Regenerative Endodontics Essay Sample Ireland
In this following essay sample, we shall discuss the methodology of Regenerative Endodontics. This is a 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 defence against any infection further.
In this technique, it replaces the tooth structure which is damaged which can be root structures, dentin, and pulp dentin complex. We shall discuss the procedure of regenerative endodontics in detail, specific consideration for variation of teeth, and the limitations of such technique.
Regenerative endodontics was first developed for the immature necrotic permanent teeth to achieve the root end closure and thickening of canal wall and development of roots. While the conventional endodontics therapy the canal is obstructed with the biocompatible foreign materials and the 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 anaesthesia and a rubber dam is placed.
Following the canal preparation, the canal is irrigated with 1.5% of sodium hydrochloride to avoid killing the stem cells depending on 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 the survival rate of the stem cells from the apical papilla. While they doze or usage can impact negatively 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 regenerative endodontics, the clinician should first consider the response of the patient toward the initial therapy of regenerative endodontics. If there is an infection then the first therapy should only be considered.
For the successful completion of regenerative endodontics, the periapical bleeding into the canal is mandatory. Such bleeding can bring stem cells, blood-derived bioactive growth factors, and 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 six months to three years is given. The goal of this procedure of regenerative endodontics is the removal of symptoms, healing, and continuous root development with 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 the procedure of endodontics, an apexification procedure was performed on immature necrotic teeth with the help of the calcium hydroxide or mineral trioxide.
Regenerative endodontics is used for the necrotic mature permanent teeth, the resorption teeth, the mature permanent dentition, and the scalar obturated teeth. Even if the 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 require the removal of the necrotic pulp tissue from the canal with the minimum preparation of the canal due to the canal walls being thin and any over-preparation can weaken the structure of the root that may lead to fracture.
Mature Nectrotic Permanent Teeth
The mature necrotic permanent teeth require 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 are used for the mature vital permanent teeth as well. These teeth can be treated in just one single visit that can eliminate the need for the placement of calcium hydroxide into the canal. Any bacterial infection is not the same as the necrotic mature permanent teeth.
Traumatized Teeth with an External Root Resorption
This particular procedure on the traumatized teeth with external inflammatory root resorption is the technique that is used in the immature necrotic permanent teeth. This treatment is done with minimum preparation of the canal for preventing thinning of the 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 training for skill development for inducing the bleeding and placement of the biomaterial over the blood clot. It is only supposed to be performed by a trained dentist or clinician as it is much more time-effective than the apexification procedure.
- This technique can even cause the discolouration of the tooth which is being damaged and replaced. It is very common due to minocycline in the barrier placed at CEJ. The discolouring 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 regenerative endodontics does not provide any 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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