Aim. (1) The aim of the clinical study revolves around the accurate diagnosis, proper case selection, and the management of acute irreversible pulpitis in permanent molars with closed apices using conservative and economical treatment modalities like vital pulpotomies with regenerative approaches over conventional root canal procedures. (2) To evaluate the use of autologous substances such as platelet concentrates and calcium silicate based materials in promoting the healing and regeneration of the inflamed pulp. Summary. Vital pulpotomy was performed on 5 carious involved, permanent molars diagnosed with acute irreversible pulpitis in 17- to 22-year-old patients. Taking into consideration the patient's age and the condition of the underlying pulp tissue, PRF pulpotomy was planned in view of preserving the vitality of the intact radicular pulps. Regenerative procedures with second generation blood matrices were chosen to encourage the recovery of the inflamed pulps. The systematic follow-up examinations performed at 3, 6, 9, 12, 18, 22, and 24 months revealed a successful clinical and radiological outcome. Within the limits of the present clinical study and correlating the success across the treated clinical cases, we safely conclude the potential scope of regenerative pulpotomy approaches in acute irreversible pulpitis in adult permanent teeth.
Developmental anomalies are marked deviations from normal size, shape, contour, and various other parameters. An understanding of these anomalies and its application has been a clinical challenge. With the advances in diagnostic technology, the field of endodontics has been evolving with new treatment protocols, which gives promising results. The aim of this article is to present a case report on tooth anomaly that is taurodontism and its management in a patient with multiple taurodont teeth. This article brings discussion on anatomical variations of the taurodont teeth and the techniques related to the endodontic treatment of the same and how it differs from normal teeth.
Regenerative endodontic procedures are biologically based procedures which deal with the regeneration of pulp-like tissue, more idealistically the pulp-dentin complex. The regeneration of this pulp-dentin complex in an infected necrotic tooth with an open apex is possible only when the canal is effectively disinfected. Though there are various procedures for treating open apex ranging from Ca(OH) 2 apexification, mineral trioxide aggregate apexification and surgical approach, regeneration of tissues has always taken superior hand over the repair of tissues. The mechanics behind the regenerative endodontic procedures is that despite the tooth being necrotic, some pulp tissue can survive apically which under favorable conditions proliferate to aid in the process of regeneration. In the past 2 decades, an increased understanding of the physiological roles of platelets in wound healing and after tissue injury has led to the idea of using platelets as therapeutic tools in the field regenerative endodontics. In the present case report with an open apex, high sterilization protocol is followed using triple antibiotic paste as intra-canal medicament, followed which platelet rich fibrin is used as the regenerative material of choice. Over an 18-month follow-up period, clinically patient is asymptomatic and radiographically there is complete regression of the periapical lesion and initiation of the root end closure.
Endodontic treatment options for immature, nonvital teeth conventionally include surgical endodontics, apexification with calcium hydroxide, or single visit mineral trioxide aggregate plug. Regeneration is a new concept which is been introduced in the treatment of traumatized open apex tooth. Regeneration of pulp-dentin complex in an infected necrotic tooth with an open apex is possible if the canal is effectively disinfected. The purpose of this case report is to add a new vista in regenerative, endodontic therapy by using platelet-rich fibrin for revitalization of immature nonvital tooth.
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