International Journal of Clinical Pediatric Dentistry

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VOLUME 12 , ISSUE 3 ( May-June, 2019 ) > List of Articles

Original Article

A Regenerative Approach for Root Canal Treatment of Mature Permanent Teeth: Comparative Evaluation with 18 Months Follow-up

Preeti Jha, Mandeep S Virdi, Suman Nain

Keywords : Mature teeth, Necrotic pulp, Periapical abscess, Regenerative endodontics, SealBio,Apical periodontitis

Citation Information : Jha P, Virdi MS, Nain S. A Regenerative Approach for Root Canal Treatment of Mature Permanent Teeth: Comparative Evaluation with 18 Months Follow-up. Int J Clin Pediatr Dent 2019; 12 (3):182-188.

DOI: 10.5005/jp-journals-10005-1616

License: CC BY-NC 4.0

Published Online: 00-06-2019

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


Abstract

Aim: SealBio is a novel technique which stimulates the periradicular cells to deposit a biological barrier at the root apex by inducing healing and regeneration. This clinical trial was undertaken to compare the outcome of teeth treated with the SealBio and the obturation technique. Materials and methods: Thirty patients met the inclusion criteria and consented to participate in the study. Patients were randomly assigned to the SealBio and the obturation group. The time taken for both the techniques and periapical healing was evaluated. The patients of both the groups were evaluated at 6, 12, and 18 months follow up. The periapical index (PAI) was the primary outcome measure to check the apical bone density and healing. The secondary outcome measure was the presence/absence of signs and symptoms. The final outcome measure was the sum of the primary and secondary outcome measures. Results and conclusion: The time taken to perform endodontic treatment with the SealBio technique was significantly lesser than that of obturation. Both groups showed equally favorable outcomes at the end of 18 months without any statistically significant differences. Clinical significance: The results of the present study have demonstrated that SealBio technique gives similar results as that of conventional gutta-percha obturation. The shortcomings of obturation such as difficulty in obtaining a fluid-tight seal and difficulty in obturating tortuous canals can be overcome by the SealBio method. The SealBio method is cost effective, less technique sensitive, and takes lesser chair time.


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  1. Shah N, Logani A. SealBio: a novel, non-obturation endodontic treatment based on concept of regeneration. J Conserv Dent 2012 Oct;15(4):328–332. DOI: 10.4103/0972-0707.101889.
  2. Shah N, Logani A. SealBio: A novel, non-obturation endodontic treatment based on concept of regeneration. United States Patent Application Publication, Naseem et al. Pub. No: US 2012/0231422 A1. Pub. Date: Sep 13, 2012.
  3. Andreasen JO, Andreasen FM, et al. Textbook and Color Atlas of Traumatic Injuries to the Teeth. Blackwell Publishing Ltd, Oxford, United Kingdom, 4th edn, 2013.
  4. Östby BN. The role of the blood clot in endodontic therapy: An experimental histologic study. Acta Odontol Scand 1961 Jan 1;19(3–4):323–353. DOI: 10.3109/00016356109043395.
  5. Rule DC, Winter GB. Root growth and apical repair subsequent to pulpal necrosis in children. Br Dent J 1966 Jun 21;120(12):586.
  6. Banchs F, Trope M. Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod 2004 Apr 30;30(4):196–200. DOI: 10.1097/00004770-200404000-00003.
  7. Thibodeau B, Teixeira F, et al. Pulp revascularization of immature dog teeth with apical periodontitis. J Endod 2007 Jun 30;33(6):680. DOI: 10.1016/j.joen.2007.03.001.
  8. Ding RY, Cheung GS, et al. Pulp revascularization of immature teeth with apical periodontitis: a clinical study. J Endod 2009 May 31;35(5):745–749. DOI: 10.1016/j.joen.2009.02.009.
  9. Hoshino E. Information on LSTR 3Mix-MP therapy [Internet]. 2009 [updated 2015 July 7; cited 2017 Feb 28]. 2009, Available from: http://www.lstr.jp/e/information.html.
  10. Ørstavik D, Kerekes K, et al. The periapical index: a scoring system for radiographic assessment of apical periodontitis. Dent Traumatol 1986 Feb 1;2(1):20–34. DOI: 10.1111/j.1600-9657.1986.tb00119.x.
  11. Friedman S. Prognosis of initial endodontic therapy. Endod Topics 2002 Jul 1;2(1):59–88. DOI: 10.1034/j.1601-1546.2002.20105.x.
  12. Penesis VA, Fitzgerald PI, et al. Outcome of one-visit and two-visit endodontic treatment of necrotic teeth with apical periodontitis: a randomized controlled trial with one-year evaluation. J Endod 2008 Mar 31;34(3):251–257. DOI: 10.1016/j.joen.2007.12.015.
  13. Seltzer S, Bender IB, et al. Factors affecting successful repair after root canal therapy. J Am Dent Assoc 1963 Nov 30;67(5):651–662. DOI: 10.14219/jada.archive.1963.0349.
  14. Younis O, Hembree JH. Leakage of different root canal sealants. Oral Surg Oral Med Oral Pathol 1976 Jun 30;41(6):777–784. DOI: 10.1016/0030-4220(76)90192-4.
  15. Dubrow H. Silver points and gutta-percha and the role of root canal fillings. J Am Dent Assoc 1976 Nov 30;93(5):976–980. DOI: 10.14219/jada.archive.1976.0029.
  16. Asgary S, Fazlyab M. A Successful Endodontic Outcome with Non-Obturated Canals. Iran Endod J 2015;10(3):208.
  17. Shah N. A regeneration-based, nonobturation root-canal treatment for fully-mature teeth: six years’ experience with “SealBio”. Contemp Clin Dent 2016 Jul;7(3):296. DOI: 10.4103/0976-237X.188541.
  18. Paryani K, Kim SG. Regenerative endodontic treatment of permanent teeth after completion of root development: a report of 2 cases. J Endod 2013 Jul 31;39(7):929–934. DOI: 10.1016/j.joen.2013.04.029.
  19. Saoud TM, Sigurdsson A, et al. Treatment of a large cyst like inflammatory periapical lesion associated with mature necrotic teeth using regenerative endodontic therapy. J Endod 2014 Dec 31;40(12):2081–2086. DOI: 10.1016/j.joen.2014.07.027.
  20. Saoud TM, Huang GT, et al. Management of teeth with persistent apical periodontitis after root canal treatment using regenerative endodontic therapy. J Endod 2015 Oct 31;41(10):1743–8. DOI: 10.1016/j.joen.2015.07.004.
  21. Saoud TM, Martin G, et al. Treatment of mature permanent teeth with necrotic pulps and apical periodontitis using regenerative endodontic procedures: a case series. J Endod 2016 Jan 31;42(1):57–65. DOI: 10.1016/j.joen.2015.09.015.
  22. Sabeti MA, Nekofar M, et al. Healing of apical periodontitis after endodontic treatment with and without obturation in dogs. J Endod 2006 Jul 31;32(7):628–633. DOI: 10.1016/j.joen.2005.12.014.
  23. Bender IB, Seltzer S, et al. To culture or not to culture? Oral Surg Oral Med Oral Pathol 1964 Oct 31;18(4):527–540. DOI: 10.1016/0030-4220(64)90403-7.
  24. Chng HS, Pitt Ford TR, et al. Effects of prilocaine local anaesthetic solutions on pulpal blood flow in maxillary canines. Dent Traumatol 1996 Apr 1;12(2):89–95. DOI: 10.1111/j.1600-9657.1996.tb00103.x.
  25. Petrino JA, Boda KK, et al. Challenges in regenerative endodontics: a case series. J Endod 2010 Mar 31;36(3):536–541. DOI: 10.1016/j.joen.2009.10.006.
  26. McLean C, Reader A, et al. An evaluation of 4% prilocaine and 3% mepivacaine compared with 2% lidocaine (1:100,000 epinephrine) for inferior alveolar nerve block. J Endod 1993 Mar 31;19(3):146–150. DOI: 10.1016/S0099-2399(06)80510-8.
  27. Ørstavik D. Time course and risk analyses of the development and healing of chronic apical periodontitis in man. Int Endod J 1996 May 1;29(3):150–155. DOI: 10.1111/j.1365-2591.1996.tb01361.x.
  28. Friedman S, Löst C, et al. Evaluation of success and failure after endodontic therapy using a glass ionomer cement sealer. J Endod 1995 Jul 31;21(7):384–390. DOI: 10.1016/S0099-2399(06)80976-3.
  29. Hargreaves KM, Berman LH. Pathways of Pulp. Elsevier, Philadelphia, 11th edn, 2016.
  30. Vianna ME, Horz HP, et al. In vivo evaluation of microbial reduction after chemomechanical preparation of human root canals containing necrotic pulp tissue. Int Endod J 2006 Jun 1;39(6):484–492. DOI: 10.1111/j.1365-2591.2006.01121.x.
  31. Hockett JL, Dommisch JK, et al. Antimicrobial efficacy of two irrigation techniques in tapered and nontapered canal preparations: an in vitro study. J Endod 2008 Nov 30;34(11):1374–1377. DOI: 10.1016/j.joen.2008.07.022.
  32. Takushige T, Cruz EV, et al. Endodontic treatment of primary teeth using a combination of antibacterial drugs. Int Endod J 2004 Feb 1;37(2):132–138. DOI: 10.1111/j.0143-2885.2004.00771.x.
  33. Borlina SC, de Souza V, et al. Influence of apical foramen widening and sealer on the healing of chronic periapical lesions induced in dogs’ teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010 Jun 30;109(6):932–940. DOI: 10.1016/j.tripleo.2010.01.028.
  34. Abbas AK, Lichtman AH, et al. Cellular and Molecular Immunology. Saunders, Philadelphia, 6th edn, 2010.
  35. Diogenes A, Henry MA, et al. An update on clinical regenerative endodontics. Endod Topics 2013 Mar 1;28(1):2–3. DOI: 10.1111/etp.12040.
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