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Table of Contents   
LETTER TO EDITOR  
Year : 2013  |  Volume : 16  |  Issue : 3  |  Page : 277
Comment on: SealBio: A novel, non-obturation endodontic treatment based on concept of regeneration


Department of Conservative Dentistry, Pvt Practice, Dental clinic, 2nd St. Maglagiri Road, Guntur, Andhra Pradesh, India

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Date of Submission03-Dec-2012
Date of Decision04-Jan-2013
Date of Acceptance15-Mar-2013
Date of Web Publication4-May-2013
 

How to cite this article:
Kumar R. Comment on: SealBio: A novel, non-obturation endodontic treatment based on concept of regeneration . J Conserv Dent 2013;16:277

How to cite this URL:
Kumar R. Comment on: SealBio: A novel, non-obturation endodontic treatment based on concept of regeneration . J Conserv Dent [serial online] 2013 [cited 2020 May 27];16:277. Available from: http://www.jcd.org.in/text.asp?2013/16/3/277/111334
Sir,

We read with great interest the article by Shah and Logani [1] regarding the formation of a biological seal after revascularization procedures. Unfortunately, the formation of so-called "biological seal" has not been demonstrated in the entire manuscript. There is no evidence of formation of seal in any of the presented case reports. The results shown in the case reports are not surprising. Any acute case with apical abscess or large periapical radiolucency will respond to cleaning/disinfection of the root canal system. Yet, the procedure described in the manuscript does not imply that a complete disinfection was even aimed at. The discussion clearly states that "apical canal widening to 300-500 μm is required to thoroughly cleanse the apical portion of the canal." But the next line states that "apical foramen widening was done with gradually increasing number of files till no #25 or #30." An apical widening up to size 25 or 30 (250-300 μm) may not be sufficient for thorough cleansing of the canal (as compared with 300-500 μm).

[Figure 1] Shows the clinical and radiographic image of a 53-year-old man treated with revascularization procedures. On closer inspection of the radiographs, one can easily figure out that the position of third molar is dubious. The 6-month follow-up radiograph shows a coronal movement of third molar as compared with the initial radiograph (surprising in a 53-year-old patient), but the 3-year follow-up shows a remarkable down movement of the third molar!

In the entire article, we were unable to find any kind of "seal." It is very well documented that there is formation of connective tissue or periodontal tissue into the pulp space when a blood clot scaffold is available. [2],[3] This new tissue growth only lays down cellular and acellular cementum. The apical part of the root may become a little stronger because of cementum buildup, but the coronal half will be as weak as before. The ethics of not obturating the canal and whole point of a "sealbio" crashes in the last line of the discussion when the authors state that "further well-planned experimental animal studies can provide information on the type of cells involved and the tissue deposited." The authors are still not sure of what type of tissue has been deposited in the "sealbio" and recommend an animal study to verify the results of the study that has already been done in human beings. Should not the treatment modality be first checked in animals and, if found successful, only then done in human patients? Although in an experimental study on dogs it has been found that after the revascularization protocol, the final product in the root canal space has little similarity with the pulp tissue and looks like a mixture of cementum and periodontal ligament.

 
   References Top

1.Shah N, Logani A. SealBio: A novel, non-obturation endodontic treatment based on concept of regeneration. J Conserv Dent 2012;15:328-32.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.OSTBY BN. The role of the blood clot in endodontic therapy. An experimental histologic study. Acta Odontol Scand 1961;19:323-53.  Back to cited text no. 2
    
3.Wang X, Thibodeau B, Trope M, Lin LM, Huang GT. Histologic characterization of regenerated tissues in canal space after the revitalization/revascularization procedure of immature dog teeth with apical periodontitis. J Endod 2010;36:56-63.  Back to cited text no. 3
    

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Correspondence Address:
Ram Kumar
Department of Conservative Dentistry, Pvt Practice, Dental clinic, 2nd St. Maglagiri Road, Guntur - 522 001, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-0707.111334

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