- Keywords
- Micro-Apical Placement,
- MeSH
- Apexification MeSH
- Humans MeSH
- Pulp Capping and Pulpectomy Agents * therapeutic use MeSH
- Root Canal Obturation methods MeSH
- Silicates therapeutic use MeSH
- Aluminum Compounds therapeutic use MeSH
- Root Canal Therapy * MeSH
- Tooth Root injuries MeSH
- Check Tag
- Humans MeSH
- MeSH
- Apexification methods adverse effects MeSH
- Tooth Avulsion * therapy MeSH
- Child MeSH
- Endodontics methods MeSH
- Calcium Phosphates adverse effects therapeutic use MeSH
- Humans MeSH
- Orthodontic Brackets utilization MeSH
- Incisor MeSH
- Composite Resins therapeutic use MeSH
- Dental Restoration, Permanent methods nursing adverse effects MeSH
- Tooth Discoloration chemically induced MeSH
- Dental Materials adverse effects therapeutic use MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
In case of failure of endodontic surgery, a non-surgical root canal retreatment can be in particular cases a viable approach to safe a tooth. This approach can be preferred especially when primary non-surgical root canal treatment was poorly executed and subsequent surgical treatment was not indicated properly and had not followed particular rules such as adequate retrograde filling, resection angle etc. which are discussed in this case report.
- MeSH
- Apexification methods MeSH
- Adult MeSH
- Endodontics * methods MeSH
- Humans MeSH
- Microsurgery methods MeSH
- Silicate Cement therapeutic use MeSH
- Root Canal Therapy methods MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
Úvod a cíl práce: Endodontické ošetření stálých zubů s nedokončeným vývojem a nekrotickou dření patří k nejnáročnějším výkonům v endodoncii. V posledních dvou dekádách byly popsány postupy, které využívají poznatků regenerativní medicíny a jejichž cílem je obnova pulpodentinového orgánu. Cílem naší studie bylo retrospektivně porovnat klinickou úspěšnost a rentgenologický přírůstek mineralizovaných tkání při ošetření apexifikací hydroxidem vápenatým – Ca(OH)2 a maturogenezí. Metodika: Byly shromážděny záznamy pacientů do 16 let věku, kteří podstoupili endodontické ošetření stálého zubu s neukončeným vývojem a nekrotickou dření na Klinice zubního lékařství v Olomouci v období let 2011–2015. Z celkového počtu 54 pacientů bylo podle stanovených kritérií vybráno 17 pacientů, z čehož devět bylo ošetřeno apexifikací Ca(OH)2 a osm maturogenezí. V rámci kontrol byly zhotoveny kontrolní RTG snímky a bylo provedeno klinické vyšetření. Následně byla provedena matematická korekce kontrolních snímků z poslední návštěvy a stanovila se procentuální změna radiologického povrchu kořene a procentuální změna radiologické délky kořene oproti původnímu stavu. Po vyhodnocení normality získaných dat Wilkovým-Shapirovým testem byly nulové hypotézy zkoumány Studentovým t-testem a jednovýběrovým a dvouvýběrovým Wilcoxonovým testem. Klinická úspěšnost byla testována Fisherovým faktoriálovým testem. Výsledky: Při porovnání změn radiologického povrchu kořene byl pozorován signifikantní přírůstek hmoty ve prospěch maturogeneze, kde průměrná změna radiologického povrchu kořene je 16 % (p = 0,0041) oproti apexifikaci Ca(OH)2, která je 5,9 %. Statisticky signifikantní rozdíly nebyly zjištěny ani ve změně mezi radiologickými délkami (p = 0,939), tak ani v klinické úspěšnosti (p = 0,5459). Závěr: Nebyl nalezen signifikantní rozdíl mezi maturogenezí a apexifikací Ca(OH)2 v klinické úspěšnosti a rentgenologické změně délky kořene. Signifikantní rozdíl ale byl ve změně rentgenologického povrchu kořene, jenž je u maturogeneze větší než u apexifikace Ca(OH)2.
Introduction and aim: The endodontic treatment of necrotic immature permanent teeth is one of the most demanding intervention in the field of endodontics. In the last two decades there was an emerging evidence supporting the use of regenerative medicine concepts which aims to regenerate pulpdentinal organ. The aim of our study was to compare clinical success rate and change in radiological root area and radiological length between Ca(OH)2 apexification and maturogenesis. Methods: Data of patients treated between years 2011 and 2015 at Institute of Dentistry and Oral Sciences in Olomouc who were younger than 16 years and simultaneously underwent endodontic treatment of immature permanent tooth were collected. From total of 54 patients, 17 were chosen according to designated criteria. Nine patients were treated by Ca(OH)2 apexification and 8 by maturogenesis. In the scope of follow-up, the control X-rays were taken and clinical examination was performed. The mathematical correction of control X-rays was carried out and percentual change in radiological root area and radiological length in comparison to diagnostic X-ray were determined. After assessment of normality of collected data with Wilk-Shapiro test, the null hypothesis was examined by student t-test and Wilcoxon signed-rank/rank-sum tests. The clinical outcome was tested by Fisher factorial test. Results: There was significant difference in comparison of change in radiological root area among teeth treated with Ca(OH)2 apexification and maturogenesis (p = 0.0041). The average change in radiological root area was 16% in cases treated with maturogenesis and 5.9% in cases treated with Ca(OH)2 apexification. No statistically significant differences were found in radiological length change (p = 0.939) and clinical success rate (p = 0.5459). Conclusion: According to our data there were no significant differences between maturogensis and Ca(OH)2 apexification in clinical success rates and change of radiological lengths. Significant difference was observed in the change of radiological root, which was higher in cases treated by maturogenesis.
- Keywords
- maturogeneze, revaskularizace, stálý zub s nedokončeným vývojem,
- MeSH
- Apexification * methods utilization MeSH
- Calcium Hydroxide therapeutic use MeSH
- Clinical Studies as Topic MeSH
- Humans MeSH
- Dental Pulp Necrosis * therapy MeSH
- Guided Tissue Regeneration methods MeSH
- Tooth Root MeSH
- Check Tag
- Humans MeSH
- MeSH
- Apexification * methods MeSH
- Adult MeSH
- Endodontics methods MeSH
- Humans MeSH
- Microsurgery methods MeSH
- Silicate Cement therapeutic use MeSH
- Root Canal Therapy methods MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
Traumatic dental injuries (TDI) occur in childhood and puberty very often. Almost one third of adults experienced dental trauma to permanent teeth and most of them happened before adulthood. These injuries present a challenge even for experienced dentists. It is not only because of difficult and demanding diagnosis, treament planning and adequate intervention is arduous as well. Consequently, proper diagnosis, treatment planning and follow-ups are critical to assure a favourable outcome.
- MeSH
- Apexification * methods MeSH
- Child MeSH
- Tooth Fractures nursing MeSH
- Calcium Hydroxide therapeutic use MeSH
- Dental Pulp Cavity drug effects MeSH
- Humans MeSH
- Odontogenesis drug effects MeSH
- Prognosis MeSH
- Pulpotomy * MeSH
- Incisor MeSH
- Silicate Cement therapeutic use MeSH
- Treatment Outcome MeSH
- Tooth Discoloration chemically induced MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
- Keywords
- zuby s nedokončeným vývojem, mineral trioxide aggregate - MTA,
- MeSH
- Apexification * methods statistics & numerical data MeSH
- Child MeSH
- Adult MeSH
- Humans MeSH
- Adolescent MeSH
- Radiography, Dental MeSH
- Retrospective Studies MeSH
- Root Canal Therapy * methods statistics & numerical data MeSH
- Root Canal Filling Materials therapeutic use MeSH
- Treatment Outcome MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
V třetí části přehledového sdělení se podrobně zabýváme indikacemi maturogeneze a možnými alternativami ošetření. Dále je podrobně popsán samotný doporučený klinický protokol, s velkým důrazem na praktické provedení v praxi praktického zubního lékaře. Výplachový protokol a intrakanalikulární medikace je upravena tak, aby došlo k dostatečné dezinfekci kořenového systému a zároveň co nejmenšímu poškození dentinu a kmenových buněk podílejících se na vzniku nové tkáně. Jsou zmíněny na trhu dostupné materiály, které jsou vhodné pro maturogenezi včetně jejich výhod a nevýhod. V neposlední řadě je popsáno hodnocení úspěchu provedené terapie a charakterizace nově vzniklé tkáně.
In the third article, the indications of revascularization treatment and possible alternative treatment options are considered. Furthermore, step-by-step clinical protocol in detail is described, with emphasis on clinical execution in every-day office of general practicioners. Irrigation protocol and intracanal medication is adjusted to obtain adequate disinfection of root canal system and at the same time the damage to dentin and stem cells is decresed. The materials which are suitable for revascularization treatment including their pros and cons are mentioned. Finally, the assesment of therapy outcomes and characterization of newly formed tissue are described.
- Keywords
- Biodentin, MTA zátka, krevní sraženina, mineral trioxide aggregate,
- MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Apexification * methods MeSH
- Dentinogenesis physiology MeSH
- Child MeSH
- Drug Combinations MeSH
- Outcome Assessment, Health Care methods MeSH
- Calcium Hydroxide therapeutic use MeSH
- Clinical Protocols MeSH
- Humans MeSH
- Pulp Capping and Pulpectomy Agents MeSH
- Dental Pulp Necrosis * therapy MeSH
- Oxides therapeutic use MeSH
- Platelet-Rich Plasma MeSH
- Root Canal Irrigants MeSH
- Regeneration physiology MeSH
- Regenerative Endodontics MeSH
- Guided Tissue Regeneration methods MeSH
- Silicates therapeutic use MeSH
- Aluminum Compounds therapeutic use MeSH
- Calcium Compounds therapeutic use MeSH
- Root Canal Therapy * methods MeSH
- Tooth Injuries therapy MeSH
- Root Canal Filling Materials therapeutic use MeSH
- Dental Cements MeSH
- Tooth Root growth & development MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
This article deals with the unusual course of failed revascularization/revitalization cases. Up to this date the evidence of success and failure rates of revascularization/revitalization treatment is scarce. These case reports present "unsuccessful" revascularization/revitalization treatment of permanent immature teeth with apical periodontitis. Although the teeth were treated by protocol suggested by the American Association of Endodontists and the symptoms disappeared, maturation of teeth continued, and periapical lesion was reduced, the teeth went symptomatic during the follow-up. Subsequently, regular root canal treatment was performed. Despite chronic infection that was probably left inside the root canal after a disinfection protocol, the secondary aims of the treatment were achieved even when the primary ones were not. The possible causes of failures of revascularization/revitalization treatment and their prevention are discussed.
- MeSH
- Apexification methods MeSH
- Child MeSH
- Neovascularization, Physiologic MeSH
- Tooth Apex growth & development pathology MeSH
- Humans MeSH
- Dental Pulp Necrosis therapy MeSH
- Treatment Failure * MeSH
- Periapical Periodontitis therapy MeSH
- Root Canal Preparation methods MeSH
- Root Canal Irrigants therapeutic use MeSH
- Incisor MeSH
- Root Canal Therapy methods MeSH
- Root Canal Filling Materials therapeutic use MeSH
- Tooth Root drug effects growth & development pathology MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- Geographicals
- Czech Republic MeSH
