Biologically Based Treatment of Immature Permanent Teeth with Pulpal Necrosis: A Case Series

Regenerative endodontics – biologically‐based treatment for immature permanent teeth: a case report and review of the literature

“…15 Regenerative procedures generally advocate the placement of a tri-antibiotic paste to eliminate the intra-radicular infection which is regarded as a mandatory requirement for success. [3][4][5][6][7][8][9] The tri-antibiotic paste in these studies consists of a combination of ciprofoxacilin, metronidazole and minocycline which has been shown to reliably eliminate bacteria in infected root dentine whereas the respective drugs used alone have only substantially reduced but did not eliminate the bacteria. 16 This combination of drugs has also been shown to be effective at eliminating bacteria in the deep layers of root canal dentine.…”

“…2 Recently, a number of case series and case reports have described continued root development and even responses to pulp sensibility testing in treated necrotic immature teeth with infected root canal systems, including those with draining sinus tracts. [3][4][5][6][7][8][9] These regenerative endodontic procedures and revasularization of the root canal in teeth with infected root canal systems have been termed 'a paradigm shift' in the treatment protocol for endodontic management. 7,10 Traditionally, the clinical protocol for immature teeth with infected root canal systems was termed 'apexification' and involved placing calcium hydroxide as an intra-canal medicament to firstly eliminate the intra-radicular infection and then induce an apical barrier over time.…”

Influência de medicações intracanal utilizadas em procedimentos endodônticos regenerativos na sobrevivência de células da papila apical in vitro

“…Além dos estudos in vitro; a ação antimicrobiana desta pasta composta por antibióticos tem sido relatada in vivo em estudos com cães (Windley et al, 2005;Wang et al, 2010) e estudos clínicos (Petrino, 2007;Jung et al, 2008;Shah et al, 2008;Ding et al, 2009;Reynolds et al, 2009;Kim et al, 2010;Petrino et al, 2010;Thomson;Kahler, 2010;Nosrat et al, 2011;Turman, 2011;Jeeruphan et al, 2012;Lenzi;Trope, 2012;Nosrat et al, 2012).…”

“…A maioria dos protocolos propostos na literatura envolve a manipulação dos tecidos periapicais, com o objetivo de promover o sangramento para induzir a formação de um coágulo sanguíneo no espaço do canal radicular (Banchs;Trope, 2004;Huang, 2006;Petrino, 2007;Thibodeau;Cotti et al, 2008;Jung et al, 2008;Shah et al, 2008;Ding et al, 2009;Reynolds et al, 2009;Shin et al, 2009;Thibodeau, 2009;Kim et al, 2010;Petrino et al, 2010;Thomson;Kahler, 2010;Cehreli et al, 2011;Nosrat et al, 2011;Chen et al, 2012;Jeeruphan et al, 2012;Lenzi;Trope, 2012;Nosrat et al, 2012;Soares et al, 2013;Nagata et al, 2014a,b Turman, 2011).…”

“…Há também outros tipos de "scaffolds" biodegradáveis ou permanentes disponíveis como colágeno, ácido hialurônico ou sintéticos como o ácido poliglicólico ou hidroxiapatita (Gotlieb et al, 2008;Chandrahasa et al, 2011 (Banchs;Trope, 2004;Petrino, 2007;Thibodeau;Cotti et al, 2008;Jung et al, 2008;Ding et al, 2009;Reynolds et al, 2009;Shin et al, 2009;Thibodeau, 2009;Kim et al, 2010;Petrino et al, 2010;Thomson;Kahler, 2010;Cehreli et al, 2011;Turman, 2011;Chen et al, 2012;Jeeruphan et al, 2012;Lenzi;Trope, 2012;Nosrat et al, 2012). Nosrat et al (2011) utilizaram uma mistura enriquecida de cálcio (CEM), uma substância que tem características de selamento e biocompatibilidade semelhantes ao MTA, é capaz de promover a formação de hidroxiapatita, induzir diferenciação de células-tronco e induzir a formação de tecido mineralizado (Asgary et al, 2009 (Lovelace et al, 2011).…”