Regenerative Potential of Mature Teeth with Necrotic Pulp and Apical Periodontitis

Abstract

The aim of the present investigation was to histopathological assessment of the regenerative potential of permeant mature teeth with necrotic pulp and apical periodontitis with different apical diameters in comparing to conventional endodontic treatment.

72 premolars in six health dogs (12 premolars in each dog) to sum 72 teeth and 144 root canals were collected for this study. Teeth were distributed into sex groups: root canal obturation (RCT) with continuous wave compaction for root canals prepared up to #F3 ProTaper file, Regenerative endodontic therapy for root canals prepared up to #F3 ProTaper file (RET-F3), RET for root canals prepared up to a #F4 ProTaper file (RET-F4), RET for root canals prepared up to a #F4 ProTaper file (RET-F5), positive (P) and negative (N) controls included infected and healthy teeth respectively. Each group was further subdivided into two subgroups according to evaluation periods (one and three months).

Induction of infection was done followed by canal disinfection using the Ca(OH)2 paste. Treatment protocols were performed according to the previous classification and samples were left for follow up according to the period for each sup-group.

Histological evaluation included inflammatory reaction, bone/resorption, tissue in-growth, hard tissue formation, quantitatively results were evaluated using appropriate scoring system. Data were collected, tabulated and statistically analyzed. Histological evaluation of inflammatory cell count showed that the RCT group had the highest count comparing to RET groups and increasing the apical size diameter among RET groups resulted in decrease in inflammatory cell count in both evaluation period. At three-month evaluation period there was no statistical significance difference between RET-F4 and RET-F5 groups.