Author(s): Petrović Vanja, Marković D, Čakić S, Krstić N
Keywords:apexogenesis, hydroxyapatite, clinical study, monkeys, radiography
Management of the affected pulp in teeth with incomplete root formation is still an issue. Calcium hydroxide and other materials have been employed for this purpose to a greater or lesser success. Bioceramic materials are in the last decades well established in a number of different medical fields. Having its constituents the same as those of the unorganic portion of bone tissue, hydroxiapatite (HAP), one of the two forms of calcium-phosphate ceramics, is already accepted in endodontic treatment of teeth with completed root formation. The aim of this study was to examine apexogenesis in teeth with immature roots, following the use of HAP on their affected pulp. Examination was performed on eight young monkeys (Cercopithecus Aethiops) with incomplete root development. The 100 m synthetic HAP material was applied on 32 teeth divided into two groups of 16 teeth each. In one group teeth underwent pulpotomy, in the other high pulpotomy. Evaluation of root growth was recorded from radiographs (pre-treatment, 3 and 12 months following treatment) and by Demjrian's scale for dental maturity and tooth age determination. On the basis of radiographic analysis, immature teeth with affected pulp treated with HAP, both with pulpotomy and high pulpotomy, reached the same stage of root development as control teeth in 50% of cases at 3-months radiographic assesment. After 12 months all tested teeth had the same rate of root development as control teeth, except for 1 of 8 with high pulpotomy. Dentinal bridge was radiographically visible in 50% and 87.5% of pulpotomized teeth after 3 and 12 months, respectively. Neither obliteration of the root canal, presence of denticles nor the presence of deformities in the periapical region were found in any of the observed teeth.
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