1.
Regenerative potential of immature permanent teeth with necrotic pulps after different regenerative protocols.
Nagy, MM, Tawfik, HE, Hashem, AA, Abu-Seida, AM
Journal of endodontics. 2014;(2):192-8
Abstract
INTRODUCTION Regenerative endodontics is a promising alternative treatment for immature teeth with necrotic pulps. The present study was performed to assess the regenerative potential of young permanent immature teeth with necrotic pulp after the following treatment protocols: (1) a mineral trioxide aggregate (MTA) apical plug, (2) the regenerative endodontic protocol (blood clot scaffold), and (3) the regenerative endodontic protocol with a blood clot and an injectable scaffold impregnated with basic fibroblast growth factor. METHODS Immature necrotic permanent maxillary central incisors (n = 36) of patients 9-13 years old were divided into 3 groups according to the treatment protocol: the MTA group (MTA apical plug), the REG group (regenerative endodontic protocol [blood clot]), and the FGF group (regenerative endodontic protocol [blood clot + injectable scaffold]). Follow-up was done up to 18 months. Standardized radiographs were digitally evaluated for an increase in root length and thickness, a decrease in the apical diameter, and a change in periapical bone density. RESULTS After a follow-up period of 18 months, most of the cases showed radiographic evidence of periapical healing. Groups 2 and 3 showed a progressive increase in root length and width and a decrease in apical diameter. CONCLUSIONS The regenerative endodontic procedure allowed the continued development of roots in teeth with necrotic pulps. The use of artificial hydrogel scaffold and basic fibroblast growth factor was not essential for repair.
2.
Culture of human gingival fibroblasts on a biodegradable scaffold and evaluation of its effect on attached gingiva: a randomized, controlled pilot study.
Mohammadi, M, Shokrgozar, MA, Mofid, R
Journal of periodontology. 2007;(10):1897-903
Abstract
BACKGROUND An adequate width of attached gingiva is necessary to maintain healthy periodontium, especially in orthodontics or restorative treatments in periodontics. The purpose of this study was to evaluate the width of attached gingiva after clinical application of a cultured gingival graft compared to a periosteal fenestration technique. METHODS This study was conducted on nine patients (18 sites) with insufficient attached gingiva adjacent to at least two teeth in contralateral quadrants of the same jaw. A small portion (approximately 3 x 2 x 1 mm) of attached gingiva (epithelial + connective tissue) was removed with a surgical blade. After culture of gingival fibroblasts, 2 x 10(5) cells in 250 microl nutritional medium were added to 250 microl collagen gel. One tooth in each patient was randomized to receive a periosteal fenestration technique for gingival augmentation (control) or a tissue-engineered mucosal graft (test). Clinical parameters measured at baseline and 3 months included width of keratinized tissue, probing depth, and width of attached gingiva. RESULTS An increased amount of keratinized tissue was seen at all treated sites after 3 months. The mean increased amount of attached gingiva was 2.8 mm at test sites and 2 mm at control sites; this difference was significant (P < 0.05). CONCLUSION Based on the results of this investigation, the tissue-engineered mucosal graft is safe and capable of generating keratinized tissue.