International Journal of Clinical Pediatric Dentistry

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VOLUME 12 , ISSUE 2 ( March-April, 2019 ) > List of Articles

CASE REPORT

Revascularization of a Nonvital, Immature Permanent Tooth Using Amniotic Membrane: A Novel Approach

Meghna Bajaj, Ashu J Soni

Keywords : Amniotic membrane, Immature teeth, Pulp necrosis, Revascularization

Citation Information : Bajaj M, Soni AJ. Revascularization of a Nonvital, Immature Permanent Tooth Using Amniotic Membrane: A Novel Approach. Int J Clin Pediatr Dent 2019; 12 (2):150-152.

DOI: 10.5005/jp-journals-10005-1596

License: CC BY-NC 4.0

Published Online: 00-04-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: To evaluate the clinical and radiological results of a revascularization treatment done in a nonvital, immature permanent tooth using the amniotic membrane. Case description: A 12-year-old boy reported with a complaint of pain in the lower left back tooth since 1 month due to dental caries. On clinical examination, the mandibular left second premolar was tender on percussion and discolored due to dental caries. Radiographic examination of the same tooth revealed open apex, thin root dentinal walls, and periodontal ligament widening. An access opening was prepared, necrotic pulp extirpated completely followed by thorough irrigation. After drying the canal, closed dressing with the 3-mix antibacterial paste was given for 15 days. After 15 days, the paste was removed and the amniotic membrane was placed inside the canal extending 1 mm beyond the apex and mineral tri-oxide aggregate was placed over this followed by sealing of the cavity. The patient was followed up at 1, 3, and 6 months for clinical and radiographic evaluation. Conclusion: After 6 months, clinically the tooth found asymptomatic. Radiographic examination showed continued root elongation, closure in the periapical opening, thick root dentinal walls with narrowing of the canal space, and normal periradicular architecture. Clinical significance: Amniotic membrane can be used as a scaffold for revascularization in nonvital immature teeth.


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  1. Rafter M. Apexification: a review. Dent Traumatol 2005;21:1–8. DOI: 10.1111/j.1600-9657.2004.00284.x.
  2. Banchs F, Trope M. Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod 2004;30:196–200. DOI: 10.1097/00004770-200404000-00003.
  3. Cotti E, Mereu M, et al. Regenerative treatment of an immature, traumatized tooth with apical periodontitis: report of a case. J Endod 2008;34:611–616. DOI: 10.1016/j.joen.2008.02.029.
  4. Huang GT, Sonoyama W, et al. The hidden treasure in apical papilla: the potential role in pulp/dentin regeneration and bioroot engineering. J Endod 2008;34:645–651. DOI: 10.1016/j.joen.2008.03.001.
  5. Jadhav G, Shah N, et al. Revascularization with and without plateletrich plasma in nonvital, immature, anterior teeth: a pilot clinical study. J Endod 2012;38:1581–1587. DOI: 10.1016/j.joen.2012.09.010.
  6. Keswani D, Pandey RK. Revascularization of an immature tooth with a necrotic pulp using platelet-rich fibrin: a case report. Int Endod J 2013;46:1096–1104. DOI: 10.1111/iej.12107.
  7. Geeta IB, Galagali G, et al. A natural meliorate: revolutionary tissue engineering in endodontics. J Clin Diagn Res 2013;7:2644–2646. DOI: 10.7860/JCDR/2013/6915.3638.
  8. Hotwani K, Sharma K. Platelet rich fibrin – a novel acumen into regenerative endodontic therapy. Rest Dent Endod 2014;39:1–6. DOI: 10.5395/rde.2014.39.1.1.
  9. Chen YJ, Chung MC, et al. The effects of acellular amniotic membrane matrix on osteogenic differentiation and ERK1/2 signalling in human dental apical papilla cells. Biomaterials 2010;33:455–463. DOI: 10.1016/j.biomaterials.2011.09.065.
  10. Kubo M, Sonoda Y, et al. Immunogenicity of human amniotic membrane in experimental xenotransplantatation. Invest Ophthalmol Vis Sci 2001;42:1539–1546.
  11. Ahn J, Pogrel MA. The effects of 2% lidocaine with 1:100,000 epinephrine on pulpal and gingival blood flow. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;85:197–202. DOI: 10.1016/S1079- 2104(98)90426-7.
  12. El Ashiry EA, Farsi NM, et al. Dental pulp revascularization of necrotic permanent teeth with immature apices. J Clin Pediatr Dent 2016;40:361–366.
  13. IIancheran S, Moodley Y, et al. Human fetal membranes: a source of stem cells for tissue regeneration and repair? Placenta 2009;30:2–10. DOI: 10.1016/j.placenta.2008.09.009.
  14. John T. Human amniotic membrane transplantation: past, present and future. Ophthalmol Clin North Am 2003;16:43–65. DOI: 10.1016/S0896-1549(02)00110-4.
  15. Niknejad H, Peirovi H, et al. Properties of the amniotic membrane for potential use in tissue engineering. Eur Cell Mater 2008;15:88–99. DOI: 10.22203/eCM.v015a07.
  16. Steed DL, Trumpower C, et al. Amnion-derived cellular cytokine solution: a physiological combination of cytokines for wound healing. Eplasty 2008;8:e18.
  17. Fetterolf DE, Snyder RJ. Scientific and clinical support for the use of dehydrated amniotic membrane in wound management. Wounds 2012;24:299–307.
  18. Ghahroudi AA, Khorsand A, et al. Comparison of amnion allograft with connective tissue graft for root coverage procedures: a doubleblind, randomized, controlled clinical trial. J Int Acad Periodontol 2013;15:101–112.
  19. Faulk WP, Matthews R, et al. Human amnion as an adjunct in wound healing. Lancet 1980;1:1156–1158. DOI: 10.1016/S0140-6736(80)91617-7.
  20. Toda A, Okabe M, et al. The potential of amniotic membrane/amnion-derived cells for regeneration of various tissues. J Pharma Sci 2007;105:215–228. DOI: 10.1254/jphs.CR0070034.
  21. Uberti MG, Pierpont YN, et al. Amnion-derived cellular cytokine solution (ACCS) promotes migration of keratinocytes and fibroblasts. Annals Plastic Surg 2010;64:632–635. DOI: 10.1097/SAP.0b013e3181c39351.
  22. Russo A, Bonci PL, et al. The effects of different preservation processes on the total protein and growth factor content in a new biological product developed from human amniotic membrane. Cell Tissue Bank 2012;13:353–361. DOI: 10.1007/s10561-011-9261-5.
  23. Forbes J, Fetterolf DE. Dehydrated amniotic membrane allografts for the treatment of chronic wounds: a case series. J Wound Care 2012;21:294–296. DOI: 10.12968/jowc.2012.21.6.290.
  24. Kothari CR, Goudar G, et al. Use of amnion as a graft material in vestibuloplasty: a clinical study. Br J Oral Maxillofac Surg 2012;50: 545–549. DOI: 10.1016/j.bjoms.2011.09.022.
  25. Rohleder NH, Loeffelbein DJ, et al. Repair of oronasal fistulae by interposition of multilayered amniotic membraneallograft. Plast Reconstr Surg 2013;132:172–181. DOI: 10.1097/PRS.0b013e3182910b50.
  26. Koike T, Yasuo M, et al. Cultured epithelial grafting using human amniotic membrane: the potential for using human amniotic epithelial cells as a cultured oral epithelium sheet. Arch Oral Biol 2011;56:1170–1176. DOI: 10.1016/j.archoralbio.2011.04.009.
  27. Karaman M, Tuncel A, et al. Amniotic membrane covering for facial nerve repair. Neural Regen Res 2013;8(11):975–982. DOI: 10.3969/j.issn.1673-5374.2013.11.002.
  28. Tsuno H, Arai N, et al. Intraoral application of hyperdry amniotic membrane to surgically exposed bone surface. Oral Surg Oral Med Oral Pathol Oral Radiol 2014;117(2):e83–e87. DOI: 10.1016/j.oooo.2012.05.014.
  29. Brian G. A novel dehydrated amnion allograft for use in the treatment of gingival recession: an observational case series. J Implants Advan Clin Dent 2009;1:11–16. DOI: 10.5005/jp-journals-10004-1009.
  30. Koob TJ, Rennert R, et al. Biological properties of dehydrated human amnio/chorion composite graft: implications for chronic wound healing. Int Wound J 2013;10:493–500. DOI: 10.1111/iwj.12140.
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