Citation Information :
Turk T, Cicconetti A, Di Nardo D, Gabriele M, Coppola S, Bhandi S, Seracchiani M, Testarelli L, Gambarini G. Nonsurgical Retreatment Using Regenerative Endodontic Protocols: A Case Report. J Contemp Dent Pract 2020; 21 (11):1275-1278.
Aim and objective: The aim of this case report was to describe regenerative endodontic procedures (REPs) of the previously treated mature teeth with long-term results.
Background: Regenerative endodontic procedures are aimed to treat apical periodontitis and regenerate the pulp–dentin complex in necrotic teeth. However, there is no consensus in using REPs in the previously treated mature teeth. The aim of this case report was to describe REPs of the previously treated mature teeth with long-term results.
Case description: A 25-year-old woman presented pain on chewing on 15 and swelling (WHO numbering system). The tooth had been endodontically treated and restored 4 years ago. After removing the old root canal filing, the roots were irrigated with 2.5% sodium hypochlorite and 17% EDTA using sonic activation. Calcium hydroxide (CH) was used as medicament for 3 weeks. At the second visit, CH was removed, and canals were irrigated as like as the first visit. Apical bleeding was induced, and concentrated growth factors (CGFs) were placed inside the root canal. The tooth has been followed up to 3 years.
Conclusion: The tooth was functional and asymptomatic at the recall visits. Since the first-year follow-up, the tooth responded to the electric pulp test and the thermal test. Radiological examinations revealed healing of apical lesion and hard tissue deposition.
Clinical significance: Regenerative endodontic procedures can offer an advantage over traditional endodontic procedures in terms of tertiary healing, with a predictable, user-friendly procedure also for retreatment cases.
Hoen MM, Pink FE. Contemporary endodontic retreatments: an analysis based on clinical treatment findings. J Endod 2002;28(12):834–836. DOI: 10.1097/00004770-200212000-00010.
Friedman S. Considerations and concepts of case selection in the management of post-treatment endodontic disease (treatment failure). Endod Topics 2002;1(1):54–78. DOI: 10.1034/j.1601-1546.2002.10105.x.
Nair PNR, Sjögren U, Krey G, et al. Intraradicular bacteria and fungi in root-filled, asymptomatic human teeth with therapy-resistant periapical lesions: a long-term light and electron microscopic follow-up study. J Endod 1990;16(12):580–595. DOI: 10.1016/S0099-2399(07)80201-9.
Siqueira J. Aetiology of root canal treatment failure: why well-treated teeth can fail. Int Endod J 2001;34(1):1–10. DOI: 10.1046/j.1365-2591.2001.00396.x.
Ray HA, Trope M. Periapical status of endodontically treated teeth in relation to technical quality of the root filling and the coronal restoration. Int Endod J 1995;28(1):12–18. DOI: 10.1111/j.1365-2591.1995.tb00150.x.
Donfrancesco O, Seracchiani M, Morese A, et al. Analysis of stability in time of marginal adaptation of endosequence root repair material on biological samples. Dent Hypotheses 2020;11:11–15.
Song M, Kim HC, Lee W, et al. Analysis of the cause of failure in nonsurgical endodontic treatment by microscopic inspection during endodontic microsurgery. J Endod 2011;37(11):1516–1519. DOI: 10.1016/j.joen.2011.06.032.
He L, Kim SG, Gong Q, et al. Regenerative endodontics for adult patients. J Endod 2017;43(9S):57–64. DOI: 10.1016/j.joen.2017.06.012.
Arslan H, Ahmed HMA, Şahin Y, et al. Regenerative endodontic procedures in necrotic mature teeth with periapical radiolucencies: a preliminary randomized clinical study. J Endod 2019;45(7):863–872. DOI: 10.1016/j.joen.2019.04.005.
Diogenes A, Ruparel NB, Shiloah Y, et al. Regenerative endodontics: a way forward. J Am Dent Assoc 2016;147(5):372–380. DOI: 10.1016/j.adaj.2016.01.009.
Diogenes A, Henry MA, Teixeira FB, et al. An update on clinical regenerative endodontics. Endod Topics 2013;28(1):2–23. DOI: 10.1111/etp.12040.
Hargreaves KM, Diogenes A, Teixeira FB. Treatment options: biological basis of regenerative endodontic procedures. J Endod 2013;39(3 Suppl):30–43. DOI: 10.1016/j.joen.2012.11.025.
Chrepa V, Henry MA, Daniel BJ, et al. Delivery of apical mesenchymal stem cells into root canals of mature teeth. J Dent Res 2015;94(12):1653–1659. DOI: 10.1177/0022034515596527.
Galler KM, Krastl G, Simon S, et al. European society of endodontology position statement: revitalization procedures. Int Endod J 2006;49(8):717–723. DOI: 10.1111/iej.12629.
Geisler TM. Clinical considerations for regenerative endodontic procedures. Dent Clin North Am 2012;56(3):603–626. DOI: 10.1016/j.cden.2012.05.010.
Lagisetti AK, Hegde P, Hegde MN. Evaluation of bioceramics and zirconia-reinforced glass ionomer cement in repair of furcation perforations: an in vitro study. J Conserv Dent 2018;21(2):184–189. DOI: 10.4103/JCD.JCD_397_16.