Regenerative Endodontic Management of an Immature Molar Using Calcium Hydroxide and Triple Antibiotic Paste: A Two-Year Follow-Up

Published on Feb 10, 2020in Case Reports in Dentistry
· DOI :10.1155/2020/9025847
Mohannad Alasqah1
Estimated H-index: 1
Sulthan Ibrahim Raja Khan (National Guard Health Affairs)+ 1 AuthorsAhmed Jamleh8
Estimated H-index: 8
(National Guard Health Affairs)
The regenerative endodontic procedure (REP) is considered a viable treatment option for immature teeth with necrotic pulp and periapical radiolucency which can facilitate continued root formation. In this report, an immature necrotic mandibular molar received REP in three appointments wherein chemomechanical debridement was performed with a sequential application of nonsetting calcium hydroxide (in the whole canal) and triple antibiotics paste (in the root’s middle third) dressings in the first and second appointments, respectively. In the third appointment, blood clots were created in the root canals. MTA was placed over the blood clots and the tooth was restored with a composite filling and stainless-steel crown. Recall appointments were performed for two years where the tooth was deemed asymptomatic clinically and a complete root formation with significant periapical healing was evident radiographically. More cases are required to warrant the feasibility of this disinfection protocol.
📖 Papers frequently viewed together
3 Citations
4 Citations
185 Citations
#1Paulo Palma (UC: University of Coimbra)H-Index: 11
#2João Martins (UC: University of Coimbra)H-Index: 15
Last. João Miguel Santos (UC: University of Coimbra)H-Index: 13
view all 7 authors...
19 CitationsSource
#1Paulo Palma (UC: University of Coimbra)H-Index: 11
#2Joana A Marques (UC: University of Coimbra)H-Index: 4
Last. João Carlos Ramos (UC: University of Coimbra)H-Index: 10
view all 7 authors...
Aim: The purpose of the present study is to assess the color stability of two calcium silicate-based cements (CSCs) used in regenerative endodontic procedures (REPs). Methods: A total of 40 acrylic single-rooted transparent teeth, with immature apex, were used. Root canals were filled up to 3 mm below the level of the cementoenamel junction, with either saline solution (Mineral Trioxide Aggregate (MTA)/saline and Biodentine/saline) or blood (MTA/blood and Biodentine/blood). Subsequently, ProRoot...
15 CitationsSource
#1Paulo Palma (UC: University of Coimbra)H-Index: 11
#2Joana A Marques (UC: University of Coimbra)H-Index: 4
Last. João Carlos Ramos (UC: University of Coimbra)H-Index: 10
view all 6 authors...
The purpose of the present study was to assess the proper time to perform a restoration (immediately or delayed) after placement of two calcium silicate-based cements (CSCs) and to test the performance of two different restorative protocols regarding shear bond strength (SBS). Seventy-five acrylic blocks were randomly divided into five groups (n = 15). Specimens were filled with either ProRoot MTA (Dentsply Tulsa Dental) or Biodentine (Septodont). The restoration was performed at an immediate (1...
18 CitationsSource
#1Qusai Al Khasawnah (University of Giessen)H-Index: 1
#2Fathi Hassan (University of Giessen)H-Index: 7
Last. Christian Heiss (University of Giessen)H-Index: 62
view all 9 authors...
Background. The study aim is to avoid tooth extraction by nonsurgical treatment of periapical lesion. It assesses healing progress in response to calcium hydroxide-iodoform-silicon oil paste (CHISP). Numeric Pain Rating Scale was used to validate the approach. Furthermore, CHISP was used to treat cystic lesions secondary to posttraumatic avulsion of permanent teeth. Materials and Methods. Over 200 patients with radicular cysts were treated with CHISP through the root canal. Radiographs were used...
3 CitationsSource
The aim of this Scoping Study was to evaluate the survival rate and nature of tissue formed inside root canals of human Necrotic Immature Permanent Teeth (NIPT) under root canal revascularization (RCR). The search was performed in SciVerse Scopus®, PubMed/Medline, Web of Science®, BIREME and in grey literature up to November 2015. The keywords were selected using MeSH terms and DECs. Two independent reviewers scrutinized the records obtained considering specific inclusion criteria. The included ...
20 CitationsSource
#1João Carlos Ramos (UC: University of Coimbra)H-Index: 10
#2Paulo Palma (UC: University of Coimbra)H-Index: 11
Last. João Miguel Santos (UC: University of Coimbra)H-Index: 13
view all 7 authors...
Abstract Introduction The purpose of this study was to compare tooth discoloration that occurs in teeth filled with ProRoot MTA (DENTSPLY Tulsa Dental Specialties, Tulsa, OK) or Biodentine (Septodont, Saint Maur des Fosses, France) over the course of 1 year. Methods Twenty-eight intact premolars were resected 2 mm apical to the cementoenamel junction and the pulp tissues extirpated via the cervical cut. After the preparation of occlusal access to the pulp chamber, specimens were assigned into 4 ...
31 CitationsSource
#2Şerife Özalp (Bezmialem Foundation University)H-Index: 1
Last. Seda Aydemir (Kocaeli University)H-Index: 4
view all 4 authors...
Dens invaginatus is a developmental anomaly that results in an enamel-lined cavity intruding into the crown or root before the mineralization phase. This report presents regenerative endodontic treatment of a necrotic immature tooth with Oehler’s type III dens invaginatus of a nine-year-old female patient. A diagnosis of dens invaginatus (Oehler’s type III) and a large periapical lesion was established with the aid of cone-beam computed tomography (CBCT). In the presented case contrary to the cl...
9 CitationsSource
#1Mamatha Yadlapati (University of Texas Health Science Center at Houston)H-Index: 5
#2Letícia Chaves de Souza (University of Texas Health Science Center at Houston)H-Index: 11
Last. Renato Menezes Silva (University of Texas Health Science Center at Houston)H-Index: 16
view all 6 authors...
Aim To evaluate the cytotoxic effects of triple antibiotic paste (TAP), double antibiotic paste (DAP), minocycline and calcium hydroxide and their influence on cytokine mRNA expression levels on human periodontal ligament (HPDL) fibroblasts. Methodology Triple antibiotic paste, DAP and Ca(OH)2 test samples were immersed in culture medium and incubated at 37 °C for 24 and 48 h. HPDL cells were seeded at a density of 2 × 104 cells and exposed to either culture media (negative control), 0.1% SDS (p...
30 CitationsSource
#1Jiajie Guo (PRC: China Medical University (PRC))H-Index: 6
#2Di Yang (PRC: China Medical University (PRC))H-Index: 11
Last. Tatsuji Haneji (University of Tokushima)H-Index: 24
view all 7 authors...
Porphyromonas endodontalis and its main virulence factor, lipopolysaccharide (LPS), are associated with the development of periapical diseases and alveolar bone loss. Calcium hydroxide is commonly used for endodontic therapy. However, the effects of calcium hydroxide on the virulence of P. endodontalis LPS and the mechanism of P. endodontalis LPS–induced bone destruction are not clear. Calcium hydroxide rescued the P. endodontalis LPS–suppressed viability of MC3T3-E1 cells and activity of nuclea...
24 CitationsSource
#1Louis M. Lin (NYU: New York University)H-Index: 28
#2Emi Shimizu (NYU: New York University)H-Index: 21
Last. Domenico RicucciH-Index: 39
view all 5 authors...
Abstract Introduction Mechanical debridement plays an important role in eliminating intracanal bacteria, such as biofilm on the canal walls and bacteria in the dentinal tubules. Mechanical debridement is not recommended for root canal disinfection in revascularization/revitalization therapy. Here we report a failed revascularization/revitalization case, which could be due to inadequate root canal disinfection without mechanical removal of biofilm and bacteria in dentinal tubules. Methods A 6-yea...
72 CitationsSource
Cited By3
#1Dixin Cui (Sichuan University)H-Index: 5
#2Sihan Yu (Sichuan University)
Last. Mian Wan (Sichuan University)H-Index: 9
view all 8 authors...
Dental caries and trauma always lead to pulp necrosis and subsequent root development arrest of young permanent teeth. The traditional treatment, apexification, with absence of further root formation, results in abnormal root morphology and compromises long-term prognosis. Regeneration endodontics procedures (REPs) have been developed and considered as an alternative strategy for management of immature permanent teeth with pulpal necrosis, including cell-free REPs and cell-based REPs. Cell-free ...
#1Ardavan Parhizkar (Shahid Beheshti University of Medical Sciences and Health Services)H-Index: 3
#2Hanieh Nojehdehian (Shahid Beheshti University of Medical Sciences and Health Services)H-Index: 8
Last. Saeed Asgary (Shahid Beheshti University of Medical Sciences and Health Services)H-Index: 39
view all 4 authors...
The objective of the current study was to introduce "Polylactic co-Glycolic Acid- (PLGA-) Coated Ceramic Microparticles" as an innovative drug delivery system, loaded with a new combination of triple antibiotics (penicillin G, metronidazole, and ciprofloxacin (PMC)) for use in endodontic treatments. Ceramic microparticles were made from β-tricalcium phosphate and hydroxyapatite and examined by "Scanning Electronic Microscope (SEM)." Then, fixed amounts of the selected antibiotics were added to a...
#1Sara Ayoub (Lebanese University)H-Index: 3
#2Ali Cheayto (Lebanese University)H-Index: 1
Last. Mohammad Fayyad-Kazan (Lebanese University)H-Index: 10
view all 6 authors...
: Regenerative endodontics is a biologically based treatment designed for immature permanent teeth with necrotic pulp to replace dentin and root structures, as well as dental pulp cells. This procedure has become a part of novel modality in endodontics therapeutic manner, and it is considered as an alternative to apexification. In the last decade, numerous case reports, which describe this procedure, have been published. This therapeutic approach succeeded due to its lower financial cost and eas...
2 CitationsSource
#1Faisal T. Alghamdi (KAU: King Abdulaziz University)H-Index: 1
#2Alaa E. Alqurashi (Ibn Sina National College for Medical Studies)H-Index: 1
Background and Objective. Management of immature permanent teeth exhibiting necrotic pulp is clinically challenging. An appropriate diagnosis, case selection, and good management ensure good outcomes. The objective of this review reviews all up-to-date data in regard to endodontic regeneration therapy in the management of immature permanent teeth with necrotic pulp and which conducts are most used and appropriate for this procedure in human and animal investigations. Materials and Methods. The e...
1 CitationsSource