Histologic observation of a human immature permanent tooth with irreversible pulpitis after revascularization/regeneration procedure

Emi Shimizu, George Jong, Nicola Partridge, Paul Rosenberg, Louis Lin

Research output: Contribution to journalArticle

Abstract

Introduction: Histological studies of immature human permanent necrotic teeth with or without apical periodontitis after revascularization have not been reported. This case report describes the histological findings of tissue formed in the canal space of an immature permanent tooth #9 with irreversible pulpitis without apical periodontitis after revascularization. Methods: An immature human permanent tooth #9 was fractured 3.5 weeks after revascularization and could not be retained. The tooth was extracted and prepared for routine histological and immunohistochemical evaluation in order to examine the nature of tissue formed in the root canal following the revascularization procedure. Results: At 3.5 weeks after revascularization, more than one half of the canal was filled with loose connective tissue similar to the pulp tissue. A layer of flattened odontoblast-like cells lined along the predentin. Layers of epithelial-like cells, similar to the Hertwig's epithelial root sheath, surrounded the root apex. No hard tissue was formed in the canal. Conclusions: Based on the histological findings in the present case, regeneration of pulp-like tissue is possible after revascularization. In this case, both the apical papilla and the Hertwig's epithelial root sheath survived in an immature permanent tooth despite irreversible pulpitis but without apical periodontitis.

Original languageEnglish (US)
Pages (from-to)1293-1297
Number of pages5
JournalJournal of Endodontics
Volume38
Issue number9
DOIs
StatePublished - Sep 2012

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Pulpitis
Periapical Periodontitis
Regeneration
Tooth
Observation
Odontoblasts
Dental Pulp Cavity
Connective Tissue
Epithelial Cells

Keywords

  • Immature permanent tooth
  • irreversible pulpitis
  • pulp-like tissue regeneration
  • revascularization

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

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title = "Histologic observation of a human immature permanent tooth with irreversible pulpitis after revascularization/regeneration procedure",
abstract = "Introduction: Histological studies of immature human permanent necrotic teeth with or without apical periodontitis after revascularization have not been reported. This case report describes the histological findings of tissue formed in the canal space of an immature permanent tooth #9 with irreversible pulpitis without apical periodontitis after revascularization. Methods: An immature human permanent tooth #9 was fractured 3.5 weeks after revascularization and could not be retained. The tooth was extracted and prepared for routine histological and immunohistochemical evaluation in order to examine the nature of tissue formed in the root canal following the revascularization procedure. Results: At 3.5 weeks after revascularization, more than one half of the canal was filled with loose connective tissue similar to the pulp tissue. A layer of flattened odontoblast-like cells lined along the predentin. Layers of epithelial-like cells, similar to the Hertwig's epithelial root sheath, surrounded the root apex. No hard tissue was formed in the canal. Conclusions: Based on the histological findings in the present case, regeneration of pulp-like tissue is possible after revascularization. In this case, both the apical papilla and the Hertwig's epithelial root sheath survived in an immature permanent tooth despite irreversible pulpitis but without apical periodontitis.",
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AU - Jong, George

AU - Partridge, Nicola

AU - Rosenberg, Paul

AU - Lin, Louis

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N2 - Introduction: Histological studies of immature human permanent necrotic teeth with or without apical periodontitis after revascularization have not been reported. This case report describes the histological findings of tissue formed in the canal space of an immature permanent tooth #9 with irreversible pulpitis without apical periodontitis after revascularization. Methods: An immature human permanent tooth #9 was fractured 3.5 weeks after revascularization and could not be retained. The tooth was extracted and prepared for routine histological and immunohistochemical evaluation in order to examine the nature of tissue formed in the root canal following the revascularization procedure. Results: At 3.5 weeks after revascularization, more than one half of the canal was filled with loose connective tissue similar to the pulp tissue. A layer of flattened odontoblast-like cells lined along the predentin. Layers of epithelial-like cells, similar to the Hertwig's epithelial root sheath, surrounded the root apex. No hard tissue was formed in the canal. Conclusions: Based on the histological findings in the present case, regeneration of pulp-like tissue is possible after revascularization. In this case, both the apical papilla and the Hertwig's epithelial root sheath survived in an immature permanent tooth despite irreversible pulpitis but without apical periodontitis.

AB - Introduction: Histological studies of immature human permanent necrotic teeth with or without apical periodontitis after revascularization have not been reported. This case report describes the histological findings of tissue formed in the canal space of an immature permanent tooth #9 with irreversible pulpitis without apical periodontitis after revascularization. Methods: An immature human permanent tooth #9 was fractured 3.5 weeks after revascularization and could not be retained. The tooth was extracted and prepared for routine histological and immunohistochemical evaluation in order to examine the nature of tissue formed in the root canal following the revascularization procedure. Results: At 3.5 weeks after revascularization, more than one half of the canal was filled with loose connective tissue similar to the pulp tissue. A layer of flattened odontoblast-like cells lined along the predentin. Layers of epithelial-like cells, similar to the Hertwig's epithelial root sheath, surrounded the root apex. No hard tissue was formed in the canal. Conclusions: Based on the histological findings in the present case, regeneration of pulp-like tissue is possible after revascularization. In this case, both the apical papilla and the Hertwig's epithelial root sheath survived in an immature permanent tooth despite irreversible pulpitis but without apical periodontitis.

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