Periodontal regeneration by minimally invasive procedures and its influence on pulp status.

Stefanía H Caceres, Hernán Bonta, Federico G Galli, Liliana G Sierra, Pablo A Rodríguez, Facundo Caride
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Abstract

Dental pulp and periodontium have different communication routes including, e.g., apical foramen, accessory canals and dentin tubules. Scaling, planing and root surface treatment with ethylenediaminetetraacetic acid (EDTA)-based conditioner are used in regenerative periodontal procedures. Such treatment may generate pathological communication between the two structures due to interruption of the vascular pedicle or migration of bacteria and/or inflammatory byproducts from deep periodontal pockets, which may generate pulp pathology.

Aim: The aim of this study was to evaluate the influence of minimally invasive periodontal regenerative surgery on pulp vitality status in single-rooted and multi-rooted teeth associated to infraosseous defects extending to the middle and apical thirds.

Materials and method: This was a retrospective study on 30 teeth from 14 patients who received care between August 2018 and August 2019 at the postgraduate Department of Specialization in Periodontics of the Buenos Aires University School ofDentistry (FOUBA). Clinical and radiographic endodontic diagnosis was performed 6 months after the minimally invasive regenerative periodontal treatment.

Results: Only two out of the 30 teeth presented changes in pulp status following regenerative periodontal procedure: irreversible pulpitis at 30 days and pulp necrosis at 180 days post-treatment. The rate for risk of change in pulp vitality status was 6.7%. Teeth with grade I and II furcation lesions (n=9) presented no change in pulp status.

Conclusions: Regenerative periodontal surgery had no significant influence on pulp status in single-rooted and multi-rooted teeth with infraosseous defects extending to the level of the middle and apical third.

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微创牙周再生及其对牙髓状态的影响。
牙髓与牙周组织有不同的交流途径,包括牙髓的根尖孔、副牙髓管和牙本质小管等。以乙二胺四乙酸(EDTA)为基础的调理剂用于再生牙周手术的洗牙、刨牙和牙根表面处理。由于血管蒂的中断或细菌和/或深层牙周袋的炎症副产物的迁移,这种治疗可能会导致两种结构之间的病理交流,这可能会导致牙髓病理。目的:本研究的目的是评估微创牙周再生手术对延伸至中、尖三分之一骨下缺损的单根和多根牙的牙髓活力状态的影响。材料和方法:这是一项回顾性研究,对2018年8月至2019年8月在布宜诺斯艾利斯大学牙科学院牙周病专业研究生部接受治疗的14名患者的30颗牙齿进行了研究。在微创再生牙周治疗6个月后进行临床和影像学诊断。结果:30颗牙齿中只有2颗在牙周再生手术后出现牙髓状态的改变:治疗后30天出现不可逆的牙髓炎,治疗后180天出现牙髓坏死。牙髓活力状态变化风险率为6.7%。有I级和II级分叉病变的牙齿(n=9)的牙髓状态没有变化。结论:再生牙周手术对骨下缺损延伸至中尖三分之一水平的单根和多根牙的牙髓状态无显著影响。
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