Regenerative Endodontic Treatment (Revascularization) of Necrotic Immature Permanent Teeth

Abstract

 Introduction: Although apexification has been used to successfully treat necrotic immature permanent teeth, regardless of the presence of apical lesions, it has also been shown to be associated with reduced strength in these teeth as well as thin dentin walls. Dentin walls remain short and thin because continued root formation rarely occurs after apexification. In recent years, revascularization has been reported as a new treatment to promote root growth in necrotic immature permanent teeth. Here we report a case of revascularization treatment in a necrotic immature permanent tooth.
 Case: The patient was a 15-year-old girl with chronic apical periodontitis caused by a fractured dens evaginatus in her lower right second premolar. Informed consent regarding the therapeutic strategy was obtained before starting the treatment.
 Methods: All procedures were performed in accordance with the treatment protocols of the American Association of Endodontists.
 Results: No symptoms were evident at a 24-month follow-up after the root canal filling. A marked reduction in the size of the apical lesion was observed on radiographic examination. In addition, some hard tissue formation was observed on the dentin walls. Positive reactions to the electric pulp test and cold test were also seen.
 Conclusion: The results in this case support the findings obtained in previous studies and suggest that revascularization is useful in the treatment of necrotic immature permanent teeth. Long-term follow-up observation is planned for this case.