodontic retreatment of maxillary incisors previously treated with a conventional apexification protocol: A case report. AUST ENDOD J 2011; 37:31-5. [DOI: 10.1111/j.1747-4477.2011.00294.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Retrospective Analysis of Open Apex Teeth Obturated with Mineral Trioxide Aggregate. J Endod 2008; 34:1171-6. [DOI: 10.1016/j.joen.2008.07.005] [Citation(s) in RCA: 133] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2008] [Revised: 06/25/2008] [Accepted: 07/01/2008] [Indexed: 11/23/2022]
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Abstract
This paper reviews the rationale and techniques for treatment of the non-vital immature tooth. The importance of careful case assessment and accurate pulpal diagnosis in the treatment of immature teeth with pulpal injury cannot be overemphasized. The treatment of choice for necrotic teeth is apexification, which is induction of apical closure to produce more favorable conditions for conventional root canal filling. The most commonly advocated medicament is calcium hydroxide, although recently considerable interest has been expressed in the use of mineral trioxide aggregate. Introduction of techniques for one-visit apexification provide an alternative treatment option in these cases. Success rates for calcium hydroxide apexification are high although risks such as reinfection and tooth fracture exist. Prospective clinical trials comparing this and one-visit apexification techniques are required.
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Affiliation(s)
- Mary Rafter
- University of Michigan School of Dentistry, Ann Arbor, MI 48109-1078, USA.
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Duprez JP, Bouvier D, Bittar E. Infected immature teeth treated with surgical endodontic treatment and root-reinforcing technique with glass ionomer cement. Dent Traumatol 2004; 20:233-40. [PMID: 15245524 DOI: 10.1111/j.1600-9657.2004.00241.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The authors propose surgical endodontic treatment of immature teeth characterized by necrosis and infection, especially after failure of apexification or in the presence of older, fibrous, and extensive lesion. A glass ionomer cement, autopolymerizable and condensable, is used as retro-filling material and as a reinforcement material for the canal walls. The variety of different cases presented here show that this rapid technique is reliable and reproducible.
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Affiliation(s)
- Jean-Pierre Duprez
- Department of Pediatric Dentistry, Faculty of Odontology, University Claude Bernard Lyon I, France
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Steinig TH, Regan JD, Gutmann JL. The use and predictable placement of Mineral Trioxide Aggregate in one-visit apexification cases. AUST ENDOD J 2003; 29:34-42. [PMID: 12772971 DOI: 10.1111/j.1747-4477.2003.tb00496.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Endodontic treatment of the pulpless tooth with an immature root apex poses a special challenge for the clinician. The main difficulty encountered is the lack of an apical stop against which to compact an interim dressing of calcium hydroxide (Ca(OH)2), or the final obturation material. In these situations the unpredictability of the result, the difficulty in creating a leak-proof temporary restoration for the duration of treatment, and the difficulty in protecting the thin root from fracture may lead to complications when using traditional (Ca(OH)2-based) apexification techniques. Furthermore, given the increased mobility of today's society, lengthy treatment protocols are fraught with problems, and may not be followed through to completion. This may lead to ultimate failure of the case. Mineral Trioxide Aggregate (MTA) has recently been introduced for use in endodontics. Current literature supports its efficacy in a multitude of procedures including apexification. The focus of this paper is to propose a one-visit apexification protocol with MTA as an alternative to the traditional treatment practices with Ca(OH)2. One-visit apexification may shorten the treatment time between the patient's first appointment and the final restoration. The importance of this approach lies in the expedient cleaning and shaping of the root canal system, followed by its apical seal with a material that favours regeneration. Furthermore, the potential for fractures of immature teeth with thin roots is reduced, as a bonded core can be placed immediately within the root canal.
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Affiliation(s)
- Torsten H Steinig
- Department of Endodontics, Texas A&M University System Health Science Center, Baylor College of Dentistry, Dallas, TX 75246, USA.
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