Regenerative endodontic therapy in mature teeth with necrotic pulp and apical periodontitis using two disinfection protocols

Abstract

Abstract Objective This study compared the effect of diode laser (DL) 980 nm and double antibiotic paste (DAP) on response of mature teeth with necrotic pulp and apical periodontitis to regenerative endodontic therapy in a dog model. Methods Pulp necrosis and periapical pathosis were induced in 40 mature double rooted premolars in four 2-year-old mongrel dogs. These teeth were randomly divided according to disinfection protocol into four equal groups (10 teeth each/20 roots), group I: DAP; group II: DL980 nm; group III: positive control (without treatment) and group IV: negative control (untouched teeth). These groups were further subdivided into 2 subgroups (5 teeth each/10 roots) according to evaluation period, subgroup (A): one month and subgroup (B): three months. Revascularization techniques were performed using bleeding induction and application of platelet rich fibrin (PRF). The coronal cavities were sealed with mineral trioxide aggregate (MTA) and glass ionomer cement. The inflammatory response, vital tissue in-growth, new hard tissue formation and bone resorption were assessed. Statistical analysis was done utilizing ANOVA, Tukey’s post hoc and paired t tests. Results In both subgroups, there were no significant differences between DAP and DL980 in terms of inflammatory cell count, vital tissue in-growth, new hard tissue formation and bone resorption (P ≤ 0.05). Conclusion Diode laser 980 nm can alternate DAP as a disinfection method of the root canal during RET for mature necrotic teeth, therefore it may accelerate regenerative endodontic therapy for both the patient and dentist and allows for RET in a single appointment.

Keywords

• Diode laser
• Double antibiotic paste
• Periapical pathosis
• Regenerative endodontic
• Revascularization.