Evaluation of Clinical Outcomes of Various Materials Used for Apexification in South Asia: A Systematic Review
Published: 2024-04-11
Page: 100-110
Issue: 2024 - Volume 7 [Issue 1]
R Jesanth Joel *
Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu – 625001, India.
Swathi Priyadharshini
Department of Conservative Dentistry and Endodontics, Saveetha Dental college, Poonamallee, Chennai – 600077, India.
I Anand Sherwood
Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu – 625001, India.
Vaanjay M
Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu – 625001, India.
Rathna Piriyanga
CSI College of Dental Sciences and Research, Madurai, 625001, India.
A Azhagu Abirami
Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu – 625001, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Endodontic treatment encounters challenges, especially with open tooth apices affected by trauma or pulpal pathology, resulting in divergent or flaring root walls known as "Blunderbuss" or "non-blunderbuss" canals. Conventional root canal procedures for managing open apices have a risk of material extrusion. Notably, there is a lack of documented analysis on materials and methods for apexification in South Asian countries, highlighting a gap in research within the field.
Aim: This paper aims in providing a comprehensive review of various materials and methods utilized in apexification procedures in South Asian countries.
Materials and Methods: This systematic review, from January 2000 to August 2023, employed a thorough computerized search on apexification procedures in South Asian countries. Utilizing keywords, articles from Google Scholar and PubMed databases were examined using Boolean operators. Following inclusion and exclusion criteria the articles were screened and 8 articles were selected, fully read, and analysed in association with the review question.
Results: From the chosen articles, three primary materials—Calcium Hydroxide, MTA, and Biodentine were prominently used in apexification procedures. Notably, Biodentine demonstrated superiority over the other materials, while Calcium Hydroxide was identified as the gold standard for apexification in teeth with shorter roots.
Conclusion: The conducted studies distinctly point Biodentine as a preferred material for apexification in South Asian countries. Nevertheless, further studies have to be made within the region to enhance understanding of apexification procedures and explore newer materials available.
Keywords: Apexification, immature apex, Calcific bridge, biodentine, mineral trioxide aggregate, calcium hydroxide
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References
Dawoud A, Elboraey M. Clinical and CBCT comparison of MTA revascularization versus apexification for immature permanent incisors. Egyptian Dental Journal. 2022;68(4):3041-54.
Shobhana R, Prakash V, Venkatesh A, Vivekanandhan P. A Review on management of open apex in permanent teeth. Int. J. of Aquatic Science. 2021;12(3):2055-61.
Huang GJ. Apexification: The beginning of its end. International Endodontic Journal. 2009;42(10):855-66.
Agrafioti A, Giannakoulas DG, Filippatos CG, Kontakiotis EG. Analysis of clinical studies related to apexification techniques. Eur J Paediatr Dent. 2017;18(4):273-84.
Morse DR, O’Larnic J, Yesilsoy C. Apexification: review of the literature. Quintessence Int. 1990;21(7):589-98.
Ruaaz R, Bashir MB, Anwar M, Rashid S, Ali S, Aliuddin AM. Efficacy of calcium hydroxide and mineral trioxide aggregate in the formation of Dentin Bridge-A randomized controlled trial. Journal of the Pakistan Dental Association. 2022;31(3).
Goel S, Nawal RR, Talwar S. Management of dens invaginatus type II associated with immature apex and large periradicular lesion using platelet-rich fibrin and biodentine. Journal of Endodontics. 2017;43(10):1750-5.
McGuinness, LA, Higgins, JPT. Risk-of-bias VISualization (robvis): An R package and Shiny web app for visualizing risk-of-bias assessments. Res Syn Meth. 2021; 12:55-61. Available:https://doi.org/10.1002/jrsm.1411
Singh N, Mittal N, Baranwal HC, Tripathi R, Wang CK. Single-visit apexification in immature necrotic teeth using mineral trioxide aggregate as an apical plug: Case series. SRM Journal of Research in Dental Sciences. 2019;10(4):239-44.
Pavula, S.; Sherwood, I. Anand; Amaechi, Bennett Tochukwu1; Murugadoss, Vaanjay; Prakasam, Ernest Prince; Abirami, A. Azhagu. Cone-beam computed tomographic evaluation of biodentine apexification for traumatized necrotic immature permanent incisors: One-year clinical study. Endodontology. 2024;36 (1):67-74 DOI: 10.4103/endo.endo_233_22
Conventional Multivisit calcium hydroxide apexification with rare apexogenesis like outcome and novel single visit MTA apexification followed by root reinforcement with fiber post: Two case reports. Saudi Journal of Oral and Dental Research DOI: 10.21276/sjodr.2017.2.2.1
Sridhar N, Tandon S. Continued root-growth and apexification using a calcium hydroxide and iodoform paste (Metapex®): Three case reports. J Contemp Dent Pract. 2010;11(5):63-70.
Bajwa NK, Jingarwar MM, Pathak A. Single visit apexification procedure of a traumatically injured tooth with a novel bioinductive material (Biodentine). International Journal of Clinical Pediatric Dentistry. 2015;8(1):58.
Bhandari S. Comparison of intracanal calcium hydroxide, mineral trioxide aggregate and portland cement to induce PH changes in simulated root resorption defects in human teeth-An In vitro study (Doctoral dissertation, Rajiv Gandhi University of Health Sciences (India)).
Damle S, Bhattal H, Loomba A. Apexification of anterior teeth: a comparative evaluation of mineral trioxide aggregate and calcium hydroxide paste. Journal of Clinical Pediatric Dentistry. 2012;36(3):263-8.
Nahar R, Chowdhury F, Alam MK. Apexification with the use of calcium hydroxide. Bangladesh Journal of Medical Science. 2012;11(2):143.
Rafter M. Apexification: a review. Dent Traumatol. 2005;21(1):1-8. DOI: 10.1111/j.1600-9657.2004.00284.x. PMID: 15660748.
Ham KA, Witherspoon DE, Gutmann JL, Ravindranath S, Gait TC, Opperman LA. Preliminary evaluation of BMP-2 expression and histological characteristics during apexification with calcium hydroxide and mineral trioxide aggregate. Journal of Endodontics. 2005;31(4): 275-9.
Kumar A, Yadav A, Shetty N. One-step apexification using platelet rich fibrin matrix and mineral trioxide aggregate apical barrier. Indian Journal of Dental Research. 2014;25(6):809.
Sharma S, Sharma V, Passi D, Srivastava D, Grover S, Dutta SR. Large periapical or cystic lesions in association with roots having open apices managed nonsurgically using 1-step apexification based on platelet-rich fibrin matrix and biodentine apical barrier: A case series. Journal of Endodontics. 2018;44(1):179-85.
Ravi GR, Subramanyam RV. Calcium hydroxide-induced resorption of deciduous teeth: A possible explanation. Dental Hypotheses. 2012;3(3):90-4.
Mathew, Josey & Syriac, Gibi & Nair, Manuja & Jayakumar, Rahul. Saudi journal of oral and dental research conventional multivisit calcium hydroxide apexification with rare apexogenesis like outcome and novel single visit MTA apexification followed by root reinforcement with fiber post: Two case reports. Saudi Journal of Oral and Dental Research. 2017;2:43-48. DOI: 10.21276/sjodr.2017.2.2.1
Mathew, Josey, Syriac, Gibi, Nair, Manuja, Jayakumar, Rahul. Saudi Journal of Oral and Dental Research Conventional Multivisit Calcium Hydroxide Apexification with Rare Apexogenesis Like Outcome and Novel Single Visit MTA Apexification Followed by Root Reinforcement with Fiber Post: Two Case Reports. Saudi Journal of Oral and Dental Research. 2017;2: 43-48. DOI: 10.21276/sjodr.2017.2.2.1
Tolibah YA, Kouchaji C, Lazkani T, Ahmad IA, Baghdadi ZD. Comparison of MTA versus Biodentine in Apexification Procedure for Nonvital Immature First Permanent Molars: A Randomized Clinical Trial. Children (Basel). 2022;14;9(3): 410. DOI: 10.3390/children903041 PMID: 35327782 PMCID: PMC8946907.
Aeran, Himanshu & Sharma, Mahema & Tuli, Avantika. (2021). Biodentine: Material of choice for apexification. International Journal of Oral Health Dentistry. 2021;7:54-56. DOI: 10.18231/j.ijohd.2021.011