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Almutairi N. Pulpotomy of mature teeth: A systematic analysis of the failed cases. Saudi Dent J 2024; 36:509-515. [PMID: 38690395 PMCID: PMC11056412 DOI: 10.1016/j.sdentj.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/31/2023] [Accepted: 01/02/2024] [Indexed: 05/02/2024] Open
Abstract
Pulp therapy aims to maintain the health and integrity of teeth and their supporting tissue and preserve the vitality of the tooth pulp affected by dentinal caries or severe traumatic injury. Thus, the best clinical practice provides pulpal health or pathosis diagnosis and various therapeutic interventions evidenced in both the deciduous and permanent dentition for endodontic treatment. The pulp health status determines the type of pulpal therapy used. Vital pulp therapies for primary teeth include protective liners, pulp capping, and pulpotomy for reversible pulpitis; for permanent teeth, pulpotomy can be considered for irreversible pulpitis. For reversible or irreversible pulpitis, invasive management of decayed teeth has traditionally been performed. However, at present, coronal pulpotomy-like vital pulp therapy has led to successful treatment outcomes that are less invasive. Compared to root canal treatments, coronal pulpotomy is cost-effective, less time-consuming, and less technically demanding. The success of a pulpotomy depends on the clinician's experience, appropriate clinical techniques, and materials used. This narrative review provides insights into the systematic analysis of pulpotomy failure, causes and signs of failure, and alternative endodontic interventions.
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Affiliation(s)
- Nawaf Almutairi
- Conservative Dental Science Department, College of Dentistry, Qassim University, Qassim, Saudi Arabia
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Alharbi TM, Thabet AM, Alabbadi SH, Alhazmi MY, Khan HF, AlRasheed MA, Al-Twalbeh NA, Alsuhaim AS, Alqahtani NS. Unlocking the Potential of Cellular Guidance in Endodontics: Advancing the Process of Pulp Regeneration and Beyond. Cureus 2024; 16:e51651. [PMID: 38318576 PMCID: PMC10839349 DOI: 10.7759/cureus.51651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2024] [Indexed: 02/07/2024] Open
Abstract
Regenerative endodontics represents a paradigm shift in dental therapy, with the potential to not only restore damaged dental tissues but also to preserve the vitality of teeth. At the heart of this innovative approach is cell homing, a technique that harnesses the body's own healing mechanisms by recruiting endogenous stem cells to the site of dental injury for effective tissue regeneration. This review delves into the intricate processes of cell homing in the context of regenerative endodontics, particularly focusing on its application in immature teeth with open apices. It examines the role of bioactive molecules, scaffolds, and growth factors in orchestrating cell migration and differentiation within the root canal space. In addition, the review addresses the current limitations in clinical practice, such as the challenges in completely regenerating the pulp-dentin complex and the unpredictability in long-term outcomes. It also explores future possibilities, including the potential for more refined and effective regenerative strategies. By providing a comprehensive overview of the current state of cell homing in regenerative endodontics, this article aims to contribute to the ongoing development of advanced therapeutic techniques that could revolutionize endodontic treatment and improve patient care.
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Affiliation(s)
- Tariq M Alharbi
- Endodontics, King Fahad General Hospital, Medina, SAU
- Endodontics, Speciality Dental Center, Medina, SAU
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Lewis NV, Aggarwal S. Static Guided Endodontic Approach for Pulp Canal Obliteration: A Case Report. Cureus 2023; 15:e42379. [PMID: 37621785 PMCID: PMC10445664 DOI: 10.7759/cureus.42379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
Traumatic injuries to the permanent dentition have deleterious sequelae if not treated adequately. In luxation injuries, it has been observed that tertiary dentin apposition may occur and can lead to calcification and closure of the pulp space. This is commonly referred to as pulp canal calcification or pulp canal obliteration. This often presents a challenge to clinicians when endodontic treatment is indicated. Static guided endodontic therapy has been advocated in such cases and has been successfully employed as a treatment strategy in recent years. This involves the design and fabrication of a digital stent, which serves as a guide for the clinician and provides a straight path to the targeted tissue site. This article reports a case of pulp canal obliteration secondary to a luxation injury sustained due to a vehicular accident. The case was treated using the static guided endodontic approach to achieve a minimal direct access to the targeted pulp chamber space.
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Affiliation(s)
- Neil V Lewis
- Conservative Dentistry and Endodontics, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, IND
| | - Shalini Aggarwal
- Conservative Dentistry and Endodontics, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, IND
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Parashos P. Endodontic-orthodontic interactions: a review and treatment recommendations. Aust Dent J 2023; 68 Suppl 1:S66-S81. [PMID: 37961018 DOI: 10.1111/adj.12996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 11/15/2023]
Abstract
The literature is replete with articles describing the many and varied interactions between endodontic treatment and orthodontic tooth movement (OTM), often reporting conflicting views and findings, which creates confusion for clinicians. Original research and review articles have described aspects such as apical root resorption and potential pulpal complications of teeth related to OTM. Some interactions are of relatively minor clinical significance, whilst others may have adverse consequences. A history of dental trauma before or during OTM further complicates the interactions. This review re-assesses the historical literature on endodontic-orthodontic interactions in light of more recent research and presents guidelines for managing clinical situations involving both disciplines. © 2023 Australian Dental Association.
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Affiliation(s)
- P Parashos
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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Mickeviciene L, Ciruliene V, Greta L. Long Term Outcome of Avulsed Immature Mandibular Incisor with Progressive External Root Resorption: 9 Years Follow-Up. J Oral Maxillofac Res 2023; 14:e5. [PMID: 37521324 PMCID: PMC10382192 DOI: 10.5037/jomr.2023.14205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/13/2023] [Indexed: 08/01/2023]
Abstract
Background Avulsion of permanent teeth is the most common in young permanent dentition. Replantation of immature teeth after avulsion represents a major challenge in terms of treatment management and long-term prognosis. This case report describes 9 years of follow-up for an avulsed and replanted immature mandibular lateral incisor with progressive external root resorption. Methods A 7-year-old patient following an accident in which his mandibular left central incisor was avulsed and replanted within one hour after being stored in a physiological storage medium. However, radiographic examination conducted six weeks after the dental injury revealed inflammatory root resorption of the replanted tooth #31. To address root resorption, endodontic treatment was performed involving the use of calcium hydroxide as an intracanal medication for a short period of time, followed by root canal obturation with mineral trioxide aggregate placed below the crestal bone margin. Results Three months later the root resorption had progressed. Consequently, a decision was made to perform periodontal surgery. While the long-term follow-up revealed that the inflammatory root resorption had damaged half of the root, the tooth remained functional and aesthetically favourable. Conclusions Despite the challenges associated with replantation of an immature tooth following avulsion, this case demonstrated favourable outcomes. The tooth maintained its functionality, exhibited favourable aesthetic, and the dimensions of the alveolar ridge were preserved, allowing for the physiological expansion of the dental arch.
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Affiliation(s)
- Lina Mickeviciene
- Clinic of Dental and Oral Pathology Faculty of Odontology, Lithuanian University of Health Sciences, KaunasLithuania.
| | - Vestina Ciruliene
- Clinic of Dental and Oral Pathology Faculty of Odontology, Lithuanian University of Health Sciences, KaunasLithuania.
| | - Lodiene Greta
- Clinic of Dental and Oral Pathology Faculty of Odontology, Lithuanian University of Health Sciences, KaunasLithuania.
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Iqbal A, Sharari TA, Khattak O, Chaudhry FA, Bader AK, Saleem MM, Issrani R, Almaktoom IT, Albalawi RFH, Alserhani EDM. Guided Endodontic Surgery: A Narrative Review. Medicina (B Aires) 2023; 59:medicina59040678. [PMID: 37109636 PMCID: PMC10145231 DOI: 10.3390/medicina59040678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/08/2023] [Accepted: 03/21/2023] [Indexed: 04/03/2023] Open
Abstract
Background and objectives: Endodontic surgery has evolved over the last two decades. The use of state-of-the-art guided endodontic surgical procedures produces a predictable outcome in the healing of lesions of endodontic origin. The main objective of this review paper is to define and characterize guided surgical endodontics as well as its benefits and drawbacks by reviewing the most recent relevant scientific literature. Methods: A literature search was conducted using multiple databases comprising of MEDLINE (via PubMed), EMBASE, and Web of Science. The terms used for the search were ‘guided endodontics’, ‘surgical endodontics’, and ‘endodontic microsurgery’. Results: In total, 1152 articles were obtained from the analysis of the databases. Unrelated articles from the available full text of 388 articles were excluded. A total of 45 studies were finally included in the review. Conclusions: Surgical-guided endodontics is a relatively new area of study that is still maturing. It has many applications such as root canal access and localization, microsurgical endodontics, endodontic retreatment, and glass fiber post removal. Additionally, it does not matter how experienced the operator is; the procedure can be completed for the patient in less time and provides greater accuracy and safety than conventional endodontics.
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Affiliation(s)
- Azhar Iqbal
- Department of Restorative Dentistry, Jouf University, Sakaka 72388, Saudi Arabia
- Correspondence: (A.I.); (F.A.C.)
| | - Thani Al Sharari
- Department of Restorative and Dental Science, Faculty of Dentistry, Taif University, Taif 11099, Saudi Arabia
| | - Osama Khattak
- Department of Restorative Dentistry, Jouf University, Sakaka 72388, Saudi Arabia
- Edinburgh Medical School, Department of Medical Education, The University of Edinburgh, GU, 316 Chancellor’s Building, Edinburgh EH16 4SB, UK
| | - Farooq Ahmad Chaudhry
- School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Islamabad 44000, Pakistan
- Correspondence: (A.I.); (F.A.C.)
| | - Alzarea K. Bader
- Department of Prosthetic Sciences, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia;
| | - Muhammad Mudassar Saleem
- Consultant Oral and Maxillofacial Surgeon, Ministry of Health, Dental Center, Yanbu General Hospital, Yanbu 46411, Saudi Arabia
| | - Rakhi Issrani
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia
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Implications of Post-Traumatic Treatment of Immature Maxillary Incisors. Int Dent J 2023; 73:337-345. [PMID: 36804746 DOI: 10.1016/j.identj.2023.01.005] [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: 12/12/2022] [Revised: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 02/20/2023] Open
Abstract
The aim of this review was to discuss traumatic dental injuries in view of their treatment implications to provide an evidence-based resource for clinicians when planning treatment for traumatised immature maxillary incisors. Dental trauma to immature maxillary incisors can result in various complications, such as critical fractures, resorptions, or ankylosis, and might lead to tooth loss. Traumatised teeth may exhibit various unaesthetic discolourations as a result of different dental trauma sequelae or materials used for treatment. All of the above can influence patients' social experience, including self-esteem, confidence, eating and speaking abilities, as well as proper development and growth of the jaw bones. Treatment of traumatised immature incisors should focus not only on the acute phase but on the long-term consequences. Any time gained with the tooth in the jaw bone, free of infection, is an achievement, as it allows normal growth and development. All these aspects are discussed in this narrative review, and an evidence-based summary resource is suggested for clinicians to use when planning treatment for traumatised immature maxillary incisors.
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Kulinkovych-Levchuk K, Pecci-Lloret MP, Castelo-Baz P, Pecci-Lloret MR, Oñate-Sánchez RE. Guided Endodontics: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13900. [PMID: 36360780 PMCID: PMC9657991 DOI: 10.3390/ijerph192113900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/18/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
The main objective of this paper is to perform an updated literature review of guided endodontics based on the available up-to-date scientific literature to identify and describe the technique, its benefits, and its limitations. Four electronic databases (PubMed, Scopus, Science Direct, and Web of Science) were used to perform a literature search from 1 January 2017 to 13 May 2022. After discarding duplicates, out of 1047 results, a total of 29 articles were eligible for review. Guided endodontics is a novel technique that is currently evolving. It is applied in multiple treatments, especially in accessing and locating root canals in teeth with pulp canal obliteration, microsurgical endodontics, and removing glass fiber posts in endodontic retreatments. In addition, it is independent of an operator's experience, requires less treatment time for the patient, and is more accurate and safer than conventional endodontics.
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Affiliation(s)
- Kateryna Kulinkovych-Levchuk
- Gerodontology and Special Care Dentistry Unit, Faculty of Medicine, IMIB-Arrixaca, Morales Meseguer Hospital, University of Murcia, 30008 Murcia, Spain
| | - María Pilar Pecci-Lloret
- Gerodontology and Special Care Dentistry Unit, Faculty of Medicine, IMIB-Arrixaca, Morales Meseguer Hospital, University of Murcia, 30008 Murcia, Spain
| | - Pablo Castelo-Baz
- Unit of Dental Pathology and Therapeutics II, School of Medicine and Dentistry, University of Santiago de Compostela, 15705 Santiago de Compostela, Spain
| | - Miguel Ramón Pecci-Lloret
- Gerodontology and Special Care Dentistry Unit, Faculty of Medicine, IMIB-Arrixaca, Morales Meseguer Hospital, University of Murcia, 30008 Murcia, Spain
| | - Ricardo E Oñate-Sánchez
- Gerodontology and Special Care Dentistry Unit, Faculty of Medicine, IMIB-Arrixaca, Morales Meseguer Hospital, University of Murcia, 30008 Murcia, Spain
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Ribeiro D, Reis E, Marques JA, Falacho RI, Palma PJ. Guided Endodontics: Static vs. Dynamic Computer-Aided Techniques—A Literature Review. J Pers Med 2022; 12:jpm12091516. [PMID: 36143301 PMCID: PMC9501573 DOI: 10.3390/jpm12091516] [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: 08/11/2022] [Revised: 09/11/2022] [Accepted: 09/12/2022] [Indexed: 11/26/2022] Open
Abstract
(1) Background: access cavity preparation is the first stage of non-surgical endodontic treatment. The inaccuracy of this step may lead to numerous intraoperative complications, which impair the root canal treatment’s prognosis and therefore the tooth’s survival. Guided endodontics, meaning computer-aided static (SN) and dynamic navigation (DN) techniques, has recently emerged as a new approach for root canal location in complex cases. This review aims to compare SN and DN guided endodontics’ techniques in non-surgical endodontic treatment. (2) Methods: an electronic search was performed on PubMed, Scopus, and Cochrane Library databases until October 2021. Studies were restricted by language (English, Spanish and Portuguese) and year of publication (from 2011 to 2021). (3) Results: a total of 449, 168 and 32 articles were identified in PubMed, Scopus, and Cochrane Library databases, respectively, after the initial search. Of the 649 articles, 134 duplicates were discarded. In this case, 67 articles were selected after title and abstract screening, of which 60 were assessed for eligibility through full-text analysis, with one article being excluded. Four cross-references were added. Thus, 63 studies were included. (4) Conclusions: guided endodontics procedures present minimally invasive and accurate techniques which allow for highly predictable root canal location, greater tooth structure preservation and lower risk of iatrogenic damage, mainly when performed by less experienced operators. Both SN and DN approaches exhibit different advantages and disadvantages that make them useful in distinct clinical scenarios.
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Affiliation(s)
- Diana Ribeiro
- Dentistry Department, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
| | - Eva Reis
- Dentistry Department, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
| | - Joana A. Marques
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
| | - Rui I. Falacho
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
- Institute of Oral Implantology and Prosthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
| | - Paulo J. Palma
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
- Correspondence: ; Tel.: +351-239-249-151
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Jiandong B, Yunxiao Z, Zuhua W, Yan H, Shuangshuang G, Junke L, Hongwei W, Hua X. Generalized pulp canal obliteration in a patient on long-term glucocorticoids: a case report and literature review. BMC Oral Health 2022; 22:352. [PMID: 35971099 PMCID: PMC9380356 DOI: 10.1186/s12903-022-02387-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 08/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The calcification of the tooth pulp is a pathological condition that occurs in response to various factors. A uncommon haematological condition known as paroxysmal nocturnal haemoglobinuria (PNH) is characterized by bouts of haemolysis, and it requires long-term use of glucocorticoids (GCs). CASE PRESENTATION A female patient who was diagnosed with PNH and had a history of long-term use of GCs came to our department for root canal therapy (RCT) for teeth 25, 26, and 27. The radiographs showed generalized pulp canal obliteration (PCO) in most of the patients. None of these teeth (25, 26, or 27) were sensitive to percussion, and they did not respond to thermal or electrical sensitivity tests. A diagnose of pulp necrosis was made for these teeth. RCT was carried out with the help of an oral microscope, and then a prosthodontic procedure was created for the teeth. CONCLUSIONS Based on the patient's long history use of GCs and a series of related studies, we conclude that the long-term usage of GCs contributes significantly to the onset of PCO.
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Affiliation(s)
- Ban Jiandong
- Department of Stomatology, Hebei Eye Hospital, Xingtai, 054000, China
| | - Zhang Yunxiao
- Department of Haematology, The First Affiliated Hospital of Xingtai Medical College, Xingtai, 054000, China
| | - Wang Zuhua
- Department of Endodontics, Stomatological Hospital of Peking University, Beijing, 100010, China
| | - Hou Yan
- Department of Stomatology, Hebei Eye Hospital, Xingtai, 054000, China
| | - Geng Shuangshuang
- Department of Stomatology, Hebei Eye Hospital, Xingtai, 054000, China
| | - Li Junke
- Department of Stomatology, Hebei Eye Hospital, Xingtai, 054000, China
| | - Wang Hongwei
- Department of Stomatology, Hebei Eye Hospital, Xingtai, 054000, China
| | - Xu Hua
- Department of Stomatology, Hebei Eye Hospital, Xingtai, 054000, China.
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