A review of the regenerative endodontic treatment procedure

Traditionally, apexification has been used to treat immature permanent teeth that have lost pulp vitality. This technique promotes the formation of an apical barrier to close the open apex so that the filling materials can be confined to the root canal. Because tissue regeneration cannot be achieved with apexification, a new technique called regenerative endodontic treatment was presented recently to treat immature permanent teeth. Regenerative endodontic treatment is a treatment procedure designed to replace damaged pulp tissue with viable tissue which restores the normal function of the pulp-dentin structure. After regenerative endodontic treatment, continued root development and hard tissue deposition on the dentinal wall can occur under ideal circumstances. However, it is difficult to predict the result of regenerative endodontic treatment. Therefore, the purpose of this study was to summarize multiple factors effects on the result of regenerative endodontic treatment in order to achieve more predictable results. In this study, we investigated the features of regenerative endodontic treatment in comparison with those of other pulp treatment procedures and analyzed the factors that have an effect on regenerative endodontic treatment.

A Case of Anterior Fibrovascular Membrane After Intraocular Lens Implantation in Congenital Aniridia

PURPOSE: To report a case of an anterior fibrovascular membrane following cataract extraction and intraocular lens implantation in a patient with congenital aniridia. CASE SUMMARY: A 13-year-old girl presented with congenital aniridia and cataracts in both eyes. She underwent cataract extraction by phacoemulcification with intraocular lens implantation. Six months after cataract surgery, a progressive anterior chamber fibrovascular membrane was noted in both intraocular lens and rudimentary iris. Surgical excision of the fibrovascular membrane was performed, but there was recurrence after five weeks in both eyes. Subsequent surgical intervention on both eyes involved intraocular lens explantation combined with membranectomy to prevent recurrence and phthisis. Surgical findings indicated that the fibrovascular membrane involved the retrolenticular space, and histopathological evidence indicated that the extensive fibrotic tissue originated from the root of the rudimentary iris. CONCLUSIONS: Patients with congenital aniridia should be monitored carefully for the development of intraocular fibrosis after intraocular lens implantation. If a fibrovascular membrane is noted, early surgical intervention is recommended, and the explantation of the intraocular lens should be considered during surgical intervention to prevent recurrence and complications.

Evaluation of a New Scoring System for Retinal Nerve Fiber Layer Photography Using HRA1 in 964 Eyes

PURPOSE: To evaluate retinal nerve fiber layer (RNFL) defect by a new scoring system for RNFL photography using the Heidelberg Retina Angiograph 1 (HRA1). METHODS: This retrospective study included 128 healthy eyes and 836 primary open-angle glaucoma eyes. The RNFL photography using HRA1 was interpreted using a new scoring system, and correlated with visual field indices of standard automated perimetry (SAP). Using the presence of RNFL defect, darkness, width, and location, we established the new scoring system of RNFL photos. RESULTS: The mean RNFL defect score I in the early, moderate, severe, and control groups were 7.3, 9.2, 10.4, and 3.6, respectively. The mean RNFL defect score II in the early, moderate, severe, and control groups were 14.5, 28.5, 43.4, and 3.4, respectively. Correlations between the RNFL defect score II and the mean deviation of SAP was the strongest of the various combinations (r=-0.675, P<.001). CONCLUSIONS: Using a new scoring system, we propose a method for semi-quantitative interpretation of RNFL photographs. This scoring system may be helpful to distinguish between normal and glaucomatous eyes, and the score is associated with the severity of visual field loss.

Hydroxyapatite Orbital Implant in Pediatric Patients with Retinoblastoma

PURPOSE: To evaluate the clinical results of implantation of hydroxyapatite orbital implant in patients with retinoblastoma. METHODS: The medical records of 31 children who had undergone hydroxyapatite implantation after enucleation or secondary hydroxyapatite implantation, for retinoblastoma from April 1994 to January 2006 were reviewed retrospectively. RESULTS: The mean age at the time of operation was 64.1 months (range, 1 to 247 months). The mean follow-up period was 35.3 months (range, 3 to 139 months). The diameter of the orbital implants most used was 20 mm (35.4%, range, 16~21 mm). Tutoplast(R), Vicryl mesh(R), and Neuropatch(R) were used as the wrapping materials for hydroxyapatite orbital implant. Of 31 patients (31 eyes), 8 eyes were found to have complications: 6 eyes showed lower lid sagging (19.4%), 1 eye granulation tissue overgrowth (3.2%) and 1 eye conjunctival sac contracture (3.2%). Exposure of the hydroxyapatite orbital implant occurred in 1 eye (3.2%). CONCLUSIONS: Hydroxyapatite implantation in children with retinoblastoma showed good surgical results and minimal complications.