Revitalisation endodontic treatment of traumatised immature teeth: a prospective long-term clinical study

Abstract

Purpose Continuation of root development following revitalisation endodontics (RET) has been shown to be unpredictable with lower success rates in traumatised teeth. This study reports the outcomes for RET in traumatised teeth over a review period of 4 years. Methods A prospective uncontrolled study, where RET was performed on traumatised upper immature anterior teeth with necrotic pulps in 15 children (mean age = 8.3 years), was conducted. Patients were reviewed at 3, 9, 12, 24, and 48 months, where clinical and radiographic assessments were performed. At the last review appointment, patients and parents answered questions assessing their perception and acceptance of tooth colour change over time. McNemar's Exact test and linear mixed model assessment were used to assess changes in pulpal electrical response and radiographic evidence of continuation of root development over time, respectively. Results There was 83.3% healing with no significant changes in EPT responses, and no significant changes in root lengths, while significant changes in root widths (p < 0.05) and root apex widths (p < 0.001) were found over time. Twenty-five percent of patients and 33% of parents felt that there were changes in tooth colour following RET over time.Conclusion Within the limitations of this study, traumatised teeth treated using RET showed no significant root lengthening, however, acceptable periapical healing, slow thickening of root dentinal walls, and rapid development of apical closure were evident over a period of 43 months. Using Portland cement and omitting minocycline, did not eliminate crown colour change following RET.

The effect of platelet‐rich plasma as a scaffold in regeneration/revitalization endodontics of immature permanent teeth assessed using 2‐dimensional radiographs and cone beam computed tomography: a randomized controlled trial

“…(2019) that agreed with the present study, in which similar clinical and radiographic outcomes of RET using PRP and BLC were reported. Interestingly, most of the studies assessing success of RET in traumatized teeth, mainly using BLC, has shown a tendency to achieve thickening of dentinal walls and apical closure rather than root lengthening in traumatized immature teeth with nonvital pulps over a long period of time (Nazzal et al, 2019). Therefore, long‐term reporting of the results of the present study is planned.…”

“…2012, Nazzal et al . 2018a, 2019). The use of bi‐antibiotic containing no minocycline (Nazzal et al .…”

A comparative evaluation of Advanced Platelet-Rich Fibrin (A-PRF) and Platelet-Rich Fibrin (PRF) as a Scaffold in Regenerative Endodontic Treatment of Traumatized Immature Non-vital permanent anterior teeth: A Prospective clinical study

“…The success of RET has been reported in terms of periapical healing, increase in root thickness and/length, apical foramen closure and tooth survival ( 30 ). In the present study complete resolution (healed) of periapical lesion was noted in 54.5% (6/11) for A-PRF and 60% (6/10) for PRF group; and “healing” was noted in 45.5% (5/11) for A-PRF and 40% (4/10) for PRF as scaffold.…”

“…These differences could be attributed to follow-up period, etiology of non-vitality and the methods used for radiographic measurement ( 19 , 25 , 32 ). Further it is possible that with longer follow-up period the root dimensions would continue to increase ( 14 , 30 ). Although in the present study, the follow-up period was longer for A-PRF than PRF group, but this was not statistically significant.…”

“…Although in the present study, the follow-up period was longer for A-PRF than PRF group, but this was not statistically significant. The sensibility test was negative in all the subjects which could be due to the coronal seal with Biodentine and GIC ( 30 ).…”