Regenerative treatment of an immature, traumatized tooth with apical periodontitis: report of a case
Abstract
This case report describes the treatment of a necrotic immature permanent central incisor with complete crown fracture, suspected root fracture, and sinus tract, which was not treated with conventional apexification techniques. Instead, a regenerative approach based on the trauma literature's methods for revascularization was provided. The root canal was gently debrided of necrotic tissue with a sharp spoon excavator and irrigated for only one third of its length with NaOCl and then medicated with calcium hydroxide. After 15 days the sinus tract had healed, and the tooth was asymptomatic. The tooth was accessed, calcium hydroxide was removed, bleeding was stimulated to form an intracanal blood clot, and mineral trioxide aggregate was placed coronally to the blood clot. After 8 months, a coronal calcified barrier was radiographically evident and accompanied with progressive thickening of the root wall and apical closure. Two and a half years after treatment was initiated, the tooth remained asymptomatic, and the sinus tract had not reappeared. The progressive increase in the thickness of the dentinal walls and subsequent apical development suggest that appropriate biologic responses can occur with this type of treatment of the n...Continue Reading
Associated Clinical Trials
References
Immature teeth with periradicular periodontitis or abscess undergoing apexogenesis: a paradigm shift
Citations
Characterization of a stem cell of apical papilla cell line: effect of passage on cellular phenotype
Pulp regeneration after non-infected and infected necrosis, what type of tissue do we want? A review
Recommendations for using regenerative endodontic procedures in permanent immature traumatized teeth
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