Considerations on pulp revascularization of endodontic interest
DOI:
https://doi.org/10.52076/eacad-v5i3.559Keywords:
Regenerative endodontic; Tooth apex; Dental pulp necrosis; Root canal therapy; Drug administration.Abstract
Teeth with incomplete apical formation undergo a process of pulp mortification, and dentin formation is interrupted, with suspended root growth and no apical closure. The objective of this research was to evaluate publications between 2019 and 2024, using a literature review with the MEDELINE/Pubmed and Scopus databases, whose selected criteria were the type of clinical cases and systematic reviews comparing the diagnosis, procedures, efficiency, and benefits of pulp revascularization compared to the use of new substances and methodologies in teeth with incomplete rhizogenesis and pulp necrosis. Two reviewers included 57 studies according to predefined selection criteria, with 28 publications meeting the inclusion criteria. From this review regarding revascularization, it is possible to infer that sodium hypochlorite in different concentrations, chlorhexidine gluconate, triple antibiotic paste such as ciprofloxacin and metronidazole, and calcium hydroxide represent agents that promote root canal disinfection. The use of MTA combined with other products, such as PRP, PRF, calcium hydroxide and chlorhexidine gel, blood clot regenerative endodontic protocol and the blood clot + injectable structure group or these alone represent material that, in contact with the blood clot, promotes thickening of the dentin walls, elongation of the roots and closure of the root apex. Stimulating apical bleeding with files is an essential maneuver in the formation of a clot within the canal. The newly formed tissues in the canals are fibrous, cementum or similar to bone along the dentin walls.
References
Alencar, M. N., Kowaltschuk, T. C., Kowalczuck, A., Carneiro, E., Silva Neto, U. X. & Ditzel Westphalen, V .P. (2022). Regen,erative Endodontic Treatment of a Traumatized Immature Necrotic Permanent Incisor: A Case Report. Iran Endod J. 17(3):146-150.
Almutairi, W., Yassen, G. H, Aminoshariae, A., Williams, K. A. & Mickel, A. (2019). Regenerative Endodontics: A Systematic Analysis of the Failed Cases. J Endod. 45(5):567-577.
Araújo, B. S. ., Casadei, B. de A. ., & Chaves, H. G. dos S. (2023). Terapia regenerativa em dente permanente jovem: Relato de caso. Research, Society and Development, 12(1), e15012139771. https://doi.org/10.33448/rsd-v12i1.39771
Araújo, L., Goulart, T. S., Gil, A. C. K., Schuldt, D. P. V., Coelho, B. S., Figueiredo, D. R., Garcia, L. D. F. R. & Almeida, J. (2022). Do alternative scaffolds used in regenerative endodontics promote better root development than that achieved with blood clots? Braz Dent J. 33(2):22-32.
Báez, V., Corcos, L., Morgillo, F., Imperatrice, L. & Gualtieri A. F. (2022). "Meta-analysis of regenerative endodontics outcomes with antibiotics pastes and calcium hydroxide. The apex of the iceberg". J Oral Biol Craniofac Res. 12(1):90-98.,
El Sheshtawy, A.S., Nazzal, H., El Shahawy, O. I., El Baz, A. A., Ismail, S. M., Kang, J. & Ezzat, K. M. (2020). The effect of platelet-rich plasma as a scaffold in regeneration/revitalization endodontics of immature permanent teeth assessed using 2-dimensional radiographs and cone beam computed tomography: a randomized controlled trial. Int Endod J. 53(7):905-921.
Maltarollo, T. F. H., Strazzi-Sahyon, H. B., Sivieri-Araújo, G., & Shitsuka, C. (2024). Metaverse applications in endodontics teaching. Australian endodontic journal : the journal of the Australian Society of Endodontology Inc, 50(1), 179–181. https://doi.org/10.1111/aej.12830
Medeiros, J. M. F. Chebat, M., Paschoal, E. C., Haddad Filho, M. S., Cerri, A., Martins, J. L. & Pedron, I .G. (2019). Revascularização em dentes imaturos com tecido pulpar necrótico: eficácia e procedimentos clínicos. Rev Assoc Paul Cir Dent. 73(2):162-72.
Medeiros, J. M. F., Pedron, I. G., Shitsuka, C., Arruda, G., Cerri, A., Martins, J. L. & Haddad Filho, M. S. (2020). Nova opção de revascularização pulpar em dentes com formação apical incompleta e necrose pulpar. Rev Assoc Paul Cir Dent. 74(2):118-29.
Meschi, N., Palma, P. J. & Cabanillas-Balsera, D. (2023). Effectiveness of revitalization in treating apical periodontitis: A systematic review and meta-analysis. Int Endod J. 56(3):510-532.
Metlerska, J., Fagogeni, I. & Nowicka, A. (2019). Efficacy of Autologous Platelet Concentrates in Regenerative Endodontic Treatment: A Systematic Review of Human Studies. J Endod. 45(1):20-30.e1
Minic, S., Vital, S., Chaussain, C., Boukpessi T. & Mangione, F. (2022). Tissue Characteristics in Endodontic Regeneration: A Systematic Review. Int J Mol Sci. 11;23(18):10534.
Mittal, N. & Parashar, V. (2019). Regenerative Evaluation of Immature Roots using PRF and Artificial Scaffolds in Necrotic Permanent Teeth: A Clinical Study. J Contemp Dent Pract. 20(6):720-726.
Nascimento, J. L. do ., & Feitosa, R. A. (2020). Metodologias ativas, com foco nos processos de ensino e aprendizagem. Research, Society and Development, 9(9), e622997551. https://doi.org/10.33448/rsd-v9i9.7551
Nicoloso, G. F., Goldenfum, G. M., Pizzol, T. D. S. D., Scarparo, R. K., Montagner, F., Almeida Rodrigues, J. & Casagrande, L. (2019). Pulp Revascularization or Apexification for the Treatment of Immature Necrotic Permanent Teeth: Systematic Review and Meta-Analysis. J Clin Pediatr Dent. 43(5):305-313.
Nygaard Östby, B. (1961). The role of the blood clot in endodontic therapy An experimental histologic study Acta Odontologica Scandinavica. 19(3-4):323-353.
Ong, T. K., Lim, G. S., Singh, M. & Fial, A. V. (2020). Quantitative Assessment of Root Development after Regenerative Endodontic Therapy: A Systematic Review and Meta-Analysis. J Endod. 46(12):1856-1866.e2.
Panda, S., Mishra L., Arbildo-Veja, H. I., Lapinska, B., Lukomska-Szymanska, M., Khijmatgar, S., Parolia, A., Bucchi, C. & Fabbro, M. D. (2020). Effectiveness of Autologous Platelet Concentrates in Management of Young Immature Necrotic Permanent Teeth-A Systematic Review and Meta-Analysis. Cells. 7;9(10):2241.
Pereira, A. C., Oliveira, M .L., Cerqueira-Neto, A. C. C. L., Gomes, B. P. F. A., Ferraz, C .C. R., Almeida, J. F. A., Marciano, M. A. & D E-Jesus-Soares, A. (2020). Treatment outcomes of pulp revascularization in traumatized immature teeth using calcium hydroxide and 2% chlorhexidine gel as intracanal medication. J Appl Oral Sci. 25;28:e20200217.
Priya, B. L., Singh, N., Mangalam, K. K., Sachdev, R. P. A., Jain, H. N. & Nagi, P. K. (2023). Success and Complication Rates of Revascularization Procedures for Immature Necrotic Teeth: A Systematic Review. Cureus. 30;15(12):e51364.
Ragab, R. A., Lattif, A. E. A. E. & Dokky, N. A. E. W. E. (2019). Comparative Study between Revitalization of Necrotic Immature Permanent Anterior Teeth with and without Platelet Rich Fibrin: A Randomized Controlled Trial. J Clin Pediatr Dent. 43(2):78-85.
Rahul, M., Lokade, A., Tewari, N., Mathur, V., Agarwal, D., Goel, S., Keshari, P., Sharma, S. & Bansal, K. (2023). Effect of Intracanal Scaffolds on the Success Outcomes of Regenerative Endodontic Therapy - A Systematic Review and Network Meta-analysis. J Endod. 49(2):110-128.
Sabeti, M., Ghobrial, D., Zanjir, M., Costa, B. R., Young, Y. & Azarpazhooh, A. (2024). Treatment outcomes of regenerative endodontic therapy in immature permanent teeth with pulpal necrosis: A systematic review and network meta-analysis. Int Endod J. 57(3):238-255.
Sellami, R., Van Holm, W., Meschi, N., Van Den Heuvel, S., Pauwels, M., Verspecht, T., Vandamme, K., Teughels, W. & Lambrechts, P. (2023). Regenerative endodontic procedures in immature permanent teeth with pulp necrosis: the impact of microbiology on the clinical and radiographic outcome. Front Dent Med. 4:1281337. doi: 10.3389/fdmed.2023.1281337
Sequeira, D. B., Diogo, P., Gomes, B. P. F. A., Peça, J. & Santos, J. M. M. (2023). Scaffolds for Dentin-Pulp Complex Regeneration. Medicina (Kaunas). 60(1):7.
Swaikat, M., Faus-Matoses, I., Zubizarreta-Macho, Á., Ashkar, I., Faus-Matoses, V., Bellot-Arcís, C., Iranzo-Cortés, J. E. & Montiel-Company, J. M. (2023). Is Revascularization the Treatment of Choice for Traumatized Necrotic Immature Teeth? A Systematic Review and Meta-Analysis. J Clin Med. 12(7):2656.
Ulusoy, A. T., Turedi, I., Cimen, M. & Cehreli, Z. C. (2019). Evaluation of Blood Clot, Platelet-rich Plasma, Platelet-rich Fibrin, and Platelet Pellet as Scaffolds in Regenerative Endodontic Treatment: A Prospective Randomized Trial. J Endod. 2019 May;45(5):560-566.
Tomazoli, A. T. P., Cabau, L., Tolentino, E. ., Pavan, N. N. O. ., Tookuni, I. V. M., & Endo, M. S. . (2022). Avaliação das técnicas de inserção de MTA em dentes preparados apicalmente simulando rizogênese incompleta: estudo in vitro. Research, Society and Development, 11(11), e456111133745. https://doi.org/10.33448/rsd-v11i11.33745
Travassos, R. M. C. ., Acioli, A. C. R. ., Barbosa, A. M. C. ., Cruz, G. V. ., Melo, J. A. ., Souza, J. V. M. de ., & Menezes, M. L. S. de . (2022). Apicificação de dente com ápice aberto utilizando MTA: relato de caso. E-Acadêmica, 3(1), e2431115. https://doi.org/10.52076/eacad-v3i1.115
Vatankhah, M., Najary, S. & Dianat, O. (2024). Clinical, Radiographic, and Histologic Outcomes of Regenerative Endodontic Treatment in Human Immature Teeth Using Different Biological Scaffolds: A Systematic Review and Meta-analysis. Curr Stem Cell Res Ther. 19(4):611-627.
Wikström, A., Brundin, M., Romani Vestman, N., Rakhimova, O. & Tsilingaridis, G. (2022). Endodontic pulp revitalization in traumatized necrotic immature permanent incisors: Early failures and long-term outcomes-A longitudinal cohort study. Int Endod J. 55(6):630-645.
Wikström, A., Romani Vestman, N., Rakhimova, O., Lazaro Gimeno, D., Tsilingaridis, G. & Brundin, M. (2024). Microbiological assessment of success and failure in pulp revitalization: a randomized clinical trial using calcium hydroxide and chlorhexidine gluconate in traumatized immature necrotic teeth. J Oral Microbiol. 16(1):2343518.
Yang, F., Sheng, K., Yu, L. & Wang, J. (2024). Does the use of different scaffolds have an impact on the therapeutic efficacy of regenerative endodontic procedures? A systematic evaluation and meta-analysis. BMC Oral Health. 9;24(1):319.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 João Marcelo Ferreira de Medeiros; Eduarda Rubio Cantelle; Giovana Biondi Galhardo; Gelson de Oliveira Zanetti; Thais Cordeshi; Caleb Shitsuka
This work is licensed under a Creative Commons Attribution 4.0 International License.
Autores que publicam nesta revista concordam com os seguintes termos:
1) Autores mantém os direitos autorais e concedem à revista o direito de primeira publicação, com o trabalho simultaneamente licenciado sob a Licença Creative Commons Attribution que permite o compartilhamento do trabalho com reconhecimento da autoria e publicação inicial nesta revista.
2) Autores têm autorização para assumir contratos adicionais separadamente, para distribuição não-exclusiva da versão do trabalho publicada nesta revista (ex.: publicar em repositório institucional ou como capítulo de livro), com reconhecimento de autoria e publicação inicial nesta revista.
3) Autores têm permissão e são estimulados a publicar e distribuir seu trabalho online (ex.: em repositórios institucionais ou na sua página pessoal) a qualquer ponto antes ou durante o processo editorial, já que isso pode gerar alterações produtivas, bem como aumentar o impacto e a citação do trabalho publicado.
