Abstract
Introduction
More data are needed before affirming that single-visit approaches are effective and
safe for regenerative endodontic procedures (REPs). This study compared clinical and
radiographic outcomes of REPs between interappointment dressing or single-visit protocols.
Methods
Twenty young patients presenting traumatized immature teeth with pulp necrosis were
divided into 2 groups. Teeth were submitted to 6% sodium hypochlorite and 2% chlorhexidine
irrigation and to 17% EDTA use before blood clot induction. In the interappointment
dressing group (n = 11), calcium hydroxide was used with 2% chlorhexidine gel for 21 days before scaffold
induction. In the single-visit group (n = 9), the scaffold was induced during the only appointment. Patients were followed
up for 24 months. Primary, secondary, and tertiary outcomes were assessed by 3 independent
evaluators. Preoperative and follow-up radiographs were assessed for quantitative
measurements of the apical diameter, root width, root length, and cervical barrier
placement and compared between groups using the t test or Mann-Whitney U test. Categoric variables were assessed with the G test and the Fisher exact test
and continuous variables with the Mann-Whitney U test. Statistical significance was set at 5%.
Results
One tooth showed persistence of infection. No difference was observed in cervical
barrier placement (P > .05); between groups regarding primary, secondary, and tertiary outcomes (P > .05); and in parameters of quantitative radiographic outcomes (P > .05).
Conclusions
Completing REPs with an interappointment dressing or a single-visit protocol presented
similar clinical and radiographic outcomes. A single-visit protocol of REPs using
6% sodium hypochlorite, 2% chlorhexidine, and 17% EDTA permitted satisfactory outcomes
in necrotic immature permanent teeth.
Key Words
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References
- Does calcium hydroxide reduce endotoxins in infected root canals? systematic review and meta-analysis.J Endod. 2020; 20: 30582-30583
- Success rate of single-versus two-visit root canal treatment of teeth with apical periodontitis: a randomized controlled trial.J Endod. 2012; 38: 1164-1169
- Single versus multiple visits for endodontic treatment of permanent teeth.Cochrane Database Syst Rev. 2016; 12: CD005296
- Clinical and molecular microbiological evaluation of regenerative endodontic procedures in immature permanent teeth.J Endod. 2020; 46: 1448-1454
- Effect of residual bacteria on the outcome of pulp regeneration in vivo.J Dent Res. 2017; 96: 100-106
- Immune modulation of stem cells and regeneration.Cell Stem Cell. 2014; 15: 14-25
- European Society of Endodontology position statement: revitalization procedures.Int Endod J. 2016; 49: 717-723
- Microbial evaluation of traumatized teeth treated with triple antibiotic paste or calcium hydroxide with 2% chlorhexidine gel in pulp revascularization.J Endod. 2014; 40: 778-783
- Limited evidence suggests benefits of single visit revascularization endodontic procedures – a systematic review.Braz Dent J. 2019; 30: 527-535
- Are single-visit regenerative endodontic procedures successful in treating non-vital, immature young permanent teeth?.Evid Based Dent. 2020; 21: 136-137
- One step pulp revascularization treatment of an immature permanent tooth with chronic apical abscess: a case report.Int Endod J. 2009; 42: 1118-1126
- Revascularization of an immature tooth with apical periodontitis using a single visit protocol: a case report.Int Endod J. 2015; 48: 484-497
- The use of a single-step regenerative approach for the treatment of a replanted mandibular central incisor with severe resorption.Int Endod J. 2016; 49: 802-812
- Single-visit pulp revascularization of a nonvital immature permanent tooth using biodentine.Iran Endod J. 2016; 11: 246-249
- Orthodontic movement after regenerative endodontic procedure: case report and long-term observations.J Endod. 2018; 44: 432-437
- Regenerative endodontic therapy in a single visit using platelet-rich plasma and biodentine in necrotic and asymptomatic immature molar teeth: a report of 3 cases.J Endod. 2016; 42: 1344-1346
- Regenerative endodontics for upper permanent central incisors after traumatic injury: case report with a 3-year follow-up.J Contemp Dent Pract. 2019; 20: 974-977
- Case report: single visit photo-activated disinfection in regenerative endodontics.F1000Res. 2019; 8: 1519
- Traumatized immature teeth treated with 2 protocols of pulp revascularization.J Endod. 2014; 40: 606-612
- Intracanal dressing paste composed by calcium hydroxide, chlorhexidine and zinc oxide for the treatment of immature and mature traumatized teeth.Braz J Oral Sci. 2014; 13: 6-11
- Clinical outcomes of immature teeth treated with regenerative endodontic procedures—a San Antonio study.J Endod. 2020; 46: 1074-1084
- Treatment outcomes of pulp revascularization in traumatized immature teeth using calcium hydroxide and 2% chlorhexidine gel as intracanal medication.J Appl Oral Sci. 2020; 28: e20200217
- Outcomes of traumatised immature teeth treated with apexification or regenerative endodontic procedure: a retrospective study.Aust Endod J. 2020; ([Epub ahead of print])https://doi.org/10.1111/aej.12447
- Regenerative potential of immature permanent teeth with necrotic pulps after different regenerative protocols.J Endod. 2014; 40: 192-198
- Worldwide analyses of maxillary first molar second mesiobuccal prevalence: a multicenter cone-beam computed tomographic study.J Endod. 2018; 44: 1641-1649
- Clinical evidence for regenerative endodontic procedures: immediate versus delayed induction?.J Endod. 2017; 43: S75-S81
- Interactions between irrigants commonly used in endodontic practice: a chemical analysis.J Endod. 2013; 39: 505-510
- Antimicrobial action of intracanal medicaments on the external root surface.J Dent. 2009; 37: 76-81
- Saberi M Interaction of intracanal medicaments with apical papilla stem cells: quantitative cytotoxicity assessment by methyl thiazolyl tetrazolium, trypan blue and lactate dehydrogenase.Minerva Stomatol. 2019; 68: 36-41
- Concentration-dependent effect of sodium hypochlorite on stem cells of apical papilla survival and differentiation.J Endod. 2014; 40: 51-55
- Effect of irrigants on the survival of human stem cells of the apical papilla in a platelet-rich plasma scaffold in human root tips.J Endod. 2011; 37: 1109-1115
- Dentin conditioning codetermines cell fate in regenerative endodontics.J Endod. 2011; 37: 1536-1541
- The effect of exposure to irrigant solutions on apical dentin biofilms in vitro.J Endod. 2006; 32: 434-437
- Antibacterial effect of different concentrations of sodium hypochlorite on Enterococcus faecalis biofilms in root canals.J Dent Res Dent Clin Dent Prospects. 2017; 11: 215-221
- Influence of adjuncts to irrigation in the disinfection of large root canals.J Endod. 2019; 45: 332-337
Article info
Publication history
Published online: July 22, 2021
Identification
Copyright
© 2021 American Association of Endodontists.
