Dental pulp auto transplantation: a new modality of endodontic regenerative therapy – follow-up of three clinical cases
Abstract
Introduction
The aim was to develop a novel method of endodontic therapy, which we refer to as dental pulp auto transplantation. Three patients (two male and one female) were selected for endodontic treatment of an uniradicular premolar and extraction of a third molar (without odontosection). Electric assessment of pulp vitality and computed tomography (CT) were undertaken, followed by endodontic access and instrumentation using triantibiotic solution as irrigating in the host tooth. Few minutes before the transplant procedure, the third molar was extracted, tooth was sectioned with diamond blade in low-speed handpiece, and pulp was carefully removed. After premolar instrumentation, the harvested and preserved pulp tissue was re-inserted into the root canal followed by direct pulp capping was performed using Biodentine (Septodont), a liner of resin-modified glass-ionomer cement and composite resin restoration.
Results
The teeth were followed up for at least 12 months after the procedures, and were analyzed using CT, electric pulp vitality test and Doppler ultrasound examination. At 3 and 6 month follow-ups, positive pulp vitality and regression of periapical lesions were verified. After 9-12 months, all teeth were revascularized as determined by Doppler imaging, and the tooth vitality was re-established with no signs of endodontic/periodontal radiolucency or complications.
Conclusions
Within the limitations of the study, considering that it was a case series with only three patients, we described a highly innovative procedure of pulp auto transplantation, which appears to be feasible, highlighting the potential for clinical application of pulp regeneration using this new modality of endodontic therapy.
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