A prospective clinical study of regenerative endodontic treatment of traumatized immature teeth with necrotic pulps using bi‐antibiotic paste

Abstract

Traumatized immature teeth with necrotic pulps treated with revitalization endodontic technique did not demonstrate continuation of root development or dentine formation when assessed by periapical radiographs. However, apical closure and periodontal healing were observed. A measurable change in crown colour (yellower, redder and lighter), with mostly no aesthetic concern to the patients/parents, was also observed.

A biocompatible decellularized pulp scaffold for regenerative endodontics

“…Indeed prospective studies have failed to predictably demonstrate any significant hard tissue gain in the root canal system (Nazzal et al . ). One of the reasons seems to be that the current techniques do not always follow the “gold standard” criteria for the bioengineering of the pulp–dentine complex, with one of the crucial factors being the selection of an appropriate scaffold for successful tissue regeneration (Murray et al .…”

Biomechanical performance of an immature maxillary central incisor after revitalization: a finite element analysis

“…Over the last decade, research has increasingly focused on the development of biology-based alternative treatment concepts such as revitalization, which aims for the regeneration of the pulp-dentine complex (Murray et al 2007) and the promotion of lengthening and thickening of dentine walls (Lolato et al 2016). The clinical outcomes of revitalization procedures have been reported to be successful (Nagy et al 2014, Lin et al 2017 with root maturation by dentine wall thickening and lengthening or apical closure (Shah et al 2008, Lolato et al 2016, Nazzal et al 2018. However, due to the presence of ectopic tissue such as cementum and the lack of cells with a distinct odontoblast phenotype in vivo (Shimizu et al 2012, Becerra et al 2014, Lei et al 2015, the generated tissue has consequently been described as reparative tissue and not as regenerated pulp tissue (Gomes-Filho et al 2013, del Fabbro et al 2015, Saoud et al 2015.…”

Management of discolouration following revitalization endodontic procedures: A case series

“…Discolouration following RET has been linked to the use of minocycline and mineral trioxide aggregate (MTA) (Ahmed & Abbott ). Therefore, some reports describe replacing minocycline with other antibiotics such as cefaclor (Thibodeau & Trope ), omitting minocycline using bi‐antibiotic paste containing metronidazole and ciprofloxacin (Nazzal et al ) or replacing antibiotics with calcium hydroxide (Chueh et al ). Indeed, the current evidence is in favour of using calcium hydroxide over antibiotics in RET (ESE ), which will hopefully reduce the need to use such antibiotics in the future.…”

“…Therefore, the use of nonbismuth containing materials, such as Portland cement (Medcem, Weinfelden, Switzerland) and Biodentine (Septodont, Saint‐Maur‐des‐Fossés, France) have been recommended (ESE ). These fulfil the requirement for the establishment of a hermetic seal and may result in less crown discolouration than MTA (Lenherr et al , Nazzal et al ). A laboratory study by Lenherr et al () compared the discolouring potential of several materials used in the management of immature teeth with necrotic pulps.…”

“…They reported significantly less discolouration following the use of Portland cement and white MTA in comparison with grey MTA. Nazzal et al () measured crown discolouration of RET treated teeth, where Portland cement and a bi‐antibiotic mixture (metronidazole and ciprofloxacin) were used, utilizing an objective colour assessment method (IKAM digital photography with MATLAB colour assessment software). The results of this laboratory study revealed marked yellower, redder and lighter crown discolouration after two years.…”