Regenerative Pulpotomy as a Novel Technique for Treatment of Permanent Mature Molars Diagnosed with Irreversible Pulpitis Using Platelet-Rich Fibrin: A Case Series Study | ||||
| Alexandria Dental Journal | ||||
| Article 10, Volume 46, Issue 1, April 2021, Page 129-135 PDF (544.68 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/adjalexu.2020.23924.1046 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Ahmed Mobarak   1; Salma Genena2; Ashraf Zaazou3; Nayera Abdelasalam Mokhless4; Sybel Mokhtar Moussa5
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| 1Conservative Dentistry Department, Faculty of Dentistry, Alexandria University Alexandria, Egypt. | ||||
| 2Conservative Dentistry Department, Faculty Of Dentistry , Alexandria University Alexandria, Egypt. | ||||
| 3Endodontic department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia. | ||||
| 4Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Egypt | ||||
| 5Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt. | ||||
| Abstract | ||||
| INTRODUCTION: Management of teeth with clinical signs/symptoms suggestive of irreversible pulpitis was conventionally invasive, but the emerging evidences suggested successful treatment outcome using the less invasive vital pulp procedures such as coronal pulpotomy, leading to preservation of the remaining pulp in a vital and functioning state. OBJECTIVES: Evaluation of the clinical/radiographic success of novel regenerative coronal pulpotomy technique using Platelet-Rich Fibrin(PRF) and Biodentine. METHODOLOGY: Three irreversibly inflamed permanent molars with mature roots in three patients were treated by regenerative pulpotomy technique. Access openings were done, and coronal pulps were removed to the level of root canal orifices. Hemostasis in all teeth were done by the compression with cotton pellets moistened with 2.5 % sodium hypochlorite(NaOCl). PRF membranes were prepared by drawing 10 ml of patients’ own blood, then they were immediately centrifuged using a table top centrifuge at 400 gforce for 12mins. The PRF membranes were placed over the remaining radicular pulps followed by Biodentine preparation and placement over the PRF. The cavities were then immediately restored. Patients were scheduled for clinical/radiographic evaluations after three-, six- and 12-months. RESULTS: Throughout the follow-up periods, the three teeth demonstrated clinical/radiographic success with complete resolution of clinical signs/symptoms. CONCLUSIONS: All presented cases showed a favorable clinical/radiographic outcomes of “Regenerative pulpotomy” procedure in treating irreversibly inflamed permanent molars using PRF and Biodentine combination. | ||||
| Keywords | ||||
| Case series. Irreversible Pulpitis; Mature Teeth; Platelet Rich Fibrin; Regenerative Pulpotomy | ||||
| References | ||||
|
Duncan HF, Yamauchi Y. Pulp exposure management. Clin Dent Rev. 2019;3:1–9.
Asgary S, Eghbal M. The effect of pulpotomy using a calcium-enriched mixture cement versus one-visit root canal therapy on postoperative pain relief in irreversible pulpitis: a randomized clinical trial. Odontology. 2010;98:126–33.
Goldberg M, Schmalz G. Toward a strategic plan for pulp healing: from repair to regeneration. Clin Oral Investig
2011;15:1–4.
Zanini M, Hennequin M, Cousson P-Y. A Review of Criteria for the Evaluation of Pulpotomy Outcomes in Mature
Permanent Teeth. J Endod 2016;42:1167–74.
Caplan DJ, Cai J, Yin G, White BA. Root canal filled versus non-root canal filled teeth: a retrospective comparison
of survival times. J Public Health Dent. 2005;65:90–6.
Zhang W, Yelick PC. Vital Pulp Therapy—Current Progress of Dental Pulp Regeneration and Revascularization.
Int J Dent 2010;2010:1–9.
Asgary S, Ehsani S. Permanent molar pulpotomy with a new endodontic cement: A case series. J Conserv Dent.
2009;12:31–7.
Schmalz G, Smith AJ. Pulp Development, Repair, and Regeneration: Challenges of the Transition from Traditional
Dentistry to Biologically Based Therapies. J Endod 2014;40:2–5.
9.Duncan HF, Galler KM, Tomson PL, Simon S, El‐Karim I, Kundzina R, et al. European Society of Endodontology position statement: Management of deep caries and the exposed pulp. International Endodontic Journal. 2019;52:923–34.
10.Kaur M, Singh H, Dhillon JS, Batra M, Saini M. MTA versus Biodentine: Review of Literature with a Comparative Analysis. J Clin Diagn Res 2017;11:1–5.
11.Surya Raghavendra S, Jadhav GR, Gathani KM, Kotadia P. Bioceramics in endodontics– A REVIEW. J Istanb Univ Fac Dent 2017;51:128-37.
12.Hiremath H, Saikalyan S, Kulkarni SS, Hiremath V. Second-generation platelet concentrate (PRF) as a pulpotomy medicament in a permanent molar with pulpitis: a case report. Int Endod J 2012;45:105–12.
13.Morotomi T, Washio A, Kitamura C. Current and future options for dental pulp therapy. Jpn Dent Sci Rev.2019;55:5–11.
14.Wang Z, Pan J, Wright JT, Bencharit S, Zhang S, Everett ET, et al. Putative Stem Cells in Human Dental Pulp with Irreversible Pulpitis: An Exploratory Study. J Endod 2010;36:820–5.
15.Dohan Ehrenfest DM, Del Corso M, Diss A, Mouhyi J, Charrier J-B. Three-dimensional architecture and cell composition of a Choukroun’s platelet-rich fibrin clot and membrane. J Periodontol. 2010;81:546–55.
16.Zhou R, Wang Y, Chen Y, Chen S, Lyu H, Cai Z, et al. Radiographic, Histologic, and Biomechanical Evaluation of Combined Application of Platelet-rich Fibrin with Blood Clot in Regenerative Endodontics. J Endod 2017;43:2034–40.
17.Moussa DG, Aparicio C. Present and future of tissue engineering scaffolds for dentin-pulp complex regeneration. J Tissue Eng Regen Med. 2019;13:58–75.
18.Wolters WJ, Duncan HF, Tomson PL, Karim IE, McKenna G, Dorri M, et al. Minimally invasive endodontics: a new diagnostic system for assessing pulpitis and subsequent treatment needs. Int Endod J 2017;50:825–9.
19.Prasanthi N, Simpsy G, Chittem J, Sajjan G. Biological Approach in the Management of Permanent Molars with Irreversible Pulpitis Using Platelet-Rich Fibrin as a Pulpotomy Medicament: Case Reports with 2-Year Follow Up. J Interdiscip Dentistry. 2018;8:30–4.
20.Asgary S, Eghbal MJ, Fazlyab M, Baghban AA, Ghoddusi J. Five-year results of vital pulp therapy in permanent molars with irreversible pulpitis: a non-inferiority multicenter randomized clinical trial. Clin Oral Investig 2015;19:335–41.
21.Taha NA, Abdelkhader SZ. Outcome of full pulpotomy using Biodentine in adult patients with symptoms indicative of irreversible pulpitis. Int Endod J. 2018;8:819–28.
22.Dummer P, Hicks R, Huws D. Clinical signs and symptoms in pulp disease. Int Endod J. 1980;13:27–35. 23.Ricucci D, Siqueira JF, Li Y, Tay FR. Vital pulp therapy: histopathology and histobacteriology-based guidelines
to treat teeth with deep caries and pulp exposure. J Dent 2019;86:41–52. 24.Patil N, Saraf P, Penukonda R, Vanaki S. Comparative clinical and radiographical evaluation of success of pulpotomy using Biodentine and PRF-Biodentine combination: an in-vivo study. Int J Recent Sci Res. 2017;08:16817–22.
25.Dammaschke T, Galler K, Krastl G. Current recommendations for vital pulp treatment. Dtsch Zahnärztl Z Int.2019;1:43–52.
26.Aguilar P, Linsuwanont P. Vital Pulp Therapy in Vital Permanent Teeth with Cariously Exposed Pulp: A Systematic Review. J Dent 2011;37:581–7.
27.Zanini M, Hennequin M, Cousson P. Which procedures and materials could be applied for full pulpotomy in permanent mature teeth? A systematic review. Acta Odontologica Scandinavica 2019;1:1–11.
28.Galani M, Tewari S, Sangwan P, Mittal S, Kumar V, Duhan J. Comparative Evaluation of Postoperative Pain and Success Rate after Pulpotomy and Root Canal Treatment in Cariously Exposed Mature Permanent Molars: A Randomized Controlled Trial. J Endod 2017;43:1953–62.
29.Solomon RV, Faizuddin U, Karunakar P, Deepthi Sarvani G, Sree Soumya S. Coronal Pulpotomy Technique Analysis as an Alternative to Pulpectomy for Preserving the Tooth Vitality, in the Context of Tissue Regeneration: A Correlated Clinical Study across 4 Adult Permanent Molars. Case Reports in Dentistry. 2015;2015:1–12.
30.Taha NA, Khazali MA. Partial Pulpotomy in Mature Permanent Teeth with Clinical Signs Indicative of Irreversible Pulpitis: A Randomized Clinical Trial. J Endod 2017;43:1417–21.
31.Gudkina J, Mindere A, Locane G, Brinkmane A. Review of the success of pulp exposure treatment of cariously and traumatically exposed pulps in immature permanent incisors and molars. Stomatologija. 2012;14:71–80.
32.Chang S-W, Lee S-Y, Ann H-J, Kum K-Y, Kim E-C. Effects of Calcium Silicate Endodontic Cements on Biocompatibility and Mineralization-inducing Potentials in Human Dental Pulp Cells. J Endod 2014;40:1194–200.
33.Collado-González M, García-Bernal D, Oñate-Sánchez RE, Ortolani-Seltenerich PS, Álvarez-Muro T, Lozano A, et al. Cytotoxicity and bioactivity of various pulpotomy materials on stem cells from human exfoliated primary teeth. Int Endod J 2017;50:19–30.
34.Camilleri J. Characterization of hydration products of mineral trioxide aggregate. Int Endod J. 2008;41:408–17.
35.Morotomi T, Tabata Y, Kitamura C. Dentin-Pulp Complex Regeneration Therapy Following Pulp Amputation.Adv Tech in Biology & Medicine 2015;03:1–5.
36.Tabatabayi MH, Tavakoli A, Ameghani BA. Regenerative property of PRF used as capping material in pulpotomy in dogs. Biomed Res 2017;28:4634–9.
37.Li Y, Nan X, Zhong TY, Li T, Li A. Treatment of Periodontal Bone Defects with Stem Cells from Inflammatory
Dental Pulp Tissues in Miniature Swine. Tissue Eng Regen Med. 2019;16:191–200. 38.Cooper PR, Holder MJ, Smith AJ. Inflammation and regeneration in the dentin-pulp complex: a double-edged sword. J Endod 2014;40:46-51. 39.Mahasneh SA, Horner K, Cunliffe J, Al‐Salehi S, Sengupta A, AlHadidi A. Guidelines on radiographic imaging as part of root canal treatment: a systematic review with a focus on review imaging after treatment. International Endodontic Journal. 2018;51:238–49.
40.Caliskan MK. Success of pulpotomy in the management of hyperplastic pulpitis. Int Endod J. 1993;26:142–8.
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