Radiographic differences observed following apexification vs revascularization in necrotic immature molars and incisors: a follow-up study of 18 teeth

Eur Arch Paediatr Dent. 2022 Jun;23(3):381-389. doi: 10.1007/s40368-022-00692-z. Epub 2022 Feb 7.

Abstract

Purpose: To evaluate the effectiveness of apexification versus revascularization in the treatment of necrotic immature teeth and determine which strategy affords the greatest radiological success rate.

Methods: An analysis was made of 18 teeth subjected to mineral trioxide aggregate (MTA) apical plugging and regenerative endodontic treatment, assessing healing of the apical lesions and the changes in root dimensions.

Results: Significantly greater root growth was observed with revascularization in terms of the percentage change in length (12.75% at 6 months) and dentin thickness (34.57% at 6 months) (p < 0.05). There were no significant differences between the two treatments in terms of the apical healing scores after 6 months of follow-up (p > 0.05).

Conclusion: Apexification with an MTA apical plug and pulp regeneration are reliable treatments for non-vital immature teeth. The radiographic outcomes are comparable between the immature teeth subjected to MTA apexification versus those subjected to revascularization. The results of the present study indicate a greater increase in root length and width with regenerative endodontic treatment.

Keywords: Immature teeth; Necrosis; Pulp treatment.

MeSH terms

  • Aluminum Compounds / therapeutic use
  • Apexification* / methods
  • Dental Pulp
  • Dental Pulp Necrosis / diagnostic imaging
  • Dental Pulp Necrosis / therapy
  • Drug Combinations
  • Follow-Up Studies
  • Humans
  • Incisor / diagnostic imaging
  • Molar
  • Oxides / therapeutic use
  • Regeneration
  • Root Canal Filling Materials* / therapeutic use
  • Silicates / therapeutic use
  • Tooth Apex / diagnostic imaging
  • Tooth Apex / pathology

Substances

  • Aluminum Compounds
  • Drug Combinations
  • Oxides
  • Root Canal Filling Materials
  • Silicates