Effects of Intracanal Medicaments on Inflammatory Resorption or Occurrence of Ankylosis in Mature

8/3/2019 Effects of Intracanal Medicaments on Inflammatory Resorption or Occurrence of Ankylosis in Mature

1/11

od Dent Tra latol 1993: 9 : 175-184k . All rights reserved Copyright , Munksgaard Endodontics &Dental Traumatolo

ISSN 0109-2502

R e v i e w a r t

f l a m m a t o r y r e s o r p t io n o r o c c u r r e n c e o fn k y lo s is in m a t u r e t r a u m a t i z e d t e e t h : a r e v iereview. Endod Dent Traum atol 1993; 9: 175-184.

A . P . V a n d e r a sPrivate practice, Pediatric Dentistry, Athens,Greece.

Key words: root canal medicaments; inflammroot resorption; dentoalveolar ankylosis; matteeth.Apostole P Vanderas, 11 Makedonlas StreeKifissia 14561, Athens, Greece.Accepted April 29, 1993

traumatized mature teeth especially in luxation

caused by bacteria present in the pulp and in

resorption (8). Ankylosis is related to the absenvital periodontal ligament and represents a fuof root surface ofthe tooth with the bone (9)cases where hmited damage has occurred toperiodontal ligament, reversal of the ankylosisoccur (10, 11). Otherwise, ankylosed teethgradually resorbed and replaced by bone. This cphcation is called replacement resorption (12).cent research on monkeys however suggests


2/11

inwhile the others clinical. All clinical studies were

seven years. Three studies (15, 17, 18)

The experimental in vivo studies (3, 4, 6, 13-16)a clinical one (17) tested the effectiveness of theicaments in avulsed teeth, while the rest of them18) used samples of teeth w ith different types of

necrosis was diagnosed by clinical andin vivo studies6, 15, 16) the root canal dressing was placed

in vivo

Regarding the results, all studies showed ar-

quency despite the fact that teeth with differenof injury and complete or incomplete root devment were included in the samples. Howevebreaking down the results into immature andture teeth the success rate in one study (5) fortreated with calcium hydroxide was 100%85.7% respectively. In the other study (18), nformation was given with respect to maturiimm aturity of 52 intrud ed teeth as well as teeth with inflammatory resorption whichveloped ankylosis. Furthermore, if the resultsbroken down by the type of injury and maturthe teeth, it is likely that in some injuries, susubluxation and extrusion, the success rate wbe higher than that in intrusive luxation. Such mation however was not given by the investiOne (5) ofthe clinical studies was comparativinvestigated the effectiveness of calcium hydrand chloropercha-guttapercha on inflammatosorption. Very slight numerical difference ifrequency of success between the two medicawas reported. The investigator commented thgroups were not really comparable because with different root development were includeach group and therefore the possibility of meical root canal cleansing was different. Howwhen considering separately the mature teeth, wroot canal cleansing makes them more compathe percentage of success was 85.7 and 94.4 fcalcium hydroxide and guttapercha groups retively. The correspondmg values for matureimmature teeth together reported by the ingator were 98% and 94% respectively. Alththe difference in the percentages may not be sicant it shows that guttapercha with sealer perbetter than calcium hydroxide in m ature teeththe reported by the investigator percentages shthe opposite trend.

All exp erimental in vivo studies were compaIwo of them (13, 14) compared the effectivof calcium hydroxide and guttapercha in avmature teeth. One investigation (13) showedno inflammatory resorption was developed in treated with calcium hydroxide or guttapewhile the other one (14) reported eliminatioinflammatory resorption in the calcium hydrgroup and less than 10% in the guttapercha gIn the first study (13), the replantation wasformed in 18 or 120 min wet and dry interv al rtively, while in the second (14) after an houinterval. One more study (15) investigated the tiveness of calcium hydroxide on the inflammresorption. It was reported that 9.6% and


3/11

Roet resorption or ani(yiosis medication in mature

stage of root Root canaldevelopment Type ol Iniuty ttvessing

Range of obs.Time placing the root period w/th ecanal dressing medicament Results

(5) 1973 84

(17) 1974b 38

(18) 1992 885

gheden et al. 20

heden et al. 24

asen and 47

asen J. 0. 471981

et 8(4) 1986

Lind- 16

ce et al. (16 ) 24

18 complete Subiuxation 33 guttaperchaExtrusion

66 incomplete Intrusion 51 Ca(OH)j

21 complete Avulsion Ca(OH)j17 incomplete

45 4 complete 296 Subluxation Ca(OH)j431 incomplete 589 luxated

{52 intrusive)

27 to 143 days 23 m $-7 yrs20 to 149 days 19 m s-5 yrs

Attet final fixation 22 -7 8 msAfter pulp necrosisAfter pulp necrosis 3- 5 4 ms

complete

complete

complete

complete

complete

complete

comptete

Avulsion

Avulsion

Avulsion

Avulsion

Avulsion

Avulsion

Avulsion

Ca(OH);

Ca(OH),Resin-chioroform& guttaperchaGuttaperchaGuttapercha

AntibioticLedermix paste

Calcitonin paste

3 wks afterreplantationExtraorallyAfter pulp extirpation

ExtraorallyAfter pulp extirpationExtraoraltyAfter pulp extirpation

3 wks after re-plantation3 wks after re-plantation3 wks afterreplantation

8 wks

8 wks

8 wks

8 wks

8 wks

8 wks

8 wks

Arrest of root resorption inteeth (94%)Arrest of root resorption inteeth (98%)Absence of the inflammatoresorption97% healing or arrest of roresotptionResidual inflammatory reso3 & 5 wks after applicationCa(OH),No inflammatory resorptionLes than 10% inflammatorysorptionNo inflammatory resorption

Significantly more inflammresorption in teeth w/extlrppulp than w/guttaperchaReduction of inflammatoryresorptionElimination of inflammatoryresorptionAlmost eliminated inflammresorption

inconducted on monkey teeth with mature roots.

period for al! experimental in vivo studies wweeks, while for the clinical one it ranged fromto 74 months. The evaluation of the effect omedicaments on the periodontal healing was formed in all experimental in vivo studies bu(19, 20) by a histometric model, while clinicalradiographic criteria were used in the clinical stAnalysing the results of the studies that usedcium hydroxide as intracanal dressing, two of t(13, 14) reported statistically significant diffein the percentage of relative surface area ofthewhich developed ankylosis between teeth treextraorally with calcium hydroxide and those guttapercha or extirpated pulps. The frequencankylosis was higher in the calcium hydrogroup, while inflammatory resorption was foonly in the pulp extirpation group. On the basthe high frequency of ankylosis found in their s

Andreasen & Kristerson (13) suggested that calhydroxide can be used two weeks after the


4/11

2 . Studies on the effect of the medicamens used as root canal dressing on the occurrence of ankylosis in traumatized teethf4 of Stage of rootteeth developmen t Type of Injury

Root canaldressing

Time placing the rootcanal dressing

Time of Obs.replantation period Results

and(13)

(17) 1974

et(19) 1986

47

38

40

complete

21 complete17 incompletecomplete

Avulsion

Avulsion

Avulsion

GuttaperchaCa(OH),

Ca(OH)^

Ca(OH)j

ExtraorallyAfter pulpextirpationAfter final fixationAfter pulp necrosis10 days afterreplantation

18 min or120 minvaried

1 min

et al. 40 complete1988

Wound in the Ca(OH)jmarginal peri- Anlibiolicsodontium

et al. 20 complete Avulsion1991

et al, 20 complete1990

ierce and Lind- 16 complete Avulsion(6) 1987

J. 0. 77 complete Avulsion) 1981

ierce et al. (16) 24 complete Avulsion988

Ca(OH);

Guttapercha

Extraorally

3 wks afterreplantation

Extraorally

Ledermix paste 3 wks afterreplantation

Guttapercha ExtraorallyEmpty canal After extirpation

of the pulp

Calcitonin paste 3 wks after re -Emp ty canal plantation

18 min or120 min

8 w ks Significantly more ankyloteeth treated w/Ca(OH)j guttapercha or extirpated

2 2 - 7 8 ms Ankylosis in 13 teeth (62Ankylosis in 4 teeth (23.

8 w ks Necrosis of the resorbingreparative cellsInflammation of periodonligamentFormation of reparativecementumTemporary ankylosis

8 w ks Temporary ankylosis

Significantly more ankyloteeth treated with Ca(0Hin non-treated teethSignificantly more ankyloteeth treated wtth Ca(OHw/guttapercha or nontreateethNo pertdontal inflammatiAnkylosisSignificantly more ankyloteeth treated w/guttapercw/empty cana! ot non-expulpNo inflammation w/outresorption within theperiodontal ligamentAnkylosis

replacement resorption. The clinical study (17)nvestigated the occurrence of ankylosis in avulsedeeth with and without mature root treated withalcium hydroxide. The results showed that therobability figure ofthe difference ofthe frequencyf ankylosis between mature and immature teethribution of the teeth with mature root in the longry interval in respect to the subsequent wet inter-al. The conclusion of this study was that if teethith necrotic pulp are adequately treated endodon-tieally with calcium hydrox ide paste as a tem poraryroot filling material, complications other than anky-losis need hardly be expected. H owever, this clinicaltudy was not designed to investigate whether cal-ium hydroxide had an effect on the occurrence of

extensive inflammation in the periodontal ligaOne week later, formation of reparative cemeand bone in the periodontal ligament wereserved. The ankylosis reported was of a trannature. Based on these results the investigpointed out that frequent changes of the calhydroxide may, in the clinical situation, be hato the reparative process. Furthermore, the intion of bone formation in the periodontal ligato such an extent that ankylosis was establisheweek after the application of calcium hydroxidebe a warning against the clinical use of this mament in teeth with damaged root surfaces.In another study the investigators (20) rep

cervical ankylosis in experimental wound omarginal periodontium after the intrapulpal acation of calcium hydroxide or antibiotics.


5/11

it s limited extent andRegarding the Ledermix paste, one experimentalvivo study (6) reported that periodontal inflam-

losis dominated the root surface. An other studyin vitro after isolation frome surface of resorbing rat mo lars. It was found that

s a direct inhibito ry effect on resorbing cells with-

Oth er studies ( 2 1 , 22) investigated the release ratea mixture of calcium hydrox-in vitro. It was found that

Finally, one study (3), using extraorally guttaper-

First, the clinical studies (5, 17, 18) were retro-

R o e t r o s o r p t i e n o r a n k y l o s i s m e d i c a t i o n i n m a t u r e the studies (5, 18). However, in both studies (5only teeth with intrusive luxation failed to hethe calcium hydroxide group which implies thafrequency of success for the other types of iwas 100%. The great majority ofthe teeth inclin the samples was not teeth with intrusive luxbut subluxated and extruded teeth. The cosition of the sample therefore, as well as the high frequency of success in subluxated andtruded teeth, influences the success rate of treinflammatory resorption with calcium hydroxidteeth with intrusive luxation. Since the progregarding pulp necrosis and other complicatiodifferent for each type of luxation injury (1),more useful to know the frequency of succeseach type of injury separately than a very success frequency for all types of injury whichnot correspond to the reality in the case of intrluxation. Also, it has been reported (1) that retrospective study, given a radiograph andphoto graphic registration, lateral luxation can mic any one ofthe other luxation categories. Sinthese clinical studies (5, 18) teeth with lateralation were not mentioned to be included insamples, one may wonder in which category ojuries they were grouped. If they were includethe subluxated and extruded teeth, the results wnot have been influenced because the frequencsuccess was 100%. However, if teeth with laluxation were included in the group of teeth intrusive luxation may influence the results tively due to different prognosis in the frequencomplications (1). Furthermore, the prognosmature and immature teeth with intrusive luxis different (1). Therefore, the results should been reported separately for this type of injury

Second, pulp necrosis was diagnosed at theof treating teeth with calcium hydroxide by cliand radiographic criteria. Since pulp necrosluxated teeth except intrusive luxation usuallycurs within 3 or 4 months (1, 25) after injurymost plausible that at the time of placing the calhydroxide in the root canal, periodontal ligarepair was completed and, therefore, these reacted to calcium hydroxide like non-injured with necrotic pulp. In some cases however inmatory resorption can develop which showsperiodontal ligament repair was not normally pleted. One could argue therefore that all cases were healed in the clinical studies withouinterference of calcium hydroxide with the odontal repair. Inflammatory resorption in


6/11

V a n d e r a speriodontal ligament or root surface was not healed.It is likely therefore that in these cases the inter-ference of calcium hydroxide with the periodontalligament was not clinically evident due to its effecton a limited area of periodontal ligament or rootsurface. It has been reported that if less than 20%of the root surface is damaged, reversal of ankylosiscan occur (10, 11). Also, mature teeth with luxationinjury except intrusive luxation run lower risk ofdeveloping inflammatory resorption (1, 27, 28)which show that severe periodontal damage withdenuded dentinal tubules and pu lp necrosis togetherare infrequent.

Third, it has recently been reported that noneof the previously accepted signs of pulp necrosis,considered alone or together, are pathognomonic ofpulp necrosis after luxation injuries on a short-termbasis (29). Transient apical resorptive processes andresorption within the root canal after luxation in-and root fracture as a result of healing processcan mimick healing complications (30, 31). It islikely that a number of teeth with these conditionswere included in the samples. One could argue thatthe overall frequency of these healing processes inthe luxation injuries is 4.2% (1) and, therefore,the probability to influence the result is very low.However, it should be pointed out that this fre-uency is not equally distributed in mature andimmature teeth and the type of injury (30). Thus,the frequency in subluxation is 2.2%, in extrusiveluxation 11.3%, in lateral luxation 12.3%, and 0%n intrusive luxation (30). Since the composition ofthe sample according to the maturity of the teethand type of injury is not given in the clinical studiesthe influence of the results ean not be estimated.However, when one computes the overall frequencyf inflammatory resorption from the actual data ofhe clinical studies it can be found that the percen-tage of inflammatory resorption in one study (5)

he frequency of inflammatory resorption was19.2%. By contrast, a recent study (1) conductedn 637 teeth with luxation injuries reported that the% despite the fact that the percentage of teeth

ively) .Finally, the effect of calcium hydroxide on inflam-

resorption was mature but the number of intrteeth with mature roots was not given. In the study (18), it was reported that in 5 teeth inflammatory resorption and 8 teeth withouflammatory resorption of 52 intruded teeth trwith calcium hydroxide ankylosis was develAgain the number of mature intruded teetcluded in the sample was not given. The third (17) showed that 13 of 21 avulsed teeth with mroots treated with calcium hydroxide after ftnaation developed ankylosis. These findings werebuted to the severity of the injury as well as wet or dry interval of replanted teeth. Howthese clinical studies were not designed to inveswhether calcium hydroxide had any effect ooccurrence of ankylosis in intrusive and avteeth. In one study (5) which compared the of calcium hydroxide and guttapercha with sonly 6 and 2 intruded teeth respectively wecluded in the sample of the groups.

All experimental in vivo studies tested the efcalcium hydroxide on periodontal ligament rin teeth with completed roots and severe odontal injury (Table 2). Their results showedcalcium hydroxide eliminated inflammatorysorption but interfered with the healing of odontal ligament in this type of injury. Two ostudies (19, 20) reported that the ankylosis fouthe experimental cavities was of a transient nwhile in three (13, 14, 15) the ankylosis deveinto replacement resorption. Also, in one studyhard tissue formation was induced at some disfrom the apical fbramen which was attributthe effect of calcium hydroxide on the periodonIn the studies which reported transient ankthe effect of calcium hydroxide was attributits diffusion through the dentinal tubules denmechanically and consequently to higher pH iexperimental eavities (19). It has been reportedin these cases calcium hydroxide causes limiteerosis of short dura tion (19, 20). In the other s(1315) which reported replacement resorptioelTect of calcium hydroxide was attributed direct relation with periodontal tissue in the aregion known to cause coagulation necrosis (1well as to its diffusion through the dent ina l tudenuded mechanically during the extraction oteeth. The most plausible explanation for the dences in the results of the studies can be thethat a model with limited damage ofthe root suwas adopted by the investigations which reptransien t ankylosis while in the others the entiresurface was involved.


7/11

On the basis of this information, the experimen-

the effect of calcium hydroxide and gu tta-

r of periodontal ligament takes place at this point

In the second category (14 h in extra-alveolar

was not to compare the eflect of calcium

In the third category (1 and 2 h extra-alveolar

R o o t r t s o r p t i o n o r a n k y l o s i s m e d i c a t i o n i o m a t u r e higher in the calcium hydroxide group than thuntreated teeth. One could argue however thapercentage of root surface area which develankylosis in calcium hydroxide group would been covered by inflammatory resorption imedicament was not placed in the root canal.likely, therefore, that the calcium hydroxide arrthe inflammatory resorption which was expectdevelop due to the compromised viability of odontal ligament facilitating the ankylotic prto take place. However, another important rreported by this study was that the percentagrelative surface area of the teeth with normalodontal ligament was significantly higher intreated teeth than that in the calcium hydrgroup. In the latter group normal periodontalment was not found. Since the application ofcium hydroxide was performed 3 weeks afteplantation allowing the healing process to take and the teeth in both groups were treated the same conditions before replantation one wexpect to find no difference in the percentanormal periodontal ligament. The reported rtherefore, shows that calcitim hydroxide interwith the healing process of periodontal ligam

The second study (13) was conducted oentire root surface of extracted monkey teethtwo hours extra-alveolar dry interval and comthe effect of calcium hydroxide and guttapwith sealer on the periodontal ligament repaidifference was found in the percentage ofthe resurface area of the root which developed ankbetween calcium hydroxide and the guttapgroups. This finding implies that the deveankylosis was due to the lack of viability ofodontal ligament and not to the effect of thecanal medicaments. It should be pointed out ever that to the greatest extent the periodontalment is not expected to be viable after 2 h alveolar dry interval and, therefore, the effect root filling materials can not be studied by this

The last study (14) was conducted on the surface of extracted teeth with an hour extveolar dry interval and compared the effect ocium hydroxide and permanent root filling (chloroforin and guttapercha) on the periodligament repair. Statistically significant highecentage of relative surface area of the root developed ankylosis was found in the calciudroxide group than that in teeth with permroot filling. These findings imply that the deve


8/11

V a n d e r a sankylosis is unavo idable. However, if only the necro-tic periodontal ligament was responsible for theankylosis one would expect to fmd no differencebetween the groups since the teeth were treatedunder the same conditions before replantation.Finally, the experimental studies (13-15) werenot designed to investigate the frequency of anky-losis in extracted monkey teeth but the percentageof relative surface area ofthe root which developedankylosis. It has been rep orted that reversal of anky-losis can occur if the damage of the periodontalligament is less than 20% (10, 11). In the light ofthis knowledge the results of these studies (1315)are of great importance since calcium hydroxideincreases the damage of the relative surface area ofthe root to such an extent that reversibility of anky-losis is impossible. Ankylosis without resorption wasfound in 80% of the relative surface area of theteeth treated with calcium hydroxide while in teethwith permanent root filling the corresponding valuewas 8.7% (14). Within this framework, the resultsof the experimental studies show that calcium hy-droxide increases the risk of ankylosis in matureteeth with severe periodontal injury.

The results of the reviewed studies using Leder-mix paste as intracanal dressing showed that inmature teeth with severe periodontal injury the in-flammatory resorption w as eliminated (6). Ankylosisdominated the root surface of the teeth. Anotherimportant finding for this medicament was the di-rect inhibitory effect on dentinoclast function with-out damaging the cells of periodontal ligament (7).On the basis of this finding, it is logical to assumethat the ankylosis developed in teeth treated withLedermix paste after an hour extra-alveolar dryinterval was exclusively due to the existing injuryof periodontal ligament and not to the effect of thismedicament. Inflammatory resorption develops intwo to three weeks after injury (32). To preven t thiscomplication, an intervention is needed before itsdevelopment and without interfering with the peri-odontal ligament healing. Since Ledermix paste tar-gets precisely the resorbing cells without damagingneighbouring tissue, it is safe to assume that thismedicament used during the healing process of peri-odontal ligament to prevent or treat inflammatoryresorption can not increase the risk of developingankylosis.

Diffusion studies showed that the antibiotic com-ponent of Ledermix paste remains effectice againstbacteria in the tubulus for a few days, while forthe corticosteroid the dentin acts as a slow releasemechanism into the periodontal tissues releasing

be needed. Although this remains to be investigin an in vivo experimental study inflammatorsorption was eliminated five weeks after the acation of Ledermix paste without any additimedicament (6). Other in vitro studies showeda mixture of Ledermix paste with calcium hydide does not improve the properties of the comnent parts (2123). On the other hand, it is gested that in advanced inflammatory resorpwhere hard tissue repair is delayed, calcium hydide can be placed in the root canal after intreatment with Ledermix paste to promote tissue formation (35).Regarding the use of guttapercha, one clistudy conducted on luxated teeth showed thasuccess rate in treating inflammatory resorptionas high as that of calcium hydroxide (5). Howthree experimental studies (3, 13, 14) conducte

avulsed teeth reported significantly more ankyin teeth treated with guttapercha and a sealer eorally than in those with or without extirppulps. It seems that the reaction of the teeth severe periodontal injury to guttapercha fillinsimilar to that of calcium hydroxide. In other winjured teeth with healed periodontal ligament to guttapercha or calcium hydroxide like nojured teeth with necrotic pulp, while the applicaof these medicaments during the period of odontal ligament healing interferes with the rprocess. However, the percentage of relative suarea of the root which developed ankylosis wasnificantly higher in teeth treated with calciumdroxide than that in those treated with guttape(13, 14). This finding implies that the effect ofcium hydroxide on periodontal ligament repamore potent than that of guttapercha filling. Sguttapercha itself is a close to inert materiainterference in the period ontal ligament repa ir be attributed to the sealers used for root fillingWith respect to antibiotics, one experiment

vivo study reported reduction, but not eliminof inflamm atory resorption (4). Also, one studyreported transient ankylosis in teeth treated antibiotics while in another one (4) ankylosis root resorption and intact cementum was foHowever, no comparative studies have been ducted yet to show whether antibiotics as root cfilling material produces higher percentage of tive surface area with ankylosis than that ofother medicaments. Calcitonin paste was founalmost eliminate inflammatory resorption (9). Hever, its effect is directed only towards the inhibof the resorbing cells and not to the inhibitio


9/11

R o o t r e s e r p t i e n or a n i ( y i e s i s m e d i c a t i o n in m a t u r e

on the results of the reviewed studies it canconcluded that:Caicium hydroxide and Ledermix paste used asintracanal dressings eliminated inflammatory re-sorption. The other medicaments reduced signifi-cantly or almost eliminated this complication.

or replacement resorption was de-veloped in the root surfaces of extracted monkeyteeth with mature roots irrespective ofthe medic-ament nsed as root canal filling material. How-ever, the percentage of relative surface area oftheroot which developed ankylosis was significantlyhigher in mature teeth treated with calcium hy-droxide than that in those treated with permanentroot filling. Ledermix paste targets precisely theresorbing cells without damaging neighbouringtissue.

Recommendations for the use of intracanal

Based on the revised guidelines (29) followingand root fractures in mature teeth

d the results of the reviewed studies, the followingcan be made regarding the use of

the observation period of luxated matureteeth, excluding intrusive luxation, is suggestedto be approximately up to one year awaiting forhealing of transient apical resorptive processesand resorption (30, 31), periodontal hgamentrepair has already been completed at this pointof time. Calcium hydroxide can be used in theseteeth as intracanal dressing like in noninjuredteeth with necrotic pulp.

) In the cases of intrusive luxation and avulsion ofmature teeth pulp necrosis is inevitable (1, 2).Also, the risk of developing inflammatory re-sorption is high (1, 2, 27). Today, it is commonlyaccepted that endodontic treatment of matureteeth should be instituted 1 to 2 weeks afterreplantation. Since at this point of time peri-odontal ligament repair has not been completedyet (11, 32, 33), the use of a medicament whichdoes not damage neighbouring tissue such asLedermix paste is preferable.

- I would like to thank Drs G.and K. Manetas for their useful comments.

. ANDREASEN J O . T he efFect ofpulp extirpation or roottreatment upon periodontal healing after replantatipermanent incisors inmonkeys. J Endod 1981; 7; 245

. HAMMARSTROM L, BLOMLOF L, FEIGLIN B, ANDERSSHEDSTROM K - G , LiNDSKOG S. Replantation of teethantibiotic treatment. Endod Dent Traumatot 1986; 2: 5. CVEK M. Treatment of non-vital permanent incisorcalcium hydroxide. II. Effect onexternal root resorptluxated teeth compared with the effect of root fillinggut tapercha. Odontol Revy 1973; 24 : 343-54.. PIERCE A, LINDSKOG S. The effect of an antibiotic csteroid combination on inflammatory root resorption mOral Surg Oral Med Oral Patkol 1987; 64 : 216-20.

. PIERCE A, HEITHERSAY G, LINDSKOG S. Evidence for inhibition ofdentinoclasts by a corticosteroid/antibiotdodontic paste. Endod Dent Traumatol 1988; 4:44-5 .

. AMERICAN ASSOCIATION OF ENDODQNTICS. Recommguidelines for treatment ofthe avulsed tooth. J Endo9; 371.'. ANDREASENJO. Analysis of pathogenesis and topograreplace me nt of root resorption (ankylosis) after re planof mature permanent incisors inmonkeys. Swed Dent J4: 135-44.I. ANDREASENJO, KRISTERSON E . The effect of limited or removal ofthe periodontal l igament. Periodontai hafter replantation ofmature permanent incisors in moActa Odontot Scand 1 9 8 1 ; 39: 1-13.

. ANDREASEN JO. Periodontal healing after replantattraumatieally avulsed human teeth. Assessment bymtesting and radiograp hy. Ada Odontol Scand 1975-, 33 :. ANDREASEN JO. Periodontal healing after replantatioauto-transplantation of incisors in monkeys. In t J Or198i ; W: 5 4 -6 1 .I. A N D R E A S E N J O , K R I S T E R S O N E. The effect of extra-alroot filling with calcium hydroxide onperiodontal hafter replan tation of perm ane nt incisors inmonkeys. J

1981; 7: 349-54.-. EENQHEDEN A, BLOMLOF L, EINDSKOG S. Effect of immcalcium hydroxide treatment andpermanent root-fillperiodontal healing incontaminated replanted teeth. J Dent Res 1990; 99.- 139-46.) . EENGHEDEN A, BLOMLOF E, EINDSKOG S. Effect of dcalcium hydroxide treatment on periodontal healing itaminated replanted teeth. Scand J Dent Res 199!; 99.-> PIERCE A, BERG J-O, EINDSKOG S. Calcitonin as an ative therapy in the t reatment of root resorption. J

1988; 14 : 459-64.^ CVEK M. Treatment of non-vital permanent incisocalcium hydroxide. HEVariation of occurrence of anof replan ted teeth with duration of extra-alve olar periostorage environment. Odont Revy 1974b; 25 : 43-56.i. CVEK M. Prognosis of luxated non-vital maxillary treated with calcium hydroxide and filled with gutta-A retrospective clinical study. Endod Dent Traumatol45-55.). HAMMARSTROM EE, BLOMLOF EB, FEIGLIN B. EINPSKEffect of calcium hydroxide treatment on periodontaland root resorption. Endod Dent Traumatol 1986; 2: 1). BLOMLor EB, EINDSKOG S, HAMMARSTROM E. Influepulpal treatments on ceAl and tissue veactions in the m

per iodont ium. ] Periodontol 1988; 59 : 577-83.i. ABBOTT PV, H U M E WR, HEITHERSAY WR, HEITHERSAEffects of com bining E edermix and calcium hy droxide


10/11

" "' -^^'-'--^- -^--^^^-^v- - -"-p - . KIM SEOW W. Th e effects of dyadic c ombinations of endodon -tic medicaments on microbial growth inhibition. Ped Dent1990; 12 : 292-97.EiLJENFELD AM, LiLiENFELD DE. Foundations of epidemi-ology. 2nd ed. New York Oxford: Oxford University Press,I98O'; 246-50.I.Criteria for diagnosis of pulp necrosis in t r auma-tized permanent incisors. Scand J Dent Res 1980; SS : 306-12.LK. Traumatic injuriues. In Endodontics. Ingle Jland Iaintor JF . eds. 3rd ed. Eea and Febiger, Philadelphia,1985 pp. 708-69.Luxation injuries. In Traumatic injuries ofthe teeth. 2nd ed. Copenhagen: Munksgaard, 1981, pp.151-201. JO. External root resorption: its implication indental traumatology, paedodontics , periodontics , orthodon-tics and endodontics. In t Endod J 1985; IS: 109-18.FM. Puipal healing after luxation injuries androot fracture in the permanent dentition. Endod DentTraumatol 1989; 5: 111-31.

30. ANDREASEN FM. Transient apical breakdown and its reto color and sensibility changes. Endod Dent Traumato2: 9-19.

31. ANDREASEN FM . A histological and b acteriological invtion of pulps extirpated following luxation injuries.Dent Traumatol 1988; 4: 170-81.32. ANDREASENJO. A time related study of periodontal hand root resorption activity after replantation ofpermanent incisors in monkeys. Swed Dent J 1980; 4:33. ANDERSON AW, SHARAY Y, MASSLER M. Periodonattachment after tooth replantation. Periodotitiis !9161-7.34. ABBOT PV, HEITHERSAY GS, H U M E WR. Release anfusion through human tooth roots invitro of corticoand tetracycline trace molecules from Eedermix pasteDent Traumatol 1988; 4: 55-62.35. PIERCE A. Experimental basis for the management ofresorption. Endod Dent Traumatol 1989; 5: 255-65.


11/11

Effects of Intracanal Medicaments on Inflammatory Resorption or Occurrence of Ankylosis in Mature

Documents

Transcript of Effects of Intracanal Medicaments on Inflammatory Resorption or Occurrence of Ankylosis in Mature