Efficacy of Diode Laser in Maturogenesis of Immature Teeth With Necrotic Pulps
Condition: Effects of the Elements
MeSH terms: Dental Pulp Necrosis; Necrosis
Study type: Interventional

Summary: 
      Recruited patients with immature permanent maxillary anterior teeth with non-vital pulp, and
      periapical radiolucency, age ranging from 8 to16 years old were randomly allocated into three
      groups (n=13): Group I, disinfected using the triple antibiotic paste, Group II, disinfection
      was done using diode laser, and Group III, were disinfected using the triple antibiotic
      paste, diode laser was used for biostimulation. All groups were evaluated for the increase in
      root length and thickness and decrease in apical diameter at baseline, 3, 6, 9, and 12 months
      after treatment
    

Detailed description: 
      -  The investigator recruited patients who are found eligible to the criteria then randomly
           allocated into three groups (n=13)

        -  Group I: thirteen teeth were disinfected by triple antibiotic paste then
           revascularization was done using the blood clot method.

        -  Group II: thirteen teeth were Laser disinfected; revascularization was done using the
           the blood clot method.

        -  Group III: thirteen teeth were disinfected by triple antibiotic paste then
           revascularization was done using the the blood clot method followed by diode laser
           bio-stimulation.

        -  periapical x rays was taken at baseline, 3, 6, 9, and 12 months after treatment for the
           increase in root length and thickness, decrease in apical diameter evaluation
    

Intervention name(s): Diode laser disinfection; Diode Laser bio-stimulation.; Triple antibiotic paste disinfection; revascularization using the standard method "Blood Clot"
Intervention type(s): Device; Device; Drug; Procedure
Intervention description(s): - Disinfection with parameter of Power: 1.5 watt, Mode: pulse: SP: Ton=10ms; Toff10ms 50Hz (50% pulse mode), for 5 seconds in spiral movement in apical to coronal direction no stop with non-initiated endodontic tip 200 micron diameter and 15 mm length three times. Irrigation with NaOCl, irradiation with the laser, then irrigation with E.D.T.A and irradiation with the laser, for three times then final rinse with distilled water with paper point dryness in between irrigations.; - The diode laser bio-stimulation with Wiser Diode Laser, Irradiation of the periapical area from the labial mucosal surface, day after day "day on-day off" for one week, two sessions will be applied at the same day with two hours interval, first session immediately after filing (blood induction), with flat top hand piece , diameter 1cm at a distance between 0 and 105 cm, at 1 watt power for 50s with CW "continues mode" in order to obtain the 5 J/cm2 fluence.; -The root canals will be copiously and slowly irrigated with 20 ml of 1.5% (17) sodium hypochlorite (NaOCl) solution for 5 minutes alternatively with 20 ml of 17% ethylene diamine tetra acetic acid (E.D.T.A) solution for 5 minutes with intermediated rinse of distilled water with paper point dryness in between irrigations. The triple antibiotic paste will be prepared using metronidazole , ciprofloxacin and doxycycline . The doxycycline capsule content will be evacuated in a sterile mortar; a tablet of metronidazole and a tablet of ciprofloxacin will be crushed and ground into homogenous powder in the same mortar using a pestle. Saline drops will be added and mixed using the pestle until a creamy paste achieved . The canals Will be dried with paper points and medicated with triple antibiotic paste; the access cavity will be sealed with intermediate restorative material (I.R.M) .; - The root canal Will be over-instrumented using finger plugger size #25 to encourage bleeding up to cemento-enamel junction. The sterile finger plugger size # 25 will be used with sharp strokes into the periapical tissue beyond the apex until bleeding becomes evident at the cervical portion of the canal. Blood column will be left 10 minutes to clot covered by sterile cotton, a collagen orifice plug "Collagen plugs" will be used as matrix against mineral trioxide aggregate (M.T.A) condensation, M.T.A will be mixed according to the manufacturer's instructions and carried to the cavity with M.T.A carrier (Dovgan M.T.A Carrier) , and then compacted using wet cotton roll on pluggers (S- Kondenser) . Finally the cavity will be restored with a glass ionomer base and light cure composite resin .
Other intervention name(s): Blood Clot revascularization method
Intervention MeSH terms: Anti-Bacterial Agents
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Diode Laser, Revascularization, Immature Necrotic Teeth.