Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 29;36(1):53-57.
doi: 10.54589/aol.36/1/53.

Periodontal regeneration by minimally invasive procedures and its influence on pulp status

Stefanía H Caceres  1   2 , Hernán Bonta  1 , Federico G Galli  1 , Liliana G Sierra  2 , Pablo A Rodríguez  2 , Facundo Caride  1
Affiliations

Periodontal regeneration by minimally invasive procedures and its influence on pulp status

Stefanía H Caceres et al. Acta Odontol Latinoam. .

Abstract
in English, Spanish

Dental pulp and periodontium have different communication routes including, e.g., apical foramen, accessory canals and dentin tubules. Scaling, planing and root surface treatment with ethylenediaminetetraacetic acid (EDTA)-based conditioner are used in regenerative periodontal procedures. Such treatment may generate pathological communication between the two structures due to interruption of the vascular pedicle or migration of bacteria and/or inflammatory byproducts from deep periodontal pockets, which may generate pulp pathology.

Aim: The aim of this study was to evaluate the influence of minimally invasive periodontal regenerative surgery on pulp vitality status in single-rooted and multi-rooted teeth associated to infraosseous defects extending to the middle and apical thirds.

Materials and method: This was a retrospective study on 30 teeth from 14 patients who received care between August 2018 and August 2019 at the postgraduate Department of Specialization in Periodontics of the Buenos Aires University School ofDentistry (FOUBA). Clinical and radiographic endodontic diagnosis was performed 6 months after the minimally invasive regenerative periodontal treatment.

Results: Only two out of the 30 teeth presented changes in pulp status following regenerative periodontal procedure: irreversible pulpitis at 30 days and pulp necrosis at 180 days post-treatment. The rate for risk of change in pulp vitality status was 6.7%. Teeth with grade I and II furcation lesions (n=9) presented no change in pulp status.

Conclusions: Regenerative periodontal surgery had no significant influence on pulp status in single-rooted and multi-rooted teeth with infraosseous defects extending to the level of the middle and apical third.

La pulpa dental y el periodonto presentan diferentes vías de comunicación. El foramen apical, los conductos accesorios y los túbulos dentinarios son ejemplos de ellos. Durante los procedimientos peri-odontales regenerativos se realiza el raspaje, alisado y tratamiento de la superficie radicular con un acondicionador a base de ácido etilendiaminotetraacético (EDTA). Este tratamiento podría generar una comunicación patológica entre ambas estructuras debido a la interrupción del pedículo vascular o a la migración de bacterias y/o subproductos inflamatorios provenientes de bolsas periodontales profundas que generen patología pulpar. Objetivo: El objetivo del presente estudio fue evaluar la influencia de la cirugía periodontal regenerativa mínimamente invasiva sobre el estado de vitalidad pulpar de piezas dentarias unirradiculares y multirradiculares con defectos infraóseos que se extendían hasta el tercio medio y apical. Materiales y Método: Se analizaron de forma retrospectiva 30 piezas dentarias de 14 pacientes atendidos entre el mes de agosto 2018 y agosto 2019 en el posgrado de la Especial-ización en Periodoncia de la Facultad de Odontología de la Universidad de Buenos Aires (FOUBA). Se realizó el diagnóstico endodóntico de forma clínica y radiográfica a los 6 meses post-tratamiento periodontal regenerativo mínimamente invasivo. Resultados: De las 30 piezas solo 2 presentaron cambios en el estado pulpar luego del procedimiento periodontal regenerativo, pulpitis irreversibles a los 30 días y necrosis pulpar a los 180 días post-tratamiento. La tasa de riesgo de cambios en el estado de vitalidad pulpar fue del 6,7%. En relación a las piezas dentarias que presentaban lesiones de furcación grado I y II (n=9) ninguna presentó cambios en su estado pulpar. Conclusiones: La cirugía periodontal regenerativa no tuvo influencia significativa en el estado pulpar de piezas unirradiculares y multirra-diculares con defectos infraóseos que se extendían a nivel del tercio medio y apical.

Keywords: MIST-M-MIST; necrosis; pulp status; pulpitis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no potential conflicts of interest regarding the research, authorship, and/or publication of this article.

Figures

Fig. 1
Fig. 1. Periapical radiograph of tooth 32. a) Prior to surgery, chamber and canal appearance normal, intraosseous defect of two walls extending to the apical third distally to the tooth and b) 180 days post-surgery there is adequate filling and slight enlargement of periodontal space.
Fig. 2
Fig. 2. Periapical radiograph of tooth 43, a) Prior to surgery, chamber and canal appearance normal, intraosseous defect of two walls extending to the apical third mesially and distally, and b) 180 days post-surgery there is a circumscribed radiolucent image at the level of the root apex.
Fig. 3
Fig. 3. Graph of survival at 180 days (Kaplan-Meier). Teeth treated by minimally invasive regenerative procedures (blue line). Events (steps).
Fig. 4
Fig. 4. a) Baseline furcation lesions according to Hamp’s classification. 78% had grade II furcation lesions (7 teeth), and the remaining 22% (2 teeth) had grade I furcation lesions. b) Final furcation lesions according to Hamp’s classification. 56% present no furcation lesion (5 teeth), and the remaining 44% had grade I furcation lesions (4 teeth).
See this image and copyright information in PMC

References

    1. De Deus QD. Frequency, location, and direction of the lateral, secondary, and accessory canals. J Endod. 1975 Nov;1(11):361–6. doi: 10.1016/S0099-2399(75)80211-1. - DOI - PubMed
    1. Rotstein I. Interaction between endodontics and periodontics. Periodontol 2000. 2017 Jun;74(1):11–39. doi: 10.11n/prd.E2188. - DOI - PubMed
    1. de Sanctis M, Goracci C, Zucchelli G. Long-term effect on tooth vitality of regenerative therapy in deep periodontal bony defects: a retrospective study. Int J Periodontics Restorative Dent. 2013 Mar-Apr;33(2):151–7. doi: 10.11607/prd.1461. - DOI - PubMed
    1. Cortellini P, Tonetti MS. Evaluation of the effect of tooth vitality on regenerative outcomes in infrabony defects. J Clin Periodontol. 2001 Jul;28(7):672–9. doi: 10.1034/j.1600-051x.2001.028007672.x. - DOI - PubMed
    1. Lowman JV, Burke RS, Pelleu GB. Patent accessory canals: incidence in molar furcation region. Oral Surg Oral Med Oral Pathol. 1973 Oct;36(4):580–4. doi: 10.1016/0030-4220(73)90316-2. - DOI - PubMed