Acceptable Healing Research Articles

Splinting of Traumatized Tooth - A Systematic Review

Background A splint is recommended after toothteeth repositioning to stabilize the toothteeth and optimize healing outcomes of the pulp andor periodontal tissues. A splint is defined as an appliance used to support protect or fixate a tooth that has been loosened reimplanted fractured or undergone certain endodontic surgical procedure.Aim To analyze and determine the effect of certain factors like duration of splinting materials used for splinting and the splinting technique on long term prognosis of traumatized teeth.Methodology This review was conducted as per the PRISMA and JBI guidelines. A total of five randomized clinical trials published over the past 30 years were included in the qualitative synthesis.Results A total of 874 replanted repositioned permanent teeth from five publications reporting short-term up to 14 days and long-term ge14 days splinting according to current clinical guidelines were pooled. Evidence for the association between short-term splinting and increased odds of functioning reduced periodontal healing acceptable healing or replacement resorption seems decisive. This study found no evidence of contraindications. Splinting duration was found to have no effect on the success of reimplantation. With future research to the contrary pending dentists are advised to continue using the current recommended splinting duration when reimplanting avulsed permanent teeth.Conclusion This study found no evidence of contraindications to current guidelines suggesting that the success of periodontal healing after reimplantation is not affected by the duration of splinting. It is recommended that the dentists continue to use the current recommended splinting duration for reimplanting avulsed teeth

Sustained-release calcium alginate/diatomite capsules for sustainable self-healing asphalt concrete

Calcium alginate capsule can gradually release the encapsulated rejuvenator after compressive loading, thus realize self-repairment of micro cracks and in-situ regeneration of aged asphalt in pavement. Nevertheless, plain calcium alginate capsules show weak mechanical strength and over-quick oil release speed and thus long-term self-healing potenial cannot be achieved. Calcium alginate/diatomite composite capsules with varying manufacturing parameters were synthesized through using orifice-coagulation method, which aims to improve mechanical strength and retard the rejuvenator release of the capsules. A series of performance tests were carried out to characterize the interior structure, thermal property, compression strength, relative rejuvenator content and rejuvenator incorporation rate of the prepared capsules. Meanwhile, the spatial location and premature rejuvenator release of capsules within asphalt concrete after manufacturing process were investigated. The rejuvenator release ratios of capsules in asphalt mixture beams after compressive loading were explored. Furthermore, the healing levels of test beams after the compressive loading and healing period were also evaluated. The calcium alginate/diatomite capsules had obvious multi-cavity structure and the diatomite with multi-pore structure offered extra rejuvenator storage units for the capsules. Meanwhile, the incorporation of diatomite could improve the thermal resistance and compressive strength and made the rejuvenator release speed of calcium alginate capsules decelerate obviously. The test beams containing diatomite modified capsules obtained acceptable healing level after long-term compression loading, which indicated that the addition of modified capsules into asphalt mixtures could realize the long-term healing of the pavement.

Self-healing of concrete containing commercial bacteria by means of water and chlorides permeability

Microbial-induced calcium precipitation (MICP) has shown adequate potential to act as a healing product through Calcium Carbonate (CaCO3) precipitation inside cracks. This work studies the self-healing capability of conventional concrete incorporating two dosages of Bacillus subtilis encapsulated in diatomaceous earth and a liquid solution consisting of a combination of Bacillus, denitrifying, and photosynthetic bacteria. The two bacterial agents used are commercial or industrial products from other sectors. For these mixes, disks of size ϕ100×50 mm were pre-cracked at the age of 21 days by splitting test until reaching residual cracks of 100 to 450 µm. At the age of 28 days, self-healing was promoted during 28 days in three exposures, continuous water immersion at 20°C, a high humidity environment at 20°C and 95% of relative humidity, and 7 days immersed in water at 20°C and 21 days in the high humidity environment. Self-healing was analyzed with water permeability by comparing the results before and after healing. Afterward, chlorides’ penetration was performed to study the possible healing protection on cracked disks compared to uncracked reference disks. As a result, after 7 days of immersion in water, the mixes with bacteria presented acceptable healing results. Some healed cracks could also significantly reduce the penetration of chlorides towards the interior of the concrete matrix.

Evaluation of human pulp tissue response following direct pulp capping with a self-etching adhesive system containing MDPB.

This study evaluated the human pulp tissue response following direct pulp capping with Clearfil Protect Bond (CPB) self-etching adhesive containing an antibacterial monomer MDPB. The pulps of third molar teeth were exposed by the removal of carious tissue. In an experimental group, CPB was applied to the exposed pulp and dentin. In the control groups, Clearfil SE Bond (CSE) or calcium hydroxide-based cement (CH) was applied to the exposed pulp surfaces. All teeth were filled with resin composite, extracted after 90 days, and the pulp responses were histologically analyzed. No severe inflammation or soft tissue disorganization was observed in CPB and CH groups. CSE group exhibited a disorganized odontoblastic layer and severe inflammatory infiltration. No hard tissue formation was observed in CSE group, and CH formed more of a hard tissue formation than CPB. CPB induced an acceptable healing response when directly applied to exposed pulps with bacterial contamination.

Early Retrieval of Spanning Plates Used for Fixation of Complex Fractures of the Distal Radius.

Background Spanning plates are being increasingly used for the treatment of complex fractures of the distal radius. The traditional recommendation is to leave the hardware in place for at least 12 weeks. Questions/Purpose This study assesses the comparative outcomes of spanning plates removed at or before 10 weeks. We hypothesized that acceptable healing and functional outcomes can be achieved with earlier hardware removal to allow for earlier range of motion, rehabilitation, and return to function. Patients and Methods All patients treated for a comminuted, intra-articular distal radius fracture with a temporary spanning plate were identified. Outcomes of bridge plates removed before 10 weeks were compared with plates removed after 12 weeks. Twenty patients in the short duration cohort were compared with 40 patients in the long duration cohort. Results All fractures healed and there were 10 complications (4 short duration, 6 long duration) and 2 reoperations (1 short duration, 1 long duration) in the study population. There were no significant differences in final Quick-DASH scores (27.4 short duration, 20.9 long duration) or radiographic alignment. Mean values for wrist extension and ulnar deviation were significantly worse in the long duration cohort, although these differences are of unclear clinical significance. Conclusion It may be safe to remove spanning bridge plates earlier than what is traditionally recommended. Plate removal at or before 10 weeks did not detract from healing or radiographic alignment. Prospective investigations assessing the optimal duration of fixation for this technique are needed. Level of Evidence This is a Level IV study.

Initial Experience With Video-Assisted Anal Fistula Treatment in the Philippines.

PurposeWe determined the outcomes of patients undergoing video-assisted anal fistula treatment (VAAFT) for fistulain-ano at the Philippine General Hospital.MethodsTwenty consecutive adult patients who underwent the VAAFT procedure from 2016–2018 were included in this investigation. Information detailing baseline demographic and clinical data, fistula type and classification, and previous surgeries were retrieved from in-hospital and operative records. Operative time, identification of the internal opening, method of internal opening closure, and occurrence of immediate postoperative complications were determined. The status of the fistula was assessed at one month, 3 months, and 6 months postoperatively based on outpatient follow-up records. The primary outcomes were healing rate and recurrence rate. Secondary outcomes were 30-day morbidity, postoperative complications, and incontinence using the Wexner score.ResultsEighteen patients (90%) had a preoperative diagnosis of complex fistula, and 13 patients (65%) had undergone a previous fistula surgery. Primary healing rate was 55% at 1 month, 63.16% at 3 months, and 78.95% at 6 months postoperatively. Eighteen patients (94.74%) maintained continence (Wexner score = 0) at 6 months.ConclusionOur study results suggest that VAAFT is a safe, minimally invasive technique for treatment of anal fistula and can preserve anal sphincter function. The technique has an acceptable healing rate with minimal complications.

Autologous Platelet-Rich Plasma in the Treatment of Perianal Fistula in Crohn’s Disease

AimTo assess clinical healing in patients with perianal Crohn’s disease with local intrafistular injection of autologous platelet-rich plasma. MethodThe pilot study was conducted at a single centre between January 2013 and December 2015. Autologous platelet-rich plasma was prepared in platelet-rich and platelet-poor fractions for local intrafistular injection in patients with proven, established perianal Crohn’s disease. Patients were permitted biological therapies, and the Perianal Crohn’s Disease Activity Index was recorded. Patients were followed for 48 weeks for clinical signs of healing (complete, partial or non-healing), monitoring fistula drainage, closure and epithelialization. ResultsThe study included 29 patients (19 males; mean age 38 ± 12.8 years) with four exclusions in the operating room because surgery was not indicated and four lost to follow-up. Five adverse events were recorded, with two requiring the drainage of abscess collections. Of the 21 patients assessable at 24 weeks, there was complete healing, partial healing and non-healing in 7 (33.3%), 8 (38.1%) and 6 (28.6%) patients, respectively. By 48 weeks, there was complete healing, partial healing and non-healing in 6 (40%), 6 (40%) and 3 (20%) patients, respectively, with a reduction in the number of visible external fistula openings at both time points (P = 0.021). By the end of the study, there was a higher trend of healing if biological therapies were continued (85.7% with biologics vs. 75% without, P = 0.527), but there were no statistically significant differences and no differences in the Perianal Crohn’s Disease Activity Index. ConclusionAutologous platelet-rich plasma is safe in patients with perianal Crohn’s disease, with an acceptable healing rate over a medium-term follow-up, particularly if biological therapies are used concomitantly.

Revitalisation endodontic treatment of traumatised immature teeth: a prospective long-term clinical study

PurposeContinuation of root development following revitalisation endodontics (RET) has been shown to be unpredictable with lower success rates in traumatised teeth. This study reports the outcomes for RET in traumatised teeth over a review period of 4 years.MethodsA prospective uncontrolled study, where RET was performed on traumatised upper immature anterior teeth with necrotic pulps in 15 children (mean age = 8.3 years), was conducted. Patients were reviewed at 3, 9, 12, 24, and 48 months, where clinical and radiographic assessments were performed. At the last review appointment, patients and parents answered questions assessing their perception and acceptance of tooth colour change over time. McNemar’s Exact test and linear mixed model assessment were used to assess changes in pulpal electrical response and radiographic evidence of continuation of root development over time, respectively.ResultsThere was 83.3% healing with no significant changes in EPT responses, and no significant changes in root lengths, while significant changes in root widths (p < 0.05) and root apex widths (p < 0.001) were found over time. Twenty-five percent of patients and 33% of parents felt that there were changes in tooth colour following RET over time.ConclusionWithin the limitations of this study, traumatised teeth treated using RET showed no significant root lengthening, however, acceptable periapical healing, slow thickening of root dentinal walls, and rapid development of apical closure were evident over a period of 43 months. Using Portland cement and omitting minocycline, did not eliminate crown colour change following RET.

Arthroscopy-assisted Treatment of Displaced Distal Clavicle Fractures Utilizing Curved Buttons and Suture Tape With a Single Coracoclavicular Tunnel.

Distal third clavicle fractures are associated with high rates of nonunion. Acceptable healing rates have been reported; however, complications and the need for additional procedures are a concern. The purpose of this study was to evaluate the functional outcomes and healing rates of an arthroscopy-assisted technique for fixation of unstable distal third clavicle fractures. Seven patients presenting to a single surgeon with displaced distal clavicle fractures were included. A curved suspensory button and suture tape construct with a single coracoclavicular tunnel was used. Visual Analog Scale, American Shoulder and Elbow Surgeons scores, Simple Shoulder Test, and Subjective Shoulder Value scores were analyzed preoperatively and at final follow-up. Radiographic evidence of union, maintenance of reduction and complications were recorded. All patients were available for 1-year follow-up. Mean Visual Analog Scale pain score improved from 6.1±1.1 to 1.1±1.0 (P=0.022). American Shoulder and Elbow Surgeons scores increased from 40.3±17.2 to 86.7±13.7 (P≤0.001). The mean Simple Shoulder Test score increased from 2.7±1.1 to 11.0±1.8 (P≤0.001). The Subjective Shoulder Value improved from 41.6±19.1 to 91.4±7.6 (P=0.210). Fracture united in 6 of 7 patients and reduction was maintained in all patients. Six patients were satisfied and returned to previous activity level. Arthroscopy-assisted fixation of unstable displaced distal clavicle fractures demonstrates improved functional outcomes and high patient satisfaction. This construct avoids many of the previously reported complications associated with other methods of fixation, while minimizing the amount of soft tissue dissection.

Use of a novel chitosan-based dressing on split-thickness skin graft donor sites: a pilot study.

Split-thickness skin graft (STSG) donor site dressings can play an integral role in reducing donor site morbidity. This study tested a novel, chitosan-based wound dressing, Opticell Ag, as an STSG donor site dressing for wounds <10% total body surface area (TBSA). Between January and December 2016, the chitosan-based dressing was placed on participating patients' donor sites immediately following graft harvest and covered with a transparent occlusive dressing. Pain was evaluated on postoperative day one, before dressing change between days 5-7, and before and after dressing removal between days 10-14 using the Visual Analog Scale (VAS). The extent of re-epithelialisation was determined between day 10-14 and at one month, and healing quality was also evaluated at one month post-operatively using the Vancouver Scar Scale (VSS). A total of 19 patients were recruited, of which 16 completed the study. Patients experienced mild-to-moderate pain in their donor sites when the chitosan-based dressing was used. Pain decreased significantly between postoperative day one and days 10-14, as well as between days 5-7 and 10-14. The mean percentage of re-epithelialisation on days 10-14 was 92% and by one month was 99%. The mean VSS at one month was 3.2±1.4. There were no statistically significant differences between patients' re-epithelialisation rates or VSS scores. There were unplanned dressing changes in four patients. No donor site infections or other adverse events were identified. The chitosan-based dressing tested in this study is safe, effective, and associated with reasonable pain control and acceptable healing quality. The results suggest that it is a promising STSG donor site dressing.

A study on functional and radiological outcome after corrective osteotomy and volar locked plate fixation for extra-articular malunion of distal radius

Background: Malunion is the most common complication following distal radius fractures occurring approximately 23% of non-surgically treated injuries and approximately 11% of operatively treated fractures. Malunion leads to functional limitation of affected wrist significantly requiring intervention. We report the functional and radiological outcome after corrective osteotomy of malunited distal radius using volar approach and fixation with a volar locked plate. Material and methods: Fifteen malunited distal radius in skeletally matured patients were treated with an osteotomy and iliac crest corticocancellous bone graft. Osteotomy was fixed in corrected position using a distal radius volar locking plate. Outcomes were evaluated using Modified Grahams criteria for acceptable healing, Fernandez scale, Modified Mayo wrist score and DASH questioner. Results: On radiological evaluation radial tilt was in the range of 9 degree dorsal to 20 degree volar. All osteotomies healed within acceptable limit by modified Graham’s radiographic criteria of acceptable healing of distal radius fractures. Functional evaluation by Fernandez scale shows excellent result in 3, good in 7, 5 fair and no poor result. Modified Mayo wrist score assessment shows 4 excellent, 6 good, 5 satisfactory and no poor result. The average score is 78.67 (range 65-90). DASH questioner analysis postoperatively revealed the average score is 15.93 improved from preoperative mean 50.8. One patient required concomitant ulnar shortening osteotomy. Conclusion: Corrective osteotomy and volar locked plate fixation of distal radius for symptomatic malunion gives favourable radiological and functional outcome and should be carried out in patients with high functional demand of the wrist joint.

Articular cartilage: injury, healing, and regeneration

Treatment of large articular cartilage defects is technically demanding, and healing is a complicated process often associated with failure. The aim of treatment of articular cartilage injuries is to induce an acceptable healing process. Invasive and noninvasive treatments usually have good short- to mid-term outcomes; however, long-term results have been disappointing probably due to scar formation. Thus, current options are more palliative than curative. Tissue engineering and regenerative medicine (TERM) that includes scaffolds, healing factors, stem cells, and genetic engineering was introduced to orthopaedic research in the last 2 decades. Although TERM has demonstrated utility, the expected goals are not necessarily realistic. Despite advancements, several problems still exist and must be solved. This review discusses articular cartilage structure and function, injury types, the healing process, and factors that influence the healing response. Current treatment modalities, including TERM-based strategies, and their limitations are reviewed to provide future directions for treatment.

Sphincter-sparing intersphincteric rectal resection as an alternative to proctectomy in long-standing fistulizing and stenotic Crohn's proctitis?

Long-standing fistulizing and stenotic proctitis (LFSP) in Crohn's disease (CD) indicates the end stage of the disease. Definitive diversion such as proctectomy is considered to be the only surgical option. The impact of intersphincteric sphincter-sparing anterior rectal resection (IAR) as an alternative to proctectomy is unclear. The aim of this study was to evaluate feasibility, morbidity, outcome, and quality of life (QL) in patients with LFSP undergoing intended IAR. Out of a single institution database, 15 patients with LFSP intended for surgery from 856 patients with CD were selected for follow-up analyses. In 12/15 cases, IAR was carried out while 3/15 patients underwent primary proctectomy due to malignancy (n = 2) or due to patient's wish (n = 1). In one case, IAR revealed unexpected malignancy, which led to secondary proctectomy. In patients with IAR, complete healing of fistulas and stenosis was observed in 46% (n = 5) while 36% (n = 4) of patients showed relapse of fistula and 18% (n = 2) developed restenosis. Ileostomy closure was performed in seven patients from which six patients remained stoma free. QL and fecal incontinence measured by standardized scoring systems were unchanged while stool frequency was reduced after IAR in patients with ileostomy closure. The rate of malignancy in this cohort was 20% (n = 3). LFSP in CD was associated with 20% of malignant transformation. Although IAR fails to improve QL, it is a suitable procedure for the treatment of fistulas and stenosis associated with acceptable healing rates and can avoid a permanent stoma.

Oral health-related quality of life in non-surgical treatment of mandibular fractures: A pilot study

Background: Absence of surgical stress and the limitations associated with maxillo-mandibular fixation have been identified as advantages with non-surgical management of mandibular fractures where indicated. This treatment modality entails close observation, feeding on soft diet, use of analgesics and antibiotics alongside warm saline mouth rinses. This study serves as a pilot to evaluate oral health-related quality of life (QoL) for patients with mandibular fractures who were managed non-surgically in a Nigerian teaching hospital. Patients and Methods: A total of 153 patients were evaluated prospectively over the space of 1 year from which 10 patients met the selection criteria for non-surgical treatment of mandibular fractures. Evaluation at presentation was done using General Oral Health Assessment Index questionnaire. The questionnaire was subsequently completed during reviews at day 1, 6 weeks, and 8 weeks, respectively. Results: There was acceptable healing of all the fractures with a significantly improved mean QoL outcome from 41.42 ± 1.14 at presentation to 59.90 ± 2.00 at 8 weeks review. Conclusion: Although very few patients meet the criteria for non-surgical treatment of mandibular fractures, it is an acceptable treatment option in patients with fractures of the mandible. This form of treatment in such selected cases results in satisfactory fracture healing and acceptable QoL to the patient.

Intramedullary repair device against volar plating in the reconstruction of extra-articular and simple articular distal radius fractures; a randomized pilot study.

This prospective randomized pilot study reports our institutional experience and early results using Sonoma Wrx (Sonoma Orthopedic Products, Santa Rosa, CA) in the treatment of extra-articular and simple intra-articular distal radius fractures. A total of 64 patients, were enrolled in the study. They were considered eligible if they had; unstable extra-articular distal radius fractures and simple intra-articular distal radius fractures suitable for closed reduction (AO types; A2.2, A2.3, A3.1 C2.1, C2.2). Patients in group I received intramedullary fixation using the Sonoma Wrx device and patients in group II received standard volar locking plate fixation. Radiographic criteria of acceptable healing were used for evaluation. Two groups were similar in terms of baseline characteristics. Mean time of operation was significantly shorter in Group 1 vs. in group 2 (36.81 ± 7.11 vs. 48.97 ± 5.9 minutes, p = 0.001). Time to healing of the fracture was not different between two groups (5.45 ± 1.09 vs. 5.70 ± 1.04 weeks for Group 1 vs. 2, respectively p = 0.36). Overall complications occurred in 9 patients in group 1 and in 15 patients in group 2 (p = 0.17). Follow-up was completed in all patients with a median time of 12 months and 13 months in group 1 and 2, respectively. On radiographic evaluation radial inclination, radial height and volar tilt were not significantly different between group 1 and 2, respectively. There were no significant differences between two groups in regard to wrist rotational degrees measured in last follow-up visit. Sonoma Wrx Device is reliable and effective in terms of achieving satisfactory outcomes in treatment of distal radius fractures. It may be reasonable to use this device to prevent complications that are related to extensive soft tissue dissection.

Phase I Study Demonstrates Safety and Tolerability of Radiofrequency Ablation (RFA) of the Anal Mucosa

Background Anal carcinoma is increasing in high-risk populations. Dysplasia is often distributed throughout the anal mucosa, and focal ablative techniques have high rates of recurrence. Methods With the goal of eradicating dysplasia from the entire anal mucosa, we conducted a phase I dose-ranging study to determine the safety and tolerability of radiofrequency ablation (RFA). HIV-infected individuals with high-grade anal intraepithelial neoplasia underwent RFA of the anal mucosa. Patient-reported procedural and postprocedural symptoms were recorded, and mucosal healing was visually assessed. Results Four groups of 3 subjects each were treated with incrementally increasing numbers of RF pulses (1-3) applied to a single area of anal mucosa. Two or three doses of 12 J/cm2 were found to have acceptable patient tolerance and healing of the mucosa within 4 weeks of ablation. Using these doses, 2 groups underwent ablation of 180° of contiguous mucosa. Subjects experienced a loss of 1 to 3 days of daily activities of living, 7 to 14 days of postprocedure symptoms, and mucosal healing within 4 weeks. One subject in the first treatment group had the procedure aborted due to severe procedural pain. Conclusions The study provides evidence of the safety and tolerability of anal RFA of 180° of contiguous mucosa in a single procedure and will allow future RFA efficacy studies in the treatment of anal dysplasia.

Evaluation of repair in duodenal perforation with human amniotic membrane: An animal model (dog).

Background:There is a growing tendency toward application of human amniotic membrane (HAM) as a biologic substitute in various tissue injuries where a significant tissue loss is a matter of concern. In gastrointestinal injuries especially duodenal ones, some potential limitations in current surgical techniques contribute to not fully acceptable healing outcomes. Thus, this study was carried out to assess repair with HAM patch for duodenal defect in comparison with simple duodenoraphy in an animal model (dog).Materials and Methods:A total of 15 male German shepherd dogs weighing 23-27 kg were randomly divided into two groups. Group A with 10 dogs, which were a candidate for duodenal repair by amniotic membrane patch and Group B consisted of 5 dogs perform simple duodenorraphy. A precise control was made to match all conditions except surgical technique. Macroscopic and microscopic features of the healed duodenal lumen in both groups were recorded.Results:Gross evaluation revealed no difference in luminal diameter in both groups. Statistical analysis of duodenal diameter between both groups after operation also showed no significant difference (Pv = 0.789). Histological assessment indicated less inflammation with better wound healing in Group A.Conclusion:It seems that repairing duodenal wall defect with HAM would result in better histological outcomes compared with what is seen in simple duodenoraphy in animal models. However, there is no significant difference regarding surgical findings.

The use of the 95-degree-angled blade plate in femoral nonunion surgery

The 95-degree-fixed angle blade plate has been in use for decades for both acute femoral fractures and nonunions. Our objective was to examine the results of use by a single surgeon of the 95-degree-angled blade plate in proximal and distal femoral nonunion surgery. The nonunion database of a single surgeon over a 16 year period was used to identify all proximal and distal femoral nonunions that were treated with open reduction and internal fixation using the 95-degree-angled blade plate. There were 78 cases in which the blade plate was used, and 68 of 78 (87.2 % follow-up rate) were followed to a final outcome, which was defined as complete healing of the nonunion, conversion to arthroplasty, or amputation. Failure was defined as revision surgery for persistence of nonunion, conversion to arthroplasty prior to healing, or amputation. Three patients who failed were lost to follow-up prior to a final outcome. In the 71 patients who were followed to failure or complete follow-up, the rate of healing with one surgery was 77.5 % (55 of 71). Eight of 16 failures required a second surgery for persistence of nonunion and eventually went on to heal the nonunion. Eleven of the 16 failures were in patients who had a known infected nonunion. When the 21 cases of infected nonunions were excluded, the healing rate for aseptic nonunions with one surgery alone using the 95-degree-angled blade plate was 91.2 % (52 of 57) compared with 47.6 % (10 of 21) in the infected nonunion group (p < 0.0001). Eleven patients who had healed their nonunion underwent all or partial removal of the implant for irritation or prominence. The 95-degree-angled blade plate is an effective reduction aid and fixation device for aseptic nonunions of the proximal and distal femur with acceptable healing rates with one surgery alone.

TITLE - MINERAL TRI-OXIDE AGGREGATE (MTA) FOR THE REPAIR OF PERIAPICAL TISSUES IN A PATIENT WITH SELF INFLICTED INJURIES: CASE REPORT

AbstractInjury to anterior teeth is a relatively common event. Dentists regularly deal with management of dental trauma and restoration of fractured teeth. Hence the treatment approach and medicaments that assures the biologically acceptable healing and improve long term success rate are of potential value and should be considered.A big cystic lesion, which is unable to heal non-surgically, heals well with use of Mineral Trioxide Aggregate (MTA Angelus) by surgical approach. Results of clinical trials have recommended the use of MTA as the most suitable root end filling material.This article presents the case report of management of big cystic lesion along with the lateral root perforation with maxillary left central incisor. Root canal treatment was followed by the resection of root end of tooth in question at the level of perforation and sealed with MTA. 12 month's follow up radiograph showed completely healed Cystic lesion.

Pulp extirpation within 14 days after tooth replantation reduces inflammatory root resorption

Systematic review conclusion The authors of this systematic review found an association between delayed pulp extirpation (performed more than 14 days after replantation) and the occurrence of inflammatory root resorption, thereby supporting the existing clinical guidelines that recommend performing pulp extirpation within seven to 10 days after replantation. Critical summary assessment The results of this systematic review showed that although there was no association between timing of pulp extirpation and periodontal healing, functional healing, acceptable healing or replacement resorption, there was an association between pulp extirpation performed within 10 to 14 days after tooth replantation and a reduced incidence of inflammatory resorption. Evidence quality rating Poor.