Apexogenesis and revascularization treatment procedures for two traumatized immature permanent maxillary incisors: a case report

Abstract

Traumatic injuries to an immature permanent tooth may result in cessation of dentin deposition and root maturation. Endodontic treatment is often complicated in premature tooth with an uncertain prognosis. This article describes successful treatment of two traumatized maxillary central incisors with complicated crown fracture three months after trauma. The radiographic examination showed immature roots in maxillary central incisors of a 9-year-old boy with a radiolucent lesion adjacent to the right central incisor. Apexogenesis was performed for the left central incisor and revascularization treatment was considered for the right one. In 18-month clinical and radiographic follow-up both teeth were asymptomatic, roots continued to develop, and periapical radiolucency of the right central incisor healed. Considering the root development of these contralateral teeth it can be concluded that revascularization is an appropriate treatment method in immature necrotic teeth.

Alternativas clínicas para el tratamiento de dientes traumatizados con rizogénesis incompleta: una visión actualizada

“…La mayoría de los traumatismos dentales se producen en el grupo de edad comprendido entre los 7 y 10 años, cuando aún la raíz no alcanzó su desarrollo completo (2). Los dientes permanentes jóvenes sin pulpa vital a menudo tienen paredes delgadas y frágiles, por lo que es difícil lograr la instrumentación efi ciente y obtener el sellado apical adecuado (3).…”

“…Los dientes permanentes jóvenes sin pulpa vital a menudo tienen paredes delgadas y frágiles, por lo que es difícil lograr la instrumentación efi ciente y obtener el sellado apical adecuado (3). Adicionalmente, las paredes delgadas del conducto radicular pueden predisponer estos dientes a fracturas (2).…”

The Management of Crown Fracture of Immature Teeth by MTA and Calcium Hydroxide: Case Reports

“…It allows further root development, with apical closure and strengthening of the root structure [9]. If the pulp vitality of a traumatized immature tooth is lost, the treatment will be a challenge, especially for pulp necrosis in teeth with inadequate radicular development due to the fact that an open apex in permanent tooth takes approximately 3 years to close after tooth eruption [2,9,[11][12][13]. In the case of pulp necrosis, pulpectomy and root canal therapy should be preferred [12].…”

“…Vital amputation (pulpotomy) is the treatment of choice for traumatized immature teeth with pulp exposure [9,10]. It allows further root development, with apical closure and strengthening of the root structure [9]. If the pulp vitality of a traumatized immature tooth is lost, the treatment will be a challenge, especially for pulp necrosis in teeth with inadequate radicular development due to the fact that an open apex in permanent tooth takes approximately 3 years to close after tooth eruption [2,9,[11][12][13].…”

“…Vital amputation (pulpotomy) is the treatment of choice for traumatized immature teeth with pulp exposure [9,10]. It allows further root development, with apical closure and strengthening of the root structure [9].…”