Histologic and Histobacteriologic Observations of Failed Revascularization/Revitalization Therapy: A Case Report
| Autor: | Emi Shimizu, Simona Loghin, Domenico Ricucci, Louis M. Lin, Jennifer L. Gibbs |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Male
Extracted tooth medicine.medical_specialty Sodium Hypochlorite medicine.medical_treatment Root canal Neovascularization Physiologic Dentistry Revascularization Calcium Hydroxide Root Canal Filling Materials Tooth Apex stomatognathic system medicine Humans Methylmethacrylates Treatment Failure Zinc Oxide-Eugenol Cement Aluminum Compounds Child General Dentistry Debridement Root Canal Irrigants Apexification business.industry Silicates Chlorhexidine Oxides Calcium Compounds Tooth Avulsion Anti-Bacterial Agents Surgery Incisor Drug Combinations stomatognathic diseases medicine.anatomical_structure Dentinal Tubule Biofilms Dentin Anti-Infective Agents Local Tooth Replantation Thickening Dental Pulp Cavity business Periapical Periodontitis Follow-Up Studies |
| Zdroj: | Journal of Endodontics. 40:291-295 |
| ISSN: | 0099-2399 |
| DOI: | 10.1016/j.joen.2013.08.024 |
| Popis: | Introduction Mechanical debridement plays an important role in eliminating intracanal bacteria, such as biofilm on the canal walls and bacteria in the dentinal tubules. Mechanical debridement is not recommended for root canal disinfection in revascularization/revitalization therapy. Here we report a failed revascularization/revitalization case, which could be due to inadequate root canal disinfection without mechanical removal of biofilm and bacteria in dentinal tubules. Methods A 6-year-old boy had a traumatic injury to tooth #9, which was avulsed and replanted within 40 minutes. The tooth subsequently developed a local swelling in the periapical area. The patient was referred to the Postgraduate Endodontic Clinic for revascularization/revitalization therapy on tooth #9. The treated tooth remained asymptomatic for 16 months and then developed pain and local periapical swelling. The oral surgeon extracted the revascularized/revitalized tooth. On request, the extracted tooth was processed for histologic and histobacteriologic examination. Results The tissue in the canal was completely destroyed. Most bacteria were observed in the apical portion and not in the coronal portion of the canal and formed biofilm on the canal walls and penetrated into the dentinal tubules. Conclusions On the basis of histobacteriologic observations, the failure of revascularized/revitalized tooth could be due to inadequate root canal disinfection without mechanical debridement. It may be important to perform mechanical debridement as part of the revascularization/revitalization therapy to disrupt the biofilm on the canal walls and remove bacteria in the dentinal tubules because revascularization/revitalization therapy is able to increase thickening of the canal walls. |
| Databáze: | OpenAIRE |
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