Regenerative Endodontics Essay Sample Ireland
In this following essay sample we shall discuss the methodology of Regenerative Endodontics. This is biological approach that induces the bleeding from the periapical region into the tooth canal that can generate the tissue which is important for providing a natural defense against any infection further.
In this technique it replaces the tooth structure which is damaged that can be root structures, dentin and pulp dentin complex. We shall discuss the procedure of the regenerative endodontics in detail, specific consideration for variation of teeth and limitations of such technique.
Regenerative endodontics was first developed for the immature necrotic permanent teeth in order to achieve the root end closure and thickening of canal wall and development of roots. While in the process of the conventional endodontics therapy the canal is obstructed with the biocompatible foreign materials and canal is filled with personal own vital tissue of the person.
Methodology of the Regenerative Endodontics
The tooth is restorable after the successful radiographs and the periapical coan beam computed tomography can be used for the treatment of the damaged tooth which is given an anesthesia and rubber dam is placed.
Following the canal preparation the canal is irrigated with the 1.5% of sodium hydrochloride to avoid killing of the stem cells depending upon the type of tooth. After the canal is being irrigated with NaOCI it must be dried and irrigated with the EDTA before placing calcium hydroxide into the canal.
The use of the EDTA and calcium hydroxide can improve survival rate of the stem cells from the apical papilla. While the over doze or usage can impact negetively the stem cells and growth factor survival. After this canal access is temporized with cotton or sponge and filling material. The patient is asked to follow up with treatment.
Second Appointment of the Regenerative Endodontics
For the second appointment of the regenerative endodontics the clinician should first consider the response of the patient towards the initial therapy of regenerative endodontics. If there is a infection then the first therapy should only be considered.
For the successful completion of the regenerative endodontics the periapical bleeding into the canal is mandatory. Such bleeding can bring the stem cells, blood derived bio active growth factors and the scaffolding. It can regenerate the tissue. There is a placement of the bioceramic materials over blood clot and the glass ionomer is positioned over such material.
After this a final composite or amalgam restoration is done over the glass ionomer the radiograph is taken. A time period of the six months to three years is given. The goal of this procedure of the regenerative endodontics is the removal of symptoms, healing and continous root development with a positive sensibility testing.
Specific Consideration for the Variations of Teeth
The procedure of regenerative endodontics was first developed for immature necrotic permanent teeth and before procedure of endodontics an apexification procedure was performed on immature necrotic teeth with the help of the calcium hydroxide or mineral trioxide.
The Regenerative endodontics is used for the necrotic mature permanent teeth, the resorption teeth, the mature permanent dentition and for the scalar obturated teeth. Even if procedure of the regenerative endodontics is similar but has the clinical variations for the different teeth such as :-
Immature Necrotic Permanent Teeth
Immature necrotic permanent teeth requires the removal of the necrotic pulp tissue from the canal with the minimum preparation of canal due to the canal walls being thin and any over preparation can weaken the roots structure that may lead to fracture.
Mature Nectrotic Permanent Teeth
The mature necrotic permanent teeth requires the full mechanical debridement to remove the necrotic pulpal tissue. The wall thickening or development of the further root is not there after the regenerative treatment and apical closure can take place.
Mature Vital Permanent Teeth
The steps involved in the mature necrotic permanent teeth procedure is used for the mature vital permanent teeth aswell. This teeth can be treated in just one single visit that can eliminate the need for placement of calcium hydroxide into the canal. Any of the bacterial infection is not same as the necrotic mature permanent teeth.
Traumatized Teeth with an External Root Resorption
This particular procedure on the traumatized teeth with an external inflammatory root resorption is the technique that is used in the immature necrotic permanent teeth. This treatment is done with with the minimum preparation of canal for prevention of thinning of wall of the canal and weakening of the root structures.
Limitations of the Regenerative Endodontic Therapy
- The technique of regenerative endodontic therapy is considered to be a very sensitive technique that needs the training for the skill development for inducing the bleeding and placement of the biomaterial over the blood clot. It is only suppose to be performed by the trained dentist or clinician as it is much time effective than the apexification procedure.
- This technique can even cause the discoloration of the tooth which is being damaged and replaced. It is very common due to minocycline in the barrier placed at CEJ. The discoloring of the damaged tooth can be reduced with the usage of double antibiotic paste or calcium hydroxide which can be used as an alternative dressing and the biomaterials.
- The procedure of the regenerative endodontics does not provide amy adequate spaces as the barrier is placed at the CEJ level. After such treatment with the technique for achieving the development of the root and apical closure then the root canal treatment and the post placement is done after therapy.
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The above-written essay sample is based on the biological approach procedure of regenerative endodontics.
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