Does Apical Papilla Survive and Develop in Apical Periodontitis Presence after Regenerative Endodontic Procedures?
Regenerative endodontic procedures (REPs) have emerged as a treatment option for immature necrotic teeth to allow the reestablishment of a newly formed vital tissue and enable continued root development. The apical papilla stem cells (SCAPs) play an important role in physiologic root development and...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2019-09-01
|
| Series: | Applied Sciences |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-3417/9/19/3942 |
| _version_ | 1818025661978116096 |
|---|---|
| author | Paulo J. Palma João Martins Patrícia Diogo Diana Sequeira João Carlos Ramos Aníbal Diogenes João Miguel Santos |
| author_facet | Paulo J. Palma João Martins Patrícia Diogo Diana Sequeira João Carlos Ramos Aníbal Diogenes João Miguel Santos |
| author_sort | Paulo J. Palma |
| collection | DOAJ |
| description | Regenerative endodontic procedures (REPs) have emerged as a treatment option for immature necrotic teeth to allow the reestablishment of a newly formed vital tissue and enable continued root development. The apical papilla stem cells (SCAPs) play an important role in physiologic root development and may also contribute to further root development during REPs. The goal of these case reports is to show evidence of the apical papilla survival and development, in human teeth with apical periodontitis, after REPs, with 5-year clinical and radiographic follow-up. In the first case, an 11-year-old girl with acute apical abscess of tooth 15 was referred for a REP. Treatment was performed with an intracanal medication followed by induction of a blood clot and a Mineral Trioxide Aggregate (MTA) cervical barrier. The 5-year follow-up showed an appreciable increase in root length as well as root canal thickness. In case 2, a 16-year-old girl was referred for endodontic treatment of tooth 21. The parents of the patient recalled a previous dental trauma (no specified on the patient records) on tooth 21 at age 7. The dental history reports a previous endodontic treatment failure and presence of a long-standing sinus tract. A mineralized tissue beyond the root apical portion could be seen at the preoperative X-ray. Nonsurgical root canal retreatment with an apical barrier was suggested as the treatment plan and accepted by the patient. After 2 weeks, the patient was recalled for a follow-up appointment presenting spontaneous pain, swelling, and sinus tract. Apical surgery was performed. Histopathological assessment of the apical root fragment collected showed the presence of dentin, cementum and pulp tissue, including odontoblasts. The 5-year follow-up depicted complete apical healing. The present case reports support survival and continued potential differentiation of the apical papilla after endodontic infection. |
| first_indexed | 2024-12-10T04:19:40Z |
| format | Article |
| id | doaj.art-cfc740f46e8a462b86a2f490a3dcaa79 |
| institution | Directory Open Access Journal |
| issn | 2076-3417 |
| language | English |
| last_indexed | 2024-12-10T04:19:40Z |
| publishDate | 2019-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Applied Sciences |
| spelling | doaj.art-cfc740f46e8a462b86a2f490a3dcaa792022-12-22T02:02:27ZengMDPI AGApplied Sciences2076-34172019-09-01919394210.3390/app9193942app9193942Does Apical Papilla Survive and Develop in Apical Periodontitis Presence after Regenerative Endodontic Procedures?Paulo J. Palma0João Martins1Patrícia Diogo2Diana Sequeira3João Carlos Ramos4Aníbal Diogenes5João Miguel Santos6Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, PortugalInstitute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, PortugalInstitute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, PortugalInstitute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, PortugalInstitute of Operative Dentistry, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, PortugalDepartment of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USAInstitute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, PortugalRegenerative endodontic procedures (REPs) have emerged as a treatment option for immature necrotic teeth to allow the reestablishment of a newly formed vital tissue and enable continued root development. The apical papilla stem cells (SCAPs) play an important role in physiologic root development and may also contribute to further root development during REPs. The goal of these case reports is to show evidence of the apical papilla survival and development, in human teeth with apical periodontitis, after REPs, with 5-year clinical and radiographic follow-up. In the first case, an 11-year-old girl with acute apical abscess of tooth 15 was referred for a REP. Treatment was performed with an intracanal medication followed by induction of a blood clot and a Mineral Trioxide Aggregate (MTA) cervical barrier. The 5-year follow-up showed an appreciable increase in root length as well as root canal thickness. In case 2, a 16-year-old girl was referred for endodontic treatment of tooth 21. The parents of the patient recalled a previous dental trauma (no specified on the patient records) on tooth 21 at age 7. The dental history reports a previous endodontic treatment failure and presence of a long-standing sinus tract. A mineralized tissue beyond the root apical portion could be seen at the preoperative X-ray. Nonsurgical root canal retreatment with an apical barrier was suggested as the treatment plan and accepted by the patient. After 2 weeks, the patient was recalled for a follow-up appointment presenting spontaneous pain, swelling, and sinus tract. Apical surgery was performed. Histopathological assessment of the apical root fragment collected showed the presence of dentin, cementum and pulp tissue, including odontoblasts. The 5-year follow-up depicted complete apical healing. The present case reports support survival and continued potential differentiation of the apical papilla after endodontic infection.https://www.mdpi.com/2076-3417/9/19/3942apical papillaapical papilla stem cells (SCAPs)apical periodontitisimmature permanent toothhistologyregenerative endodonticsroot canaltissue engineeringpulp regeneration |
| spellingShingle | Paulo J. Palma João Martins Patrícia Diogo Diana Sequeira João Carlos Ramos Aníbal Diogenes João Miguel Santos Does Apical Papilla Survive and Develop in Apical Periodontitis Presence after Regenerative Endodontic Procedures? Applied Sciences apical papilla apical papilla stem cells (SCAPs) apical periodontitis immature permanent tooth histology regenerative endodontics root canal tissue engineering pulp regeneration |
| title | Does Apical Papilla Survive and Develop in Apical Periodontitis Presence after Regenerative Endodontic Procedures? |
| title_full | Does Apical Papilla Survive and Develop in Apical Periodontitis Presence after Regenerative Endodontic Procedures? |
| title_fullStr | Does Apical Papilla Survive and Develop in Apical Periodontitis Presence after Regenerative Endodontic Procedures? |
| title_full_unstemmed | Does Apical Papilla Survive and Develop in Apical Periodontitis Presence after Regenerative Endodontic Procedures? |
| title_short | Does Apical Papilla Survive and Develop in Apical Periodontitis Presence after Regenerative Endodontic Procedures? |
| title_sort | does apical papilla survive and develop in apical periodontitis presence after regenerative endodontic procedures |
| topic | apical papilla apical papilla stem cells (SCAPs) apical periodontitis immature permanent tooth histology regenerative endodontics root canal tissue engineering pulp regeneration |
| url | https://www.mdpi.com/2076-3417/9/19/3942 |
| work_keys_str_mv | AT paulojpalma doesapicalpapillasurviveanddevelopinapicalperiodontitispresenceafterregenerativeendodonticprocedures AT joaomartins doesapicalpapillasurviveanddevelopinapicalperiodontitispresenceafterregenerativeendodonticprocedures AT patriciadiogo doesapicalpapillasurviveanddevelopinapicalperiodontitispresenceafterregenerativeendodonticprocedures AT dianasequeira doesapicalpapillasurviveanddevelopinapicalperiodontitispresenceafterregenerativeendodonticprocedures AT joaocarlosramos doesapicalpapillasurviveanddevelopinapicalperiodontitispresenceafterregenerativeendodonticprocedures AT anibaldiogenes doesapicalpapillasurviveanddevelopinapicalperiodontitispresenceafterregenerativeendodonticprocedures AT joaomiguelsantos doesapicalpapillasurviveanddevelopinapicalperiodontitispresenceafterregenerativeendodonticprocedures |