Diogenes Anibal R, Ruparel Nikita B, Teixeira Fabricio B, Hargreaves Kenneth M
Department of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
Department of Endodontics, Loma Linda University School of Dentistry, Loma Linda, California.
J Endod. 2014 Apr;40(4 Suppl):S52-7. doi: 10.1016/j.joen.2014.01.015.
The endodontic management of permanent immature teeth is fraught with challenges. Although treatment modalities for vital pulp therapy in these teeth provide long-term favorable outcome, the outcomes from the treatment of pulp necrosis and apical periodontitis are significantly less predictable. Immature teeth diagnosed with pulp necrosis have been traditionally treated with apexification or apexogenesis approaches. Unfortunately, these treatments provide little to no benefit in promoting continued root development. Regenerative endodontic procedures have emerged as an important alternative in treating teeth with otherwise questionable long-term prognosis because of thin, fragile dentinal walls and a lack of immunocompetency. These procedures rely heavily on root canal chemical disinfection of the root canal system. Traditionally, irrigants and medicaments have been chosen for their maximum antimicrobial effect without consideration for their effects on stem cells and the dentinal microenvironment. Translational research has been crucial to provide evidence for treatment modifications that aim to increase favorable outcome while steering away from common pitfalls in the currently used protocols. In this review, recent advances learned from translational research related to disinfection in regenerative endodontics are presented and discussed.
恒牙未成熟牙的牙髓治疗充满挑战。尽管这些牙齿的活髓治疗方法能带来长期良好效果，但牙髓坏死和根尖周炎的治疗结果却难以预测得多。传统上，诊断为牙髓坏死的未成熟牙采用根尖诱导成形术或根尖形成术进行治疗。不幸的是，这些治疗在促进牙根持续发育方面几乎没有益处。由于牙本质壁薄且脆弱以及缺乏免疫能力，再生牙髓治疗程序已成为治疗长期预后存疑牙齿的重要替代方法。这些程序严重依赖根管系统的根管化学消毒。传统上，冲洗液和药物的选择是基于其最大抗菌效果，而未考虑它们对干细胞和牙本质微环境的影响。转化研究对于为治疗改进提供证据至关重要，这些改进旨在提高良好效果，同时避免当前使用方案中的常见陷阱。在本综述中，将介绍并讨论从与再生牙髓病学消毒相关的转化研究中获得的最新进展。
