SealBio: A novel, non-obturation endodontic treatment based on concept of regeneration

Abstract

Introduction: "SealBio", an innovative, non-surgical endodontic treatment protocol, based on "regenerative concept" has been developed to manage pulp and periapically involved teeth.

Materials and methods: Subsequent to Institute's ethical clearance, 18 patients presenting with signs and symptoms of pulp and periapical disease were included in the study. (11/M, 7/F; Mean age - 44.7 years; range 15-76 years). The protocol included a modified cleaning and shaping technique involving apical clearing and foramen widening, combined with inducing bleeding and clot formation in the apical region. Calcium-sulphate based cement was condensed with hand pluggers into the canal orifices. An appropriate permanent restoration was given. The patients were followed-up clinically and radiographically at regular interval of 6 months. Six teeth in 3 patients were also evaluated pre and post treatment CBCT at 6-months.

Results: The novel treatment protocol was found to be favourable in resolving periapical infection, both clinically and radiographically.

Conclusions: This innovative endodontic treatment protocol highlights and reiterates the importance of cleaning and shaping and puts forth the possible role of stem cells and growth factors in healing after non-surgical endodontic therapy.

Keywords: CBCT; non-obturation Endodontic treatment; periapical healing; regenerative endodontics; sealBio.

Figure 1

(a) A 53-year-old man presented with discrete soft tissue swellings at gingival margin in relation to # 47. (b) Sinus tract traced with guttapercha point documenting a pulpoperiodontal lesion. Note the bone loss on mesial aspect of mesial root. (c) Follow up X-ray at 6 months showing healing of periodontal defect. (d) At 3-years, complete healing and new bone regeneration in inter dental area between #46 and #47 is evident

Figure 2

(a) Immediate post-treatment X-ray showing diffuse radiolucency around distal root in a 40-year-old man. (b) Just 6-weeks after the treatment, remarkable healing of the lesion is seen. (c) One-year follow-up x-ray showing complete healing

Figure 3

CBCT scan (i) & (ii) showing the pre and 6-months post treatment result

Figure 4

CBCT scan (i) & (ii) showing the pre and 6-months post treatment result