Healing teeth
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Healing Teeth: Insights from Recent Research
Biologically Oriented Preparation Technique (BOPT) and Soft Tissue Healing
Hard and Soft Tissue Healing Around Teeth
The biologically oriented preparation technique (BOPT) and the chamfer technique were compared to non-prepared teeth to evaluate their impact on hard and soft tissue healing. Both techniques resulted in a more apical location of the free gingival margin compared to non-prepared teeth, but no significant differences were found between the two techniques in terms of vertical and horizontal histometric measurements. This suggests that both BOPT and chamfer techniques induce similar changes in the healing of the supra-crestal soft tissue complex.
Regenerative Endodontic Procedures (REP) and Periapical Bone Healing
Leukocyte and Platelet Rich Fibrin (LPRF) in REP
A multicenter controlled clinical trial evaluated the impact of leukocyte and platelet rich fibrin (LPRF) on regenerative endodontic procedures (REP) for immature permanent teeth. The study found that REP with LPRF is a viable treatment option for periapical bone healing and further root development in necrotic immature permanent teeth. However, the control group showed better results in terms of root hard tissue volume and thickness.
Platelet-Rich Fibrin (PRF) in Mature Teeth
A preliminary randomized clinical trial compared revitalization and a PRF-based technique for treating mature permanent teeth with necrotic pulps. Both techniques showed significant periradicular healing at 6 and 12 months, with no significant difference between the two groups. This indicates the potential of using REPs for mature teeth with necrotic pulps.
Periodontal Healing and Replantation
Role of Physiologic Storage and Antiresorptive-Regenerative Therapy (ART)
A study on the replantation of avulsed permanent teeth highlighted the importance of immediate physiologic storage in a cell-compatible medium for optimal periodontal healing. The use of antiresorptive-regenerative therapy (ART) showed potential in enhancing the prognosis of teeth with compromised periodontal ligament (PDL).
Root Canal Medicaments and Periodontal Healing
A multi-center randomized controlled trial compared two root canal medicaments, Ledermix® and Ultracal XS®, for periodontal healing of avulsed and replanted teeth. No significant difference was found between the two medicaments, although dry time was a significant factor influencing periodontal outcome.
Soft Tissue Wound Healing
Healing Around Teeth and Dental Implants
Soft tissue wound healing around teeth and dental implants follows a similar pattern. Epithelial healing after periodontal therapy is typically completed within 7-14 days, while the formation of biological width around implants requires 6-8 weeks. The established peri-implant soft connective tissue resembles scar tissue in composition and structure.
Factors Affecting Periapical Healing
Therapeutic and Systemic Factors
The success of root canal treatment and periapical healing is influenced by various therapeutic factors, including the choice of clinical protocol, sanitization process, and quality of the sealer. Systemic conditions such as diabetes mellitus and hypertension can also inhibit wound healing, highlighting the importance of considering both local and general clinical conditions in treatment planning.
Conclusion
Recent research provides valuable insights into the healing processes of teeth, emphasizing the importance of appropriate preparation techniques, regenerative procedures, and immediate physiologic storage for optimal outcomes. Understanding the factors that influence healing can guide clinicians in improving treatment protocols and patient care.
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