Dental trauma injuries during childhood and adolescence can have an adverse impact on oral health throughout life. Population-based studies estimate that the worldwide prevalence of dental trauma in permanent young teeth is between 16-40% [1] and the incidence rate in Sweden has an upward trend [2]. When trauma injuries the teeth, dental and neurovascular supply can be disrupted, and microorganism may invade the pulp tissue, initiating and infection. About 27 % of permanent teeth with traumatic injuries can develop pulp necrosis [3]. If immature teeth lose their vitality, the root formation stops and these teeth have consequently questionable long-term survival.<\/p>\n\n\n\n
Dental management of necrotic teeth with aberrant root formation represents a challenging clinical situation. The classical approach for treating these teeth includes apexification, which consist of either a long-term application of calcium hydroxide (CH) to stimulate formation of an apical barrier [4] or application of Mineral Trioxide Aggregate (MTA) as an artificial apical barrier. These procedures, however, has the downside of increase susceptibility to cervical fractures [5], involves multiple appointments with a long treatment time [6] and do not achieve the goal of continued root development or restoration of pulp tissue functionality [7]. Thus, it may imply high costs for the patient and the society.<\/p>\n\n\n\n
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Alternative tooth replacement treatment such as dental implants are contraindicated because the still growing craniofacial skeleton in young individuals.<\/p>\n\n\n\n
In recent years, much effort has been made to find alternative treatments. A biological based approach referred as regenerative endodontic treatment (RET) has emerged as a biological procedure for necrotic pulps with aberrant root development. This treatment aims to regenerate pulp-like tissue within the root canal space after inducing an influx of stem cells from the apical papilla that results in reestablishment of pulp protective functions (Figure 2) [8]. In fact, by restoring pulpal functions, the root can continue its development. This treatment implies the possibility to help patients to maintain their natural dentition with otherwise uncertain prognosis. <\/p>\n\n\n\n
Although promising, the scientific evidence for the overall efficacy of RET is scarce [9]. Short-term longitudinal studies have so far evidenced the resolution of sign and symptoms of pathology and demonstrated continuing root development in length and thickness after regeneration procedures [10; 11]. However, failed cases related to lack of bleeding and persistent infections have been reported, indicating that new techniques are needed to improve the predictability of RET [9].
The main goal of the present project is to gain knowledge about the treatment of immature necrotic teeth in young individuals due to dental trauma.
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REFERENCES<\/em><\/strong><\/p>\n\n\n\n [1] U. Glendor, Epidemiology of traumatic dental injuries--a 12 year review of the literature. Dent Traumatol 24 (2008) 603-11. Developing new biological treatments to maintain children\u2019s natural dentition after trauma: A translational approach Dental trauma injuries during childhood and adolescence can have an adverse impact on oral health throughout life. Population-based studies estimate that the worldwide prevalence of dental trauma in permanent young teeth is between 16-40% [1] and the incidence rate in Sweden […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"vkexunit_cta_each_option":"","footnotes":""},"class_list":["post-5","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/vestmanlabb.se\/index.php?rest_route=\/wp\/v2\/pages\/5","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vestmanlabb.se\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/vestmanlabb.se\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/vestmanlabb.se\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vestmanlabb.se\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=5"}],"version-history":[{"count":10,"href":"https:\/\/vestmanlabb.se\/index.php?rest_route=\/wp\/v2\/pages\/5\/revisions"}],"predecessor-version":[{"id":268,"href":"https:\/\/vestmanlabb.se\/index.php?rest_route=\/wp\/v2\/pages\/5\/revisions\/268"}],"wp:attachment":[{"href":"https:\/\/vestmanlabb.se\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=5"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
[2] D. Lexomboon, C. Carlson, R. Andersson, I. von Bultzingslowen, and T. Mensah, Incidence and causes of dental trauma in children living in the county of Varmland, Sweden. Dental traumatology : official publication of International Association for Dental Traumatology 32 (2016) 58-64.
[3] H. Hecova, V. Tzigkounakis, V. Merglova, and J. Netolicky, A retrospective study of 889 injured permanent teeth. Dent Traumatol 26 (2010) 466-75.
[4] M. Cvek, Prognosis of luxated non-vital maxillary incisors treated with calcium hydroxide and filled with gutta-percha. A retrospective clinical study. Endod Dent Traumatol 8 (1992) 45-55.
[5] J.O. Andreasen, E.C. Munksgaard, and L.K. Bakland, Comparison of fracture resistance in root canals of immature sheep teeth after filling with calcium hydroxide or MTA. Dental traumatology : official publication of International Association for Dental Traumatology 22 (2006) 154-6.
[6] A.M. Mendoza, E.S. Reina, and F. Garcia-Godoy, Evolution of apical formation on immature necrotic permanent teeth. American journal of dentistry 23 (2010) 269-74.
[7] I.M. Bell, S.N. Gallicchio, C.A. Stump, J.G. Bruno, H. Fan, L.T. Gantert, E.D. Hostetler, A.L. Kemmerer, M. McWherter, E.L. Moore, S.D. Mosser, M.L. Purcell, K. Riffel, C.A. Salvatore, S. Sanabria-Bohorquez, D.D. Staas, R.B. White, M. Williams, C.B. Zartman, J.J. Cook, R.J. Hargreaves, S.A. Kane, S.L. Graham, and H.G. Selnick, [(11)C]MK-4232: The First Positron Emission Tomography Tracer for the Calcitonin Gene-Related Peptide Receptor. ACS medicinal chemistry letters 4 (2013) 863-8.
[8] F. Banchs, and M. Trope, Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod 30 (2004) 196-200.
[9] T.M. Botero, X. Tang, R. Gardner, J.C.C. Hu, J.R. Boynton, and G.R. Holland, Clinical Evidence for Regenerative Endodontic Procedures: Immediate versus Delayed Induction? J Endod 43 (2017) S75-S81.
[10] Y. Cao, M. Song, E. Kim, W. Shon, N. Chugal, G. Bogen, L. Lin, R.H. Kim, N.H. Park, and M.K. Kang, Pulp-dentin Regeneration: Current State and Future Prospects. Journal of dental research 94 (2015) 1544-51.
[11] S.I. Iwaya, M. Ikawa, and M. Kubota, Revascularization of an immature permanent tooth with apical periodontitis and sinus tract. Dental traumatology : official publication of International Association for Dental Traumatology 17 (2001) 185-7.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"