Regenerative Endodontic Treatment of an Immature Necrotic Molar with Arrested Root Development by Using Recombinant Human Platelet-derived Growth Factor: A Case Report

Zhujiang, Annie; Kim, Sahng G.

doi:10.1016/j.joen.2015.08.026

Cited by 42 publications

(25 citation statements)

References 36 publications

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“…There have been clinical trials in which exogenous growth factors were placed into root canals to augment the effect of endogenous dentine matrix growth factors for the regeneration of the pulp–dentine complex (Nagy et al . , Zhujiang & Kim ).…”

Section: Growth Factors and Retmentioning

confidence: 99%

“…). A clinical case report demonstrated the continued root maturation in a mandibular molar with necrotic pulp and arrested root formation and the healing of apical periodontitis after the use of human recombinant platelet derived growth factors‐loaded collagen scaffolds (Zhujiang & Kim ). Although the cell homing approach is readily performed by clinicians without special training, which growth factor(s) is/are to be used for regenerative endodontic procedures is still speculative due to the lack of comparative clinical trials.…”

Section: Cell Homing Approachmentioning

confidence: 99%

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Regenerative endodontics: a comprehensive review

et al. 2018

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The European Society of Endodontology and the American Association for Endodontists have released position statements and clinical considerations for regenerative endodontics. There is increasing literature on this field since the initial reports of Iwaya et al. (Dental Traumatology, 17, 2001, 185) and Banchs & Trope (Journal of Endodontics, 30, 2004, 196). Endogenous stem cells from an induced periapical bleeding and scaffolds using blood clot, platelet rich plasma or platelet-rich fibrin have been utilized in regenerative endodontics. This approach has been described as a 'paradigm shift' and considered the first treatment option for immature teeth with pulp necrosis. There are three treatment outcomes of regenerative endodontics; (i) resolution of clinical signs and symptoms; (ii) further root maturation; and (iii) return of neurogenesis. It is known that results are variable for these objectives, and true regeneration of the pulp/dentine complex is not achieved. Repair derived primarily from the periodontal and osseous tissues has been shown histologically. It is hoped that with the concept of tissue engineering, namely stem cells, scaffolds and signalling molecules, that true pulp regeneration is an achievable goal. This review discusses current knowledge as well as future directions for regenerative endodontics. Patient-centred outcomes such as tooth discolouration and possibly more appointments with the potential for adverse effects needs to be discussed with patients and parents. Based on the classification of Cvek (Endodontics and Dental Traumatology, 8, 1992, 45), it is proposed that regenerative endodontics should be considered for teeth with incomplete root formation although teeth with near or complete root formation may be more suited for conventional endodontic therapy or MTA barrier techniques. However, much is still not known about clinical and biological aspects of regenerative endodontics.

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Section: Growth Factors and Retmentioning

confidence: 99%

Section: Cell Homing Approachmentioning

confidence: 99%

Regenerative endodontics: a comprehensive review

et al. 2018

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“…Moreover, several techniques used in modern clinical dentistry emerged from the application of tissue engineering principles. The use of growth factors and platelet concentrates are an example of how such approaches are present and growing in dentistry 15,[21][22] . The use of PRP was the first generation of blood concentrates to be used with the aim of improving bone repair in surgeries 7 .…”

Section: Discussionmentioning

confidence: 99%

“…Although enzymatic digestion is a faster isolation method, studies have shown that the use of on growth factors 21 . Moreover, the literature presents just one case of the application of growth factors in root canal revascularization 22 . Fifteen months of follow-up demonstrated continuing root development and clinical success with the use of rhPDGF-BB in revascularization therapies 22 .…”

Section: Bioactive Moleculesmentioning

confidence: 99%

What is the clinical applicability of regenerative therapies in dentistry?

Demarco

Kirschnick

Watson

et al. 2017

RGO, Rev. Gaúch. Odontol.

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Regenerative therapies have been widely developed in dentistry and it is important to incorporate dentists' knowledge of these new therapies RESUMOTerapias regenerativas vem sendo amplamente desenvolvidas na odontologia e o conhecimento destas novas terapias por parte dos dentistas é importante para que elas sejam incorporadas na rotina clínica odontológica. Assim, este estudo revisou a literatura acerca das terapias regenerativas e suas aplicações clínicas. A engenharia tecidual tem contribuído na mudança do paradigma restaurador das ciências da saúde. Seus pilares embasam as técnicas de regeneração de tecidos e órgãos. Apesar da grande maioria dos estudos neste campo ser in vitro, uma gama de metodologias pré-clínicas foi consolidada e estudos utilizando estes princípios já estão sendo empregados em humanos. A utilização de plasma rico em plaquetas e plasma rico em fibrina como scaffolds naturais em cirurgias para reestabelecimento de tecido ósseo e periodontal são frequentemente relatadas na literatura e ensaios clínicos utilizando esta abordagem demonstram resultados promissores. Células-tronco da polpa dental autólogas já foram aplicadas com sucesso na regeneração de tecido ósseo utilizando scaffold naturais de colágeno em humanos. Além disto, a revascularização do canal radicular já aparece na literatura como uma alternativa promissora frente a opção de apecificação do canal radicular. Esta terapia utiliza como princípio o coágulo sanguíneo como scaffold e a migração das células-tronco da papila apical para regenerar o órgão pulpar. Considerações finais: Apesar de incipientes, as terapias regenerativas já podem ser utilizadas na prática clínica odontológica. O conhecimento dos princípios que regem estas terapias deve ser compreendido pelo dentista para que sejam utilizadas na prática clínica.Termos de indexação: Fibrina. Plasma rico em plaquetas. Células-tronco. Engenharia tecidual.

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“…Many case reports have since shown favourable outcomes after the eradication of bacteria from the root canal system, formation of a scaffold in the canal space, and creation of a bacteria‐tight coronal seal. Although following a similar concept of revascularisation, treatment protocols used in other reports vary in terms of irrigants, intracanal disinfectant medications, scaffolds in the canal, and sealing materials used. The search for an optimal protocol for revascularisation is an ongoing and likely long‐term process.…”

Section: Introductionmentioning

confidence: 99%