ABSTRACT
Objective: To test the ability of platelet-rich plasma clinically and radiologically for pulp regeneration of immature teeth with apical periodontitis. Material and Methods: An experimental study was conducted From (March/2018-July/2020) 12 upper central immature incisors with acute apical periodontitis and necrotic pulp from six patients receiving regenerative endodontic treatment using concentrated platelets rich plasma were performed by the same endodontist at Mediclinic Middle East Hospitals. Informed consent, including explanation of risks and alternative treatments or no treatment were prepared and filled by the patient parents. The therapeutic protocol was involved accessing the pulp chamber; irrigation copiously with sodium hypochlorite; applying calcium hydroxide as intracanal medicament and a provisionally sealing it after 4 weeks. The canal was cleaned, dried and injected with concentrated platelets rich plasma which serve as a scaffold for pulp regeneration. MTA was used to seal the chamber before final filling with composite. Evaluations: All teeth were monitored clinically (mobility, palpation, percussion, and sensitivity cold test) and radiographically. Results: Twenty months follow-up all teeth showed resolution of periapical radiolucencies, continued root development with positive response to sensitivity cold test and no discoloration. Conclusion: The results of this study confirmed the previous finding that pulp regeneration can be gained by using cPRP successfully. (AU)
Objetivo: Testar a capacidade do plasma rico em plaquetas clinicamente e radiograficamente para a regeneração pulpar em dentes imaturos com periodontite apical. Material e Métodos: O estudo experimental foi realizado em Março/2018 e Julho/2020, 12 incisivos centrais imaturos com periodontite apical aguda e necrose pulpar em 6 pacientes recebendo tratamento endodôntico regenerativo usando concentrado de plasma ricas em plaquetas. Foram realizadas pelo mesmo endodontista no Hospital Mediclinic Middle East. O consentimento informado incluindo explicação do risco e tratamentos alternativos ou de nenhum tratamento foi preenchido pelos responsáveis do paciente. O protocolo terapêutico envolveu acesso à câmara pulpar, irrigação abundante com hipoclorito de sódio, aplicação de hidróxido de cálcio como medicação intracanal e selado intracanal por 4 semanas. O canal foi limpo, seco e injetado concentrado de plasma rico em plaquetas que servem como um scaffold para a regeneração pulpar. Usou-se MTA para selar a câmara antes do preenchimento final com compósitos. Avaliações: Todos os dentes foram monitorados clinicamente (mobilidade, palpação, percussão e teste de sensibilidade com frio) e radiograficamente. Resultados: Após 20 meses de acompanhamento, todos os dentes apresentaram a resolução das radioluscências periapicais, desenvolvimento contínuo da raiz com resposta positiva ao teste de sensibilidade ao frio e sem descoloração. Conclusão: O resultado do estudo confirmou descobertas anteriores que a regeneração pulpar pode ser obtida usando cPRP com sucesso. (AU)
Subject(s)
Humans , Periodontitis , Bone Regeneration , Platelet-Rich PlasmaABSTRACT
Aim: To measure the fracture resistance of over-flared roots filled with a variety of materials (gutta-percha-nano HA, resilon-epiphany, composite and mineral trioxide aggregate - MTA) using the Instron machine test and micro-computed tomography (Micro CT) Scan. In addition, scanning electron microscopy (SEM) images were used to illustrate the type of fracture patternsof the specimens. Methods: One hundred and twenty extracted human mandibular single rooted premolars were selected. A total of 105 out of the selected teeth were prepared to the working length and over-flared, leaving the apical 5 mm undisturbed. Fifteen samples had no treatment and were used as a positive control group (Group +ve). The 105 test teeth were further divided into 7 groups of 15 samples each. One of the 7 groups was designated as negative control (Group -ve) where teeth were over prepared and left without obturation.Remaining groups were filled with gutta-percha-nanoHA (Group1), gutta-percha-nano HA+composite (Group 2), gutta-percha-nano HA+MTA (Group 3), resilon-epiphany (Group 4),resilon-epiphany+composite (Group 5), and resilon-epiphany+MTA (Group 6). Fracture resistance of all samples was measured using the Instron testing machine. Three samples from each group had the depth of their fracture line measured by Micro CT Scan, and 2 samples from each group had their fracture pattern illustrated using SEM. Results: The highest fracture resistance was observed in Group +ve, followed by Groups 3, 6, 5, 2, 4, 1, and Group -ve, with values (in N) of: 1598 (641.0), 1190.5(424.2), 1164.7 (489.4), 821.2 (220.9), 683.4(179),658.4 (211.3), 658.4 (99.0), 158.3(49.3), respectively. Statistical analysis for root fracture resistance showed highly significant difference between all groups with p value < 001.Conclusions: Micro CT Scan and SEM analysis indicated the ability of MTA to withstand vertical force.
Subject(s)
Microscopy, Electron, Scanning , Root Canal Filling MaterialsABSTRACT
Aim: To evaluate the sealing ability of gutta-percha-nano-HA and Resilon-Epiphany by electrochemical method and micro-computed tomography (CT) scan at 48 h and 20 months using three different obturation techniques (cold lateral condensation technique, warm vertical condensation - System B, and warm vertical condensation with vibration - Down-Pak). Methods: 150 human mandibular single-rooted premolars were prepared and randomly allocated into 6 groups of 25 specimens each, and filled with either gutta-percha-nano HA or Resilon-Epiphany with the three different obturation techniques (cold lateral, warm vertical - System B, and warm vertical with vibration - Down-Pak). Electrochemical microleakage method was used to measure the microleakage after 48 h and after 20 months, and a micro-CT Scanner 1072 was used to evaluate the quality of obturation after 48 h. Results: Group 6 (Resilon-epiphany/Down-Pak technique) had the highest microleakage value, followed by Group 2 (Gutta-percha-nano HA/ System B technique), Group 4 (Resilon-Epiphany/Lateral condensation technique), Group 3 (Gutta-percha-nano HA/Down-Pak technique), Group 5 (Resilon-Epiphany/System B technique), and Group 1 (Gutta-percha-nano HA/Lateral condensation technique) with the values of 4.69 (6.06) KÙ, 3.88 (2.92) KÙ, 3.77 (3.75) KÙ, 3.38 (3.92) KÙ, 2.64 (2.90) KÙ, and 2.44 (4.34) KÙ, respectively. No significant difference in the quantity of leakage was observed for each root in each group between the two tested filling materials and their sealers (p=0.143). Micro CT scan investigations revealed more micro-voids in the Resilon-Epiphany Group obturated with Down- Pak technique. Conclusions: Nano-hydroxyapatite sealer with gutta-percha filling material provided a reasonable seal compared with Epiphany sealer and Resilon filling material.