Elsevier

Journal of Endodontics

Volume 43, Issue 2, February 2017, Pages 246-251
Journal of Endodontics

Regenerative Endodontics
Clinical and Radiographic Outcomes in Immature Permanent Necrotic Evaginated Teeth Treated with Regenerative Endodontic Procedures

https://doi.org/10.1016/j.joen.2016.10.015Get rights and content

Abstract

Introduction

Regenerative endodontics is a promising alternative treatment for immature permanent teeth with necrotic dental pulp. The present study assessed the time to resolution of clinical symptoms and radiographic changes in root dimensions in immature permanent necrotic teeth with dens evaginatus.

Methods

In this prospective study, clinical and radiographic data were collected for 20 teeth with dens evaginatus treated with a revascularization protocol for 1 year. Tooth survival and success rate were analyzed, and radiographic changes in the radiographic root area, apical diameter, and root length were quantified.

Results

All 20 treated teeth (100%) survived and met the clinical criteria for success throughout the study period. The within-case percent change in radiographic root area was 28.14% at 3 months and had increased to 97.58% at 12 months. The within-case percent change in apical diameter after 3 months was 21.40% and had increased to 72.90% by 12 months, with 40% (8 of 20) showing complete apical closure at 12 months. The within-case percent change in root length was 2.65% at 3 months and had increased to 23.37% at 12 months.

Conclusions

In this study, revascularization allowed the continued development of roots in teeth with necrotic pulp as well as excellent overall survival and success rates.

Section snippets

Subjects

Twenty patients (aged 8–12 years) were referred to the pediatric dentistry clinic for treatment of non-vital immature premolars with dens evaginatus. The teeth included 8 mandibular first premolars and 12 mandibular second premolars. Patient-informed consent and approval of the institutional review board had been obtained (WYKQ2014005). The initial diagnosis of these teeth was pulp necrosis with or without apical periodontitis. A detailed medical and dental history was collected from each

Baseline Characteristics of the Study Population

The demographics and baseline clinical characteristics of the patients are summarized in Table 1. All treated teeth were premolars with dens evaginatus and with necrotic dental pulp preoperatively and showed radiographic periapical pathology and/or periapical symptomatology. All cases had periapical lesion symptoms, and 55% had radiographic periapical pathology present (Table 1).

Clinical Outcomes

All 20 revascularization cases were followed for 12 months, with review once every 3 months. All 20 teeth survived

Discussion

Dens evaginatus is usually found in mandibular premolars. The condition is more common in patients of Chinese descent and has been estimated to occur in 1%–4% of this group (19). Here we report a prospective study of RET especially on serial necrotic immature premolars with dens evaginatus. Although several case presentations and retrospective studies have reported the clinical and/or radiographic outcomes of RET on premolars 12, 22, 23, to our knowledge, this is the first prospective study to

Acknowledgments

The authors deny any conflicts of interest related to this study.

References (27)

Cited by (33)

  • Effect of Intracanal Scaffolds on the Success Outcomes of Regenerative Endodontic Therapy - A Systematic Review and Network Meta-analysis

    2023, Journal of Endodontics
    Citation Excerpt :

    Forty-nine additional records were identified via other sources. After elimination of duplicates and evaluation of titles and abstracts, 56 full-text articles were short-listed, which were then further assessed for eligibility after which 27 articles were included for reliability assessment and qualitative and quantitative analysis8,14,16,50–73. The details of the search are presented as a Preferred Reporting Items for Systemic Reviews and Meta-analysischart in Supplemental Figure S1 is available online at www.jendodon.com.

  • Biomaterial scaffolds for clinical procedures in endodontic regeneration: Biomaterial scaffolds in endodontic regeneration

    2022, Bioactive Materials
    Citation Excerpt :

    Subsequently, numerous case reports, case series and clinical studies about using blood clots as scaffolds were published. These archives achieved promising results and high success rates for permanent necrotic teeth, with the resolution of apical periodontitis, continued root development, apical narrowing and even restoration of vitality [24–37]. Recently published systematic review and meta-analysis studies also provided a high level of evidence [62–64].

View all citing articles on Scopus
View full text