Histologic characterization of engineered tissues in the canal space of closed-apex teeth with apical periodontitis

J Endod. 2013 Dec;39(12):1549-56. doi: 10.1016/j.joen.2013.08.023. Epub 2013 Sep 29.

Abstract

Introduction: The aim of this study was to investigate the capacity of endodontic regenerative procedures combining an induced blood clot, platelet-rich plasma (PRP), and bone marrow aspirate (BMA) to regenerate dental pulp in canine closed-apex necrotic teeth.

Methods: Apical periodontitis was induced in 20 upper and lower premolars of 2 dogs. After biomechanical preparation, enlargement to a #60 file, and disinfection with a triantibiotic paste for 28 days, the roots were randomly assigned to 4 treatment groups: blood clot (BC), BC + PRP gel, BC + BMA gel, and BC + BMA/PRP gel. Negative controls were also included. After a 3-month follow-up period, the animals were killed.

Results: Histologic analysis showed the presence of newly formed vital tissues (connective, cement-like, and bone-like tissue) in 23 of the 32 treated roots (71.87%). There was no statistically significant difference between the treatment groups.

Conclusions: New vital tissues were formed and characterized as connective, cementum-like, or bone-like, but not as pulp-like tissue; PRP and/or BMA did not improve the tissue ingrowth.

Keywords: Bone marrow aspirate; necrotic teeth; platelet-rich plasma; regenerative endodontics; tissue engineering; vital tissue growth.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Bicuspid / pathology
  • Blood Coagulation / physiology
  • Bone Marrow Cells / physiology
  • Bone and Bones / pathology
  • Ciprofloxacin / therapeutic use
  • Connective Tissue / pathology
  • Dental Cementum / pathology
  • Dental Pulp Cavity / pathology*
  • Dental Pulp Exposure / therapy
  • Dental Pulp Necrosis / therapy
  • Dogs
  • Drug Combinations
  • Fibroblasts / pathology
  • Male
  • Metronidazole / therapeutic use
  • Minocycline / therapeutic use
  • Neovascularization, Physiologic / physiology
  • Periapical Periodontitis / therapy*
  • Platelet-Rich Plasma / physiology
  • Random Allocation
  • Regeneration / physiology
  • Root Canal Irrigants / therapeutic use
  • Root Canal Preparation / methods
  • Thrombin / therapeutic use
  • Tissue Engineering / methods*

Substances

  • Anti-Bacterial Agents
  • Drug Combinations
  • Root Canal Irrigants
  • Metronidazole
  • Ciprofloxacin
  • Thrombin
  • Minocycline