Ghana Shyam Prasad Madu, Juvva Ramakrishna, Babu Duvvi Naveen
Dept. of Pedodontics and Preventive Dentistry, St. Joseph Dental College, Eluru, India.
Dept. of Biochemistry, St. Joseph Dental College, Eluru, India.
J Dent (Shiraz). 2019 Jun;20(2):137-140. doi: 10.30476/DENTJODS.2019.44925.
Stem cells are considered as the principal source of differentiated cells. In the past few years, the research on the stem cell in various fields had shown success, but the stem cell-based therapies in the dentistry had confined to a particular extent. The present case report was aimed to evaluate the efficacy of stem cells from human exfoliated deciduous teeth (SHED) in the management of a large periapical lesion. A 12-year-old girl reported with a chief complaint of pain in the lower right back tooth region since 5 days. Intraoral examination revealed a deep occlusal cavity in relation to tooth#46 with tenderness on percussion. Radiograph examination revealed periapical radiolucency measuring 1.8×1.0cm in size with perforation at the floor of the pulp chamber in relation to 46. A deciduous tooth from the same child was collected to isolate stem cells. After access opening for tooth #46, pulp was extirpated and a thick mucoperiosteal flap was raised. This was followed by homing of SHED into the periapical area through the window created in the buccal cortical plate and into the root canals of tooth #46 until the orifice. The access cavity was sealed with glass ionomer cement. The patient was subjected to evaluation at regular intervals i.e., two weeks, four months, twelve months, and twenty-four months. The case treated demonstrated complete resolution of periapical radiolucency in the fourth-month review with a positive response to electric pulp testing. This clinical application report concludes that SHED can be effective in treating the periapical lesions in permanent teeth.
干细胞被认为是分化细胞的主要来源。在过去几年中，干细胞在各个领域的研究都取得了成功，但牙科领域基于干细胞的治疗在一定程度上受到了限制。本病例报告旨在评估人乳牙脱落干细胞（SHED）在治疗大型根尖周病变中的疗效。一名12岁女孩因右下后牙区疼痛5天前来就诊。口腔检查发现46号牙有深咬合龋洞，叩诊时有压痛。影像学检查显示根尖周透射区大小为1.8×1.0cm，46号牙髓腔底部有穿孔。收集该患儿的一颗乳牙以分离干细胞。对46号牙进行开髓后，摘除牙髓，并掀起厚的黏骨膜瓣。随后，SHED通过在颊侧皮质骨板上创建的窗口归巢到根尖周区域，并进入46号牙的根管直至根尖孔。用玻璃离子水门汀封闭开髓腔。定期对患者进行评估，即两周、四个月、十二个月和二十四个月。在第四个月复查时，该病例治疗显示根尖周透射区完全消失，牙髓电测试呈阳性反应。本临床应用报告得出结论，SHED可有效治疗恒牙的根尖周病变。
