Comparative Study Between Revascularization (Regeneration) and Mta Apexification for Necrotic Immature Permanent Anterior Teeth With Open Apex: A Randomized Controlled Trial.

Abstract

Introduction: The purpose of the study was to compare the effectiveness of pulp revascularization and MTA apexification in the treatment of necrotic anterior teeth with periapical abscess. Methods: twenty-two patients, each with necrotic immature permanent anterior teeth were randomly divided into 2 groups (Group A apexification and group B regeneration) 11 patient per each group. A triantibiotic paste (metronidazole, ciprofloxacin and doxycycline) was used to disinfect the canal for 21 days. MTA plug was used for apexification for group A. Blood clot regeneration was used for the group B. The patients were recalled periodically for follow up. Results: The regeneration group showed better results in, increase in root length, increase in dentin thickness in mm, and in percentage, while MTA apexification group showed better results in decrease in apical diameter in millimeter. Conclusions: Both regeneration and MTA apexification are reliable procedures for treating necrotic immature anterior teeth with open apices.

Evaluation of Outcomes in Immature Teeth After Revitalization or Apexification Procedures: A Systematic Review and Meta-Analysis

“…The quality of the included studies was assessed using the JBI critical appraisal tool [16]. Six studies [17][18][19][20][21][22] were included, three were evaluated according to the checklist for randomized controlled trials, and three according to the checklist of cohort studies, as seen in Table 2 and Table 3, respectively. The overall risk of bias among the incorporated studies was assessed.…”

“…The diagnosis and the assessment of each outcome were based on the clinical and radiographic evaluation. A total of 260 non-vital immature permanent teeth were evaluated with follow-up periods ranging from 6 to 24 months [17][18][19][20][21][22]. The review of endodontic treatment used in these studies showed that, initially, all immature teeth were treated by a similar endodontic protocol.…”

“…All patients were anesthetized with either 2% lidocaine [18,19] or 3% mepivacaine [16]; the anesthetic solution was not specified in some cases [20][21][22]. After the administration of the local anesthetic solution, a rubber dam was placed, an access cavity was prepared, and the working length was determined [17][18][19][20]22]. Each canal was irrigated with sodium hypochlorite solution with a concentration ranging from 1.5-2.5% [19,20,22], 5.25% [17], or 6% [18] depending on the case.…”

“…After the administration of the local anesthetic solution, a rubber dam was placed, an access cavity was prepared, and the working length was determined [17][18][19][20]22]. Each canal was irrigated with sodium hypochlorite solution with a concentration ranging from 1.5-2.5% [19,20,22], 5.25% [17], or 6% [18] depending on the case. In most studies, a 17% ethylenediaminetetraacetic acid (EDTA) solution was also used [18,19,22].…”

“…The entirety of the revitalization cases was treated in two visits. During the first visit, and after the initial tooth preparation, a triple antibiotic paste (TAP) mixture [17][18][19][20]22] or calcium hydroxide (CH) paste [18,22] was placed into the canals, followed by a temporary restoration. The second visit typically occurred after three weeks [17][18][19], where the same preparation protocol was performed.…”