Outcome of Regenerative Endodontic Procedures in Permanent Immature Necrotic Teeth
Journal of Dental School,
Vol. 43 No. 1 (2025),
26 January 2025
,
Page 10-17
https://doi.org/10.22037/jds.v43i1.46750
Abstract
Objective(s): This study assessed the outcome of regenerative endodontic procedures (REPs) in permanent immature necrotic teeth. Methods: This longitudinal cross-sectional study was conducted on permanent immature necrotic teeth that had undergone REPs from 2013 to 2018. The patients were contacted by phone and asked to show-up for clinical and radiographic examinations of their treated teeth. The preoperative parallel periapical (PA), 6-18-month postoperative radiographs, and clinical examination results were collected and compared. Functional presence of the respective tooth in dental arch with no need for an endodontic treatment in the follow-up sessions was considered as treatment success. Data were analyzed by paired t-test (alpha=0.05). Results: Twelve patients (N=16 teeth) met the inclusion criteria; of which, 9 (N=12 teeth) showed up for the follow-up. The mean age of patients was 15±8.44 years (range 10 to 23 years). Ten teeth had experienced trauma, and the remaining two were necrotic due to anomalies (Turner’s hypoplasia and supernumerary tooth). Six teeth had undergone REPs with calcium-enriched mixture (CEM) cement, 4 with Biodentine, and 2 with mineral trioxide aggregate (MTA). Eleven out of 12 teeth were functional with no clinical sign/symptom at 6-12, and 18-month follow-ups, and were considered as treatment success. Closure of apical opening was significant (P=0.049). Conclusion: REPs through revascularization by using CEM cement, Biodentine, and MTA can be successful and increase the chance of completion of root development in permanent immature necrotic teeth.
- Patient Outcome Assessment
- Calcium-Enriched Mixture Cement
- Mineral Trioxide Aggregate
- Regeneration
- Regenerative Endodontics
How to Cite
References
Trope M. Treatment of the immature tooth with a non–vital pulp and apical periodontitis. Dental clinics. 2010;54(2):313-24. doi: 10.1016/j.cden.2009.12.006
Cvek M. Prognosis of luxated non-vital maxillary incisors treated with calcium hydroxide and filled with gutta-percha. A retrospective clinical study. Endod Dent Traumatol. 1992;8(2):45-55. doi: 10.1111/j.1600-9657.1992.tb00228.x
Jeeruphan T, Jantarat J, Yanpiset K, Suwannapan L, Khewsawai P, Hargreaves KM. Mahidol study 1: comparison of radiographic and survival outcomes of immature teeth treated with either regenerative endodontic or apexification methods: a retrospective study. J Endod. 2012;38(10):1330-6. doi: 10.1016/j.joen.2012.06.028
Murray PE. Review of guidance for the selection of regenerative endodontics, apexogenesis, apexification, pulpotomy, and other endodontic treatments for immature permanent teeth. Int Endod J. 2023:56 Suppl 2:188-99. doi: 10.1111/iej.13809
Jadhav K, Vaidya MJ, Hegde V, Kawle S. Management of non-vital immature teeth-A review. J Dent Med Sci. 2021; 20:35-40. doi.org/10.9790/0853-2007093540
Sheehy E, Roberts G. Use of calcium hydroxide for apical barrier formation and healing in non-vital immature permanent teeth: a
review. Br Dent J. 1997;183(7):241-6. doi: 10.1038/sj.bdj.4809477
Al‐Hiyasat AS, El‐Farraj HS, Alebrahim MA. The effect of calcium hydroxide on dentine composition and root fracture resistance of human teeth: An in vitro study. Eur J Oral Sci. 2021;129(4):e12798. doi: 10.1111/eos.12798
Gupta S, Sodhi SP, Brar GK, Bansal RN. Endodontic treatment of immature tooth-a challenge. J Pre Clin Clin Res. 2020;14(3):73-9. doi.org/10.26444/jpccr/126280
Kandemir Demirci G, Kaval ME, Güneri P, Çalışkan MK. Treatment of immature teeth with nonvital pulps in adults: a prospective comparative clinical study comparing MTA with Ca (OH) 2. Int Endod J. 2020;53(1):5-18. doi: 10.1111/iej.13201
Murray PE, Garcia-Godoy F, Hargreaves KM. Regenerative endodontics: a review of current status and a call for action. J Endod. 2007;33(4):377-90. doi: 10.1016/j.joen.2006.09.013
Lovelace TW, Henry MA, Hargreaves KM, Diogenes A. Evaluation of the delivery of mesenchymal stem cells into the root canal space of necrotic immature teeth after clinical regenerative endodontic procedure. J Endod. 2011;37(2):133-8. doi:10.1016/j.joen.2010.10.009
Youssef A, Ali M, ElBolok A, Hassan R. Regenerative endodontic procedures for the treatment of necrotic mature teeth: A preliminary randomized clinical trial. Int Endod J. 2022;55(4):334-46. doi: 10.1111/iej.13681
Li J, Zheng L, Daraqel B, Liu J, Hu Y. Treatment outcome of regenerative endodontic procedures for necrotic immature and mature permanent teeth: a systematic review and Meta-analysis based on randomised controlled trials. Oral Health Prev Dent. 2023:21:141-52. doi: 10.3290/j.ohpd.b4100877
Rossman LE. American Association of Endodontists. J Am Coll Dent. 2009;76(1):4-8.
Alobaid AS, Cortes LM, Lo J, Nguyen TT, Albert J, Abu-Melha AS, et al. Radiographic and clinical outcomes of the treatment of immature permanent teeth by revascularization or apexification: a pilot retrospective cohort study. J Endod. 2014;40(8):1063-70. doi: 10.1016/j.joen.2014.02.016.
Jiang X, Liu H, Peng C. Collagen membrane in regenerative endodontics: a randomized, controlled clinical trial. J Endod. 2017;43(9):1465-1471. doi: 10.1016/j.joen.2017.04.011.
Bose R, Nummikoski P, Hargreaves K. A retrospective evaluation of radiographic outcomes in immature teeth with necrotic root canal systems treated with regenerative endodontic procedures. J Endod. 2009;35(10):1343-9. doi: 10.1016/j.joen.2009.06.021
Petrino JA, Boda KK, Shambarger S, Bowles WR, McClanahan SB. Challenges in regenerative endodontics: a case series. J Endod. 2010;36(3):536-41. doi: 10.1016/j.joen.2009.10.006
Simon S, Rilliard F, Berdal A, Machtou P. The use of mineral trioxide aggregate in one-visit apexification treatment: a prospective study. International endodontic. Int Endod J. 2007;40(3):186-97. doi: 10.1111/j.1365-2591.2007.01214.x
Lin J, Zeng Q, Wei X, Zhao W, Cui M, Gu J, et al. Regenerative endodontics versus apexification in immature permanent teeth with apical periodontitis: a prospective randomized controlled study. J Endod. 2017;43(11):1821-7. doi: 10.1016/j.joen.2017.06.023
Kontakiotis EG, Filippatos CG, Agrafioti A. Levels of evidence for the outcome of regenerative endodontic therapy. 2014;40(8):1045-53. doi: 10.1016/j.joen.2014.03.013
Torabinejad M, Nosrat A, Verma P, Udochukwu O. Regenerative endodontic treatment or mineral trioxide aggregate apical plug in teeth with necrotic pulps and open apices: a systematic review and meta-analysis. J Endod. 2017 Nov;43(11):1806-1820. doi: 10.1016/j.joen.2017.06.029
Asgary S, Fazlyab M, Nosrat A. Regenerative endodontic treatment versus apical plug in immature teeth: three-year follow-up. J Clin Pediatr Dent. 2016;40(5):356-60. doi: 10.17796/1053-4628-40.5.356.
Madani Z, Alvandifar S, Bizhani A. Evaluation of tooth discoloration after treatment with mineral trioxide aggregate, calcium-enriched mixture, and Biodentine® in the presence and absence of blood. Dent Res J (Isfahan). 2019 Nov 12;16(6):377-383.
- Abstract Viewed: 162 times
- PDF Downloaded: 231 times