Restor Dent Endod.  2022 May;47(2):e24. 10.5395/rde.2022.47.e24.

Clinical and radiographic outcomes of regenerative endodontic treatment performed by endodontic postgraduate students: a retrospective study

• Alfahadi HR
• Al-Nazhan S
• Alkazman FH
• Al-Maflehi N
• Al-Nazhan N

• KMID: 2548128
• DOI: http://doi.org/10.5395/rde.2022.47.e24

Abstract

Objectives
Regenerative endodontic treatment is a clinical procedure aimed at biologically regenerating damaged root canal tissue of immature permanent teeth. This study aimed to report the outcomes of regenerative endodontic treatment performed by endodontic postgraduate students.
Materials and Methods
Clinical and radiographic data of 27 patients, aged 10–22 years, who underwent regenerative treatment of immature permanent teeth from 2015 to 2019 were followed up, wherein clinical and radiographic examinations were performed for each patient. Postoperative success rate and tooth survival were analyzed, and the postoperative radiographic root area changes were quantified.
Results
A total of 23 patients attended the dental appointments, showing that all teeth survived and were asymptomatic. Specifically, 7 periapical pathosis cases were completely healed, 12 were incompletely healed, and 4 cases failed. Moreover, significant differences were found between discolored and non-discolored teeth, and between the presence or absence of periapical radiolucency. Additionally, 3 anterior teeth showed complete closure of the apical foramen, while the apical foramen width was reduced in 17 teeth and failed in 3 teeth. Root length was also found to have been increased in 7 anterior and 4 posterior teeth, and the average length ranged from 4.00–0.63 mm in the anterior teeth, 2.85–1.48 mm of the mesial root, and 2.73–2.16 mm of the molar teeth distal root. Furthermore, calcified tissue deposition was observed in 7 teeth.
Conclusions
A favorable outcome of regenerative endodontic treatment of immature permanent teeth with necrotic pulp was achieved with a high survival rate.

Keyword

Immature teeth; Necrotic pulp; Open apex; Regenerative endodontic; Treatment outcome

Figure

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  Figure 1 Maxillary left central incisor with open apex and apical radiolucency due to trauma (A-C). Calcium hydroxide was used as an intracanal medicament and the access was filled with mineral trioxide aggregate. 31-month postoperative radiographic follow-up shows complete apical closure, an increase in the tooth length, and healed (complete) apical radiolucency (D-F).

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  Figure 2 Mandibular left the second molar of 13-years old female patient with the open apex of both mesial and distal root and apical radiolucency due to caries. Calcium hydroxide was used as an intracanal medicament and the access and part of the canals were filled with mineral trioxide aggregate (A-C). 9 months post-operative radiograph shows complete apical closure of the distal root and reduction of the apical foramen width of the mesial root regardless of the increased apical radiolucency (D-F).

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  Figure 3 Maxillary left central incisor of 11-years old male patient with open apex and no apical radiolucency due to trauma. Calcium hydroxide was used as an intracanal medicament and the access and part of the canals were filled with mineral trioxide aggregate (A). The 6-months (B) and 12-months (C, D) post-operative radiograph shows the development of periapical radiolucency and the apical foramen failed to close.

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  Figure 4 Root developmental patterns in response to regenerative endodontic therapy of immature permanent teeth with infected necrotic pulp described by Chen et al. [8] observed in the current study. Type 1 (A, B); Type 2 (C, D); Type 3 (E, F); Type 4 (G, H); and Type 5 (I, J).

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