Restor Dent Endod.  2013 Aug;38(3):178-181.

Apexogenesis and revascularization treatment procedures for two traumatized immature permanent maxillary incisors: a case report

Affiliations
  • 1Dental Research Center and Department of Endodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
  • 2Dental Materials Research Center and Department of Pediatric Dentistry, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran. parisayi@mums.ac.ir
  • 3Department of Endodontics, Gorgan University of Medical Sciences School of Dentistry, Gorgan, Iran.

Abstract

Traumatic injuries to an immature permanent tooth may result in cessation of dentin deposition and root maturation. Endodontic treatment is often complicated in premature tooth with an uncertain prognosis. This article describes successful treatment of two traumatized maxillary central incisors with complicated crown fracture three months after trauma. The radiographic examination showed immature roots in maxillary central incisors of a 9-year-old boy with a radiolucent lesion adjacent to the right central incisor. Apexogenesis was performed for the left central incisor and revascularization treatment was considered for the right one. In 18-month clinical and radiographic follow-up both teeth were asymptomatic, roots continued to develop, and periapical radiolucency of the right central incisor healed. Considering the root development of these contralateral teeth it can be concluded that revascularization is an appropriate treatment method in immature necrotic teeth.

Keyword

Apexogenesis; Open apex; Pulpotomy; Pulp revascularization; Trauma

MeSH Terms

Apexification
Crowns
Dentin
Follow-Up Studies
Incisor
Prognosis
Pulpotomy
Tooth

Figure

  • Figure 1 Preoperative (a) and immediately postoperative (b) radiographs of maxillary central incisors. Incomplete apex formation of teeth and periapical radiolucency in right central incisor was revealed.

  • Figure 2 12-month follow-up radiography.

  • Figure 3 At 18-month postoperative radiography, continued root maturation of both teeth and resolution of the periapical radiolucency in right central incisor was evident.


Reference

1. Andreasen JO, Ravn JJ. Epidemiology of traumatic dental injuries to primary and permanent teeth in a Danish population sample. Int J Oral Surg. 1972; 1:235–239. PMID: 4146883.
Article
2. Bastone EB, Freer TJ, McNamara JR. Epidemiology of dental trauma: a review of the literature. Aust Dent J. 2000; 45:2–9. PMID: 10846265.
Article
3. Canakci V, Akgül HM, Akgül N, Canakci CF. Prevalence and handedness correlates of traumatic injuries to the permanent incisors in 13-17-year-old adolescents in Erzurum, Turkey. Dent Traumatol. 2003; 19:248–254. PMID: 14708648.
Article
4. Tapias MA, Jiménez-García R, Lamas F, Gil AA. Prevalence of traumatic crown fractures to permanent incisors in a childhood population: Móstoles, Spain. Dent Traumatol. 2003; 19:119–122. PMID: 12752531.
Article
5. Witherspoon DE. Vital pulp therapy with new materials: new directions and treatment perspectives-permanent teeth. J Endod. 2008; 34:S25–S28. PMID: 18565368.
Article
6. Rafter M. Apexification: a review. Dent Traumatol. 2005; 21:1–8. PMID: 15660748.
Article
7. Katebzadeh N, Dalton BC, Trope M. Strengthening immature teeth during and after apexification. J Endod. 1998; 24:256–259. PMID: 9641130.
Article
8. Waterhouse PJ, Whitworth JM, Camp JH, Fuks AB. Chapter 23, Pediatric endodontics: endodontic treatment for the primary and young permanent dentition. In : Hargreaves KM, Cohen S, editors. Cohen's Pathways of the pulp. 10th ed. St Louis: Mosby Elsevier;2011. p. 808–857.
9. Yamauchi N, Yamauchi S, Nagaoka H, Duggan D, Zhong S, Lee SM, Teixeira FB, Yamauchi M. Tissue engineering strategies for immature teeth with apical periodontitis. J Endod. 2011; 37:390–397. PMID: 21329828.
Article
10. Hoshino E, Kurihara-Ando N, Sato I, Uematsu H, Sato M, Kota K, Iwaku M. In-vitro antibacterial susceptibility of bacteria taken from infected root dentine to a mixture of ciprofloxacin, metronidazole and minocycline. Int Endod J. 1996; 29:125–130. PMID: 9206436.
11. Tronstad L, Mjör IA. Capping of the inflamed pulp. Oral Surg Oral Med Oral Pathol. 1972; 34:477–485. PMID: 4625987.
Article
12. Swift EJ Jr, Trope M. Treatment options for the exposed vital pulp. Pract Periodontics Aesthet Dent. 1999; 11:735–739. PMID: 10635232.
13. Trope M. Chapter 36, Endodontic considerations in dental trauma. In : Ingle JI, Bakland LK, Baumgartner JC, editors. Ingle's Endodontics. 6th ed. Hamilton: BC Decker Inc;2008. p. 1330–1357.
14. Witherspoon DE, Small JC, Harris GZ. Mineral trioxide aggregate pulpotomies: a case series outcomes assessment. J Am Dent Assoc. 2006; 137:610–618. PMID: 16739540.
15. Barrieshi-Nusair KM, Qudeimat MA. A prospective clinical study of mineral trioxide aggregate for partial pulpotomy in cariously exposed permanent teeth. J Endod. 2006; 32:731–735. PMID: 16861071.
Article
16. Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol. 1965; 20:340–349. PMID: 14342926.
Article
17. Andreasen JO, Farik B, Munksgaard EC. Long-term calcium hydroxide as a root canal dressing may increase risk of root fracture. Dent Traumatol. 2002; 18:134–137. PMID: 12110105.
Article
18. Holden DT, Schwartz SA, Kirkpatrick TC, Schindler WG. Clinical outcomes of artificial root-end barriers with mineral trioxide aggregate in teeth with immature apices. J Endod. 2008; 34:812–817. PMID: 18570985.
Article
19. 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; 8:45–55. PMID: 1521505.
Article
20. Ding RY, Cheung GS, Chen J, Yin XZ, Wang QQ, Zhang CF. Pulp revascularization of immature teeth with apical periodontitis: a clinical study. J Endod. 2009; 35:745–749. PMID: 19410097.
Article
21. Thibodeau B, Teixeira F, Yamauchi M, Caplan DJ, Trope M. Pulp revascularization of immature dog teeth with apical periodontitis. J Endod. 2007; 33:680–689. PMID: 17509406.
Article
22. Hargreaves KM, Geisler T, Henry M, Wang Y. Regeneration potential of the young permanent tooth: what does the future hold? J Endod. 2008; 34:S51–S56. PMID: 18565373.
Article
23. Petrino JA, Boda KK, Shambarger S, Bowles WR, McClanahan SB. Challenges in regenerative endodontics: a case series. J Endod. 2010; 36:536–541. PMID: 20171379.
Article
24. Windley W 3rd, Teixeira F, Levin L, Sigurdsson A, Trope M. Disinfection of immature teeth with a triple antibiotic paste. J Endod. 2005; 31:439–443. PMID: 15917683.
25. Banchs F, Trope M. Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod. 2004; 30:196–200. PMID: 15085044.
Article
26. Thibodeau B, Trope M. Pulp revascularization of a necrotic infected immature permanent tooth: case report and review of the literature. Pediatr Dent. 2007; 29:47–50. PMID: 18041512.
27. da Silva LA, Nelson-Filho P, da Silva RA, Flores DS, Heilborn C, Johnson JD, Cohenca N. Revascularization and periapical repair after endodontic treatment using apical negative pressure irrigation versus conventional irrigation plus triantibiotic intracanal dressing in dogs' teeth with apical periodontitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 109:779–787. PMID: 20416538.
Article
28. 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. PMID: 20003936.
Article
Full Text Links
  • RDE
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr