Blockade of Nervus Alveolaris Inferior in 284 Patients with Semi-retained and Retained Lower Wisdom Teeth: Our Experience

Local (regional) anesthesia aimed at inferior alveolar nerve was administered in 284 patients by the direct Halsteadt method for the extraction of semi-retained and retained lower wisdom teeth. Artikain or meprivakain were used for this purpose. The average amount of the required anesthetic was 2.84ml. The study has shown that in vertical position of semi-retained teeth, one dose of the anesthetic is usually sufficient. In other cases it is necessary to expect administration of two doses, rarely even more than that

Maturogenesis. Part I. Introduction, Stem Cells, Growth Factors and Matrix

Objectives: Endodontic treatment of immature permanent tooth with necrotic pulp is one of the most challenging treatment options in endodontics. Even when the standard treatment modalities like calcium hydroxide apexification or MTA plug are succesfull, the long term prognosis of teeth is rather to be poor. It is because of thin root canal walls, which are prone to fracture. The great progress has been achieved in last two decades in the field of tissue engineering which leads to novel treatment strategies. Its aim is formation at new vital tissue inside of root canal system. This new tissue should be able to produce hard tissue, that leads to thickening of root canal wall and further development of root apex. In these reviews we would like to summarize available literature about another possible treatment modality. Maturogenesis is based on the principles of tissue engineering and can be perfomed by every general practitioner.This first part is concerned the introduction to the treatment problem of immature permamenent teeth with necrotic pulp including anatomical differencies. Furthermore, particular parts of tissue engineering concept - stem cells, growth factors and matrices which can play role in maturogenesis have been analysed

Assessment of Therapy of Necrotic Immature Permanent Teeth with Calcium Hydroxide Apexification and Maturogenesis

Introduction and aim: The endodontic treatment of necrotic immature permanent teeth is one of the most demanding intervention in the field of endodontics. In the last two decades there was an emerging evidence supporting the use of regenerative medicine concepts which aims to regenerate pulpdentinal organ. The aim of our study was to compare clinical success rate and change in radiological root area and radiological length between Ca(OH)2 apexification and maturogenesis. Methods: Data of patients treated between years 2011 and 2015 at Institute of Dentistry and Oral Sciences in Olomouc who were younger than 16 years and simultaneously underwent endodontic treatment of immature permanent tooth were collected. From total of 54 patients, 17 were chosen according to designated criteria. Nine patients were treated by Ca(OH)2 apexification and 8 by maturogenesis. In the scope of follow-up, the control X-rays were taken and clinical examination was performed. The mathematical correction of control X-rays was carried out and percentual change in radiological root area and radiological length in comparison to diagnostic X-ray were determined. After assessment of normality of collected data with Wilk-Shapiro test, the null hypothesis was examined by student t-test and Wilcoxon signed-rank/rank-sum tests. The clinical outcome was tested by Fisher factorial test. Results: There was significant difference in comparison of change in radiological root area among teeth treated with Ca(OH)2 apexification and maturogenesis (p = 0.0041). The average change in radiological root area was 16% in cases treated with maturogenesis and 5.9% in cases treated with Ca(OH)2 apexification. No statistically significant differences were found in radiological length change (p = 0.939) and clinical success rate (p = 0.5459). Conclusion: According to our data there were no significant differences between maturogensis and Ca(OH)2 apexification in clinical success rates and change of radiological lengths. Significant difference was observed in the change of radiological root, which was higher in cases treated by maturogenesis

Maturogenesis. Part 3. Clinical Protocol

In the third article, the indications of revascularization treatment and possible alternative treatment options are considered. Furthermore, step-by-step clinical protocol in detail is described, with emphasis on clinical execution in every-day office of general practicioners. Irrigation protocol and intracanal medication is adjusted to obtain adequate disinfection of root canal system and at the same time the damage to dentin and stem cells is decresed. The materials which are suitable for revascularization treatment including their pros and cons are mentioned. Finally, the assesment of therapy outcomes and characterization of newly formed tissue are described

Maturogenesis Part 2. Irrigation Protocols, Intracanal Medication

Objectives: Disinfection of the root canal system is one of the most important steps in revascularization treatment. If the disinfection of root canal system is inadequate, the succes rate is decreased. On the other hand if the disinfection of root canal system is too aggresive, the probability of new hard tissue on the root canal walls is less probable. In this second article, bacterial contamination of root canal system and its decontamination are considered. Particular irrigation solutions are analysed from both their antimicrobial activity as well as translational medicine. Furthermore, possible intracanal medications, including suggestion of the new triple antibiotic paste are explored

Misdiagnosis of Nasopalatine Duct Cyst

Introduction and aim: Nonendodontic lesions can be misdiagnosed as pathoses of endodontic origin. One of the most common nonodontogenic lesions of the oral cavity is the nasopalatine duct cyst, which is difficult to distinguish from periapical lesion. The aim of this case report is to familiarize readers with differential diagnosis of this disease. Case report: The patient who had suffered lateral luxation of tooth 11 aproximately 25 years ago presents with palatal abscess of premaxila. After non surgical retreatment of tooth 11 the symptoms disappeared, but the tooth become symptomatic two years after. After CBCT scan was taken the nasopalatine duct cyst was diagnosed and after surgical treatment histopathologically confirmed. Discussion: The possible predisposition factors, radiological signs and differential diagnosis is disccused. Conclusion: The understanding of anatomy, the use of appropriate diagnostic tests (including CBCT scan) to distinguish endodontic lesions from nonendodontitic pathoses are essential for accurate differential diagnosis and treatment

A clinical, radiographic and histologic observation of human immature permanent tooth after failed revitalization treatment and subsequent root canal treatment

Introduction and goal of casuistic: Regenerative endodontics and hence maturogenesis is currently one of the possible alternatives of permanent teeth treatment with unfinished development. In the case of the success of therapy and the formation of newly produced mineralized tissue, we have limited information on the histological character of such tissue. This case report brings clinical, radiological and histological evaluation of unsuccessful maturogenesis. Self-observation: The patient who was treated with unsuccessful maturogenesis and subsequent endodontic treatment of the root canal of the upper left permanent middle incisor appeared after 21 months with a horizontal root fracture. The tooth was extracted and examined histologically. Discussion: Radiological and histological results of previously published case reports are discussed together with possible factors that influence the character and amount of newly produced mineralized tissue. Conclusion: Newly produced mineralized tissue is similar to cement or bone tissue