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Re Vascular Is at Ion Solution For Infected
Re Vascular Is at Ion Solution For Infected
immature teeth
A new treatment option of revascularization, which involves disinfecting the root canal system, providing a
matrix of blood clot into which cells grow, and sealing of the coronal access, has proven an effective way to
treat immature non-vital, infected permanent teeth. A recent pilot study conducted at the Department of
Conservative Dentistry and Endodontics at the All India Institute of Medical Sciences in New Delhi, India,
evaluated the efficacy of revascularization in 14 cases of infected, immature teeth. None of the cases
presented with pain, re-infection, or radiographic enlargement of pre-existing apical pathology. Lead
researcher, Dr Naseem Shah, explained the significance of the study.
MTA treatment is expensive and also it does not reinforce the root canal (Tittle et al 19968). It only forms an
artificial barrier at the peri-apex without maturation or root lengthening. Some authors have suggested the
use of growth factors and bone morphogenic factors with an artificial scaffold (Krebsbach 1997 9, Gronthos S
200210). The method involves precise placement of the scaffold with BMPs and growth factors at the peri-
apex. This concept besides being expensive is still under research.
Regeneration of tissues rather than replacement with artificial substitutes is an emerging and exciting field
in the health sciences. Revascularization of infected, non-vital, immature teeth has been documented to
stimulate regeneration of apical tissues as well as to induce apexogenesis and is emerging as a new
treatment modality for such teeth.
It is a relatively inexpensive procedure which involves formation of a blood clot at the apex which acts as a
scaffold for formation of new soft and hard tissues. A larger case series with longer follow up period would
establish it as the standard protocol for management of such teeth.
Question: Will you conduct further research on this new method?
Naseem Shah: Further research on revascularization procedures is being carried out with new cases being
started and maintaining follow up of the previous cases. Narrowing of apical opening, increase in root length
and resolution of periapical radiolucencies is measured. Use of Laser Doppler Flowmetry to document
revascularization of pulp is highly desirable and would be used in future to strengthen the case for this
procedure.