Continued root maturation despite persistent apical periodontitis of immature permanent teeth after failed regenerative endodontic therapy

Louis Lin, Sahng G. Kim, Gabriela Martin, Bill Kahler

Research output: Contribution to journalArticle

Abstract

Three immature permanent teeth with pulp necrosis and apical periodontitis were treated with regenerative endodontic therapy (RET), which included root canal disinfection with sodium hypochlorite irrigation, intra-canal medication with calcium hydroxide paste, 17% EDTA rinse, induction of periapical bleeding into the canal, collagen matrix and MTA coronal seal, and composite resin restoration of access cavities. After different periods of follow-up, it was observed that continued root maturation, especially apical closure occurred despite persistent apical periodontitis of immature permanent teeth after failed RET. This finding is of interest as the secondary goal of further root maturation occurred despite failure of the primary goal of elimination of clinical symptom/sign and periapical inflammation. The possible biological mechanisms that could allow for further root maturation to occur in spite of persistent root canal infection of immature permanent teeth are discussed. Based on these observations, the biology of wound healing of immature permanent teeth after injury is not fully understood and should be further investigated. This case report demonstrates that whilst further root maturation is considered a successful outcome for teeth treated with RET, the primary objective must be the resolution of the signs and symptoms of apical periodontitis.

Original languageEnglish (US)
JournalAustralian Endodontic Journal
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Periapical Periodontitis
Endodontics
Tooth
Dental Pulp Cavity
Signs and Symptoms
Pemetrexed
Tooth Injuries
Dental Pulp Necrosis
Calcium Hydroxide
Sodium Hypochlorite
Composite Resins
Disinfection
Therapeutics
Ointments
Edetic Acid
Wound Healing
Collagen
Hemorrhage
Inflammation
Infection

Keywords

  • Apical periodontitis
  • Continued root maturation
  • Immature permanent teeth
  • Necrotic pulp
  • Persistent apical periodontitis
  • Regenerative endodontic therapy

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Continued root maturation despite persistent apical periodontitis of immature permanent teeth after failed regenerative endodontic therapy. / Lin, Louis; Kim, Sahng G.; Martin, Gabriela; Kahler, Bill.

In: Australian Endodontic Journal, 01.01.2018.

Research output: Contribution to journalArticle

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