The aim of this minireview was to identify and review the scientific evidence regarding regenerative endodontic protocols claiming to revascularize permanent immature teeth with apical periodontitis. The literature was identified using the PubMed/MEDLINE, Scopus, Scirus, EMBASE and Cochrane databases up to February 2013. Studies were selected independently by two different researchers (kappa index: 0.88), based on established inclusion/exclusion criteria. The methodological quality of the reviewed papers was classified as high, medium or low (HQ, MQ, LQ). The search strategy identified 285 titles. Nine studies, both human and animal based, were selected after application of the criteria (LQ:5; MQ:4). In most of these studies (seven of nine), the revascularization protocol included a triple antibiotic combination as canal disinfectant for a period of 1-4 weeks after blood clot formation (LQ:5; MQ:4), although there is no clear consensus about the treatment protocol. Two studies reported tooth discoloration after the revascularization process (LQ:2), and only three (LQ:1; MQ:2) reported a success rate of 54.9% in dogs and 73.6% and 80% in humans, respectively. Revascularization of immature permanent teeth with apical periodontitis is possible and preferable to apexification. Nevertheless, there is a widespread lack of randomized clinical trials and blinded measures. In addition, the small sample sizes that are common in these studies as well as the generally low quality of the analysed publications require the results to be viewed with caution. There is a high risk of bias, with a low quality of available information, for developing clinical guidelines for regenerative endodontic protocols; rigorous randomized clinical trials are therefore needed.

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.

Aims: Ectopic eruption is a change in the normal path of eruption of a tooth. The aim of this study is to determine the prevalence of ectopic eruption of the permanent maxillary first molars in a Spanish subpopulation of 505 children, its distribution as regards age and gender, unilateral and bilateral occurrence and loss of space. Methods: Periapical and panoramic X-rays were taken of the patients, with six-monthly check-ups to evaluate development. A statistical analysis of the data was performed using the chi-square test (p lessthan 0.05, 95% C.I). Results: A prevalence of 6.7% was obtained being the most common age of presentation was seven years and bilateral occurrence (67.6% of cases) with no statistically significant differences as regards to the gender. Only 14 of the 505 explored patients required treatment for ectopic eruption. Conclusion: This study provides information regarding treatment needs and prevalence regarding molar ectopic eruption in a Spanish population. It is essential for professionals to be familiar with the diagnostic factors, clinical consequences and therapeutic options for ectopic eruption of permanent molars.

No abstract

Introduction: The aim is to describe the treatment of three immature permanent incisors associated to apical periodontitis, based on the placement of an apical mineral trioxide aggregate (MTA) plug for apexification. Case Series: Apexification was carried out by opening the pulp chamber, with debridement of the canal following anesthesia and isolation of the tooth. The canal was filled with pure calcium hydroxide in powder form, dissolved in saline solution for one week, and the aperture was sealed with IRM (Dentsply, Germany). One week later, the calcium hydroxide was removed and an MTA apical plug was positioned, sealing with a humid cotton pellet and IRM (Dentsply, Germany). After setting of the MTA, conventional endodontic treatment was carried out using gutta-percha, with definitive restoration of the tooth. Conclusion: All three cases, treated with MTA showed complete apical repair with rounding of the apex at radiographic control one year later, and the patients remained free of symptoms.