Effect of "Apical Induction Combined with Apical Barrier Therapy" on Adult Patients with Open Apical Root and Chronic Apical Periapical Inflammation

doi:10.13701/j.cnki.kqyxyj.2022.10.008

Abstract

Abstract: Objective: To evaluate the clinical efficacy of "apical induction combined with apical barrier therapy" in the treatment of adult patients with open apical root and chronic apical periapical inflammation. Methods: Sixty patients with open apical root and chronic periapical periodontitis who were admitted to our hospital were selected and randomly divided into the experimental group and control group. The experimental group of 15 teeth were treated with apical induction, ie, vitapex continuous sealing was used. And iRoot BP Plus apical barrier was performed after calcification barrier was formed in the apical tip. In the control group, 15 patients received conventional iRoot BP Plus apical barrier surgery, and the postoperative old-periapical index (O-PAI), operation time of 1/3 lower root canal segment, and average efficacy were observed in the two groups. Results: Fifteen patients had correct-filling in the experimental group, while in the control group, 10 patients had correct-filling and 5 patients had overfilling. The O-PAI and periapical lesion area of experimental group 12 months after operation was lower than that of control group (P<0.05). The operation time of 1/3 lower root canal segment in the experimental group was shorter than that in the control group (P<0.05). The success rate of 12 months’ follow-up in the experimental group was higher than that in the control group (P<0.05). Conclusion: The application of "apical induction combined with apical barrier" in the treatment of adult open chronic periapical periodontitis improved the O-PAI, periapical lesion area, and success rate for 12 months, and the operation was relatively simple, which can be used for clinical promotion.

Key words: apical induction, apical barrier, root canal treatment, iRoot BP Plus

LIU Ting, HUANG Yequan, YANG Weidong, WANG Wenmei, ZHU Yanan. Effect of "Apical Induction Combined with Apical Barrier Therapy" on Adult Patients with Open Apical Root and Chronic Apical Periapical Inflammation[J]. Journal of Oral Science Research, 2022, 38(10): 941-945.

References

[1] Witherspoon DE, Ham K. One-visit apexification: technique for inducing root-end barrier formation in apical closures[J]. Pract Proced Aesthet Dent, 2001, 13(6):455-460.
[2] Plascencia H, Díaz M, Gascón G, et al. Management of permanent teeth with necrotic pulps and open apices according to the stage of root development[J]. J Clin Exp Dent, 2017, 9(11): e1329-e1339.
[3] Torabinejad M, Chivian N. Clinical applications of mineral trioxide aggregate[J]. J Endod, 1999, 25(3): 197-205.
[4] Witherspoon DE, Small JC, Regan JD, et al. Retrospective analysis of open apex teeth obturated with mineral trioxide aggregate[J]. J Endod, 2008, 34(10):1171-1176.
[5] Yang Y, Xia B, Xu Z, et al. The effect of partial pulpotomy with iRoot BP Plus in traumatized immature permanent teeth: A randomized prospective controlled trial[J]. Dent Traumatol, 2020, 36(5):518-525.
[6] Chen X, Zhang H, Zhong J, et al. Comparison of indirect pulp treatment and iRoot BP Plus pulpotomy in primary teeth with extremely deep caries: a prospective randomized trial[J]. Clin Oral Investig, 2021, 25(5): 3067-3076.
[7] 王霄燕,李宏,石晶.MTA和iRoot BP Plus对乳牙活髓切断术的临床疗效影响[J].实用口腔医学杂志,2019,35(5):672-674.
[8] Tian J, Zhang Y, Lai Z, et al. Ion Release, microstructural, and biological properties of iRoot BP Plus and ProRoot MTA exposed to an acidic environment[J]. J Endod, 2017, 43(1): 163-168.
[9] Fernandes M, de Ataide I. Nonsurgical management of a large periapical lesion associated with an immature tooth displaying external inflammatory resorption[J]. J Conserv Dent, 2015, 18(4): 349-353.
[10] Agrafioti A, Giannakoulas DG, Filippatos CG, et al. Analysis of clinical studies related to apexification techniques[J]. Eur J Paediatr Dent, 2017, 18(4): 273-284.
[11] 田青鹭,王艳.生物陶瓷材料在根尖屏障术中的应用进展[J].口腔医学研究,2021,37(3):191-194.
[12] Holland R, Mazuqueli L, de Souza V, et al. Influence of the type of vehicle and limit of obturation on apical and periapical tissue response in dogs' teeth after root canal filling with mineral trioxide aggregate[J]. J Endod, 2007, 33(6): 693-697.
[13] Nosrat A, Nekoofar MH, Bolhari B, et al. Unintentional extrusion of mineral trioxide aggregate: a report of three cases[J]. Int Endod J, 2012, 45(12):1165-1176.
[14] Nekoofar MH, Davies TE, Stone D, et al. Microstructure and chemical analysis of blood-contaminated mineral trioxide aggregate[J]. Int Endod J, 2011, 44(11):1011-1018.
[15] 游月华,张凤,元博等.成人恒牙根尖发育不全根尖屏障术治疗预后影响因素分析[J].临床口腔医学杂志,2021,37(7):406-410.
[16] Goyal A, Nikhil V, Jha P. Absorbable suture as an apical matrix in single visit apexification with mineral trioxide aggregate[J]. Case Rep Dent, 2016, 2016: 4505093.
[17] Sharma V, Sharma S, Dudeja P, et al. Endodontic management of nonvital permanent teeth having immature roots with one step apexification, using mineral trioxide aggregate apical plug and autogenous platelet-rich fibrin membrane as an internal matrix: Case series[J]. Contemp Clin Dent, 2016, 7(1): 67-70.