Pulp revascularization of immature teeth with apical periodontitis: a clinical study

J Endod. 2009 May;35(5):745-9. doi: 10.1016/j.joen.2009.02.009.

Abstract

Introduction: The purpose of this study was to examine the effect of a pulpal revascularization procedure for immature necrotic teeth with apical periodontitis.

Methods: Twelve patients, each with an immature permanent tooth with chronic or acute apical periodontitis, were recruited. A triantibiotic mix (ciprofloxacin, metronidazole, and minocycline) was used to disinfect the pulp for 1 week. Then a blood clot was created in the canal, over which grey mineral trioxide aggregate was placed. Patients were recalled periodically.

Results: Six patients dropped from the study (as a result of pain or failure to induce bleeding after canal disinfection) and instead received a standard apexification procedure. Another 3 patients did not attend any recall appointments. The remaining teeth (n = 3) were found to exhibit complete root development, with a positive response to pulp testing.

Conclusions: Revascularization could be effective for managing immature permanent teeth with apical periodontitis with appropriate case selection.

Publication types

  • Case Reports

MeSH terms

  • Aluminum Compounds / therapeutic use
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Infective Agents / administration & dosage
  • Bicuspid / pathology
  • Blood Coagulation / physiology
  • Calcium Compounds / therapeutic use
  • Child
  • Ciprofloxacin / administration & dosage
  • Dental Pulp / blood supply*
  • Dental Pulp / physiopathology
  • Dental Pulp Cavity / blood supply
  • Dental Pulp Necrosis / therapy*
  • Drug Combinations
  • Female
  • Follow-Up Studies
  • Guided Tissue Regeneration / methods
  • Humans
  • Incisor / pathology
  • Male
  • Metronidazole / administration & dosage
  • Minocycline / administration & dosage
  • Neovascularization, Physiologic / physiology*
  • Odontogenesis / physiology
  • Oxides / therapeutic use
  • Periapical Periodontitis / therapy*
  • Root Canal Filling Materials / therapeutic use
  • Root Canal Preparation / methods
  • Root Canal Therapy / methods*
  • Silicates / therapeutic use
  • Tooth Apex / physiopathology*
  • Treatment Outcome

Substances

  • Aluminum Compounds
  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Calcium Compounds
  • Drug Combinations
  • Oxides
  • Root Canal Filling Materials
  • Silicates
  • mineral trioxide aggregate
  • Metronidazole
  • Ciprofloxacin
  • Minocycline