Radiographic and clinical outcomes of the treatment of immature permanent teeth by revascularization or apexification

A pilot retrospective cohort study

Adel S. Alobaid, Lina M. Cortes, Jeffery Lo, Thuan T. Nguyen, Jeffery Albert, Abdulaziz S. Abu-Melha, Louis Lin, Jennifer Gibbs

Research output: Contribution to journalArticle

Abstract

Introduction This retrospective cohort study compared clinical and radiographic outcomes of endodontic treatment performed in immature nonvital permanent teeth by apexification (calcium hydroxide or apical barrier with mineral trioxide aggregate) versus revascularization. Methods A comprehensive chart review was performed to obtain a cohort of previously completed cases with recalls. Clinical and radiographic data were collected for 31 treated teeth (19 revascularization and 12 apexification) with an average follow-up time of 17 months and a recall rate of 63%. Tooth survival, success rate, and adverse events were analyzed. Changes in radiographic root length, width, and area were quantified. Results The majority of treated teeth survived throughout the study period, with 30 of 31 (97%) teeth surviving (18/19 [95%] revascularization and 12/12 apexification). Most cases were also clinically successful, with 27 of 31 (87%) meeting criteria for success (15/19 [78%] revascularization and 12/12 apexification; nonsignificant difference). A greater incidence of adverse events was observed in the revascularization group (8/19 [42%] vs 1/12 [11%] in apexification) (risk ratio = 5.1; P =.04; 95% confidence interval, 0.719-35.48). Although more revascularization cases than apexification cases showed an increase in radiographic root area and width, the effect was not statistically significant. Conclusions In this study, revascularization was not superior to other apexification techniques in either clinical or radiographic outcomes. Studies with large subject cohorts and long follow-up periods are needed to evaluate outcomes of revascularization and apexification while accounting for important covariants relevant to clinical success.

Original languageEnglish (US)
Pages (from-to)1063-1070
Number of pages8
JournalJournal of Endodontics
Volume40
Issue number8
DOIs
StatePublished - 2014

Fingerprint

Apexification
Tooth
Cohort Studies
Retrospective Studies
Nonvital Tooth
Calcium Hydroxide
Endodontics
Odds Ratio
Confidence Intervals

Keywords

  • Apexification
  • clinical outcomes
  • clinical success
  • endodontics
  • maturogenesis
  • radiographic outcomes
  • radiographic root area
  • regenerative endodontics
  • revascularization

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Radiographic and clinical outcomes of the treatment of immature permanent teeth by revascularization or apexification : A pilot retrospective cohort study. / Alobaid, Adel S.; Cortes, Lina M.; Lo, Jeffery; Nguyen, Thuan T.; Albert, Jeffery; Abu-Melha, Abdulaziz S.; Lin, Louis; Gibbs, Jennifer.

In: Journal of Endodontics, Vol. 40, No. 8, 2014, p. 1063-1070.

Research output: Contribution to journalArticle

Alobaid, Adel S. ; Cortes, Lina M. ; Lo, Jeffery ; Nguyen, Thuan T. ; Albert, Jeffery ; Abu-Melha, Abdulaziz S. ; Lin, Louis ; Gibbs, Jennifer. / Radiographic and clinical outcomes of the treatment of immature permanent teeth by revascularization or apexification : A pilot retrospective cohort study. In: Journal of Endodontics. 2014 ; Vol. 40, No. 8. pp. 1063-1070.
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title = "Radiographic and clinical outcomes of the treatment of immature permanent teeth by revascularization or apexification: A pilot retrospective cohort study",
abstract = "Introduction This retrospective cohort study compared clinical and radiographic outcomes of endodontic treatment performed in immature nonvital permanent teeth by apexification (calcium hydroxide or apical barrier with mineral trioxide aggregate) versus revascularization. Methods A comprehensive chart review was performed to obtain a cohort of previously completed cases with recalls. Clinical and radiographic data were collected for 31 treated teeth (19 revascularization and 12 apexification) with an average follow-up time of 17 months and a recall rate of 63{\%}. Tooth survival, success rate, and adverse events were analyzed. Changes in radiographic root length, width, and area were quantified. Results The majority of treated teeth survived throughout the study period, with 30 of 31 (97{\%}) teeth surviving (18/19 [95{\%}] revascularization and 12/12 apexification). Most cases were also clinically successful, with 27 of 31 (87{\%}) meeting criteria for success (15/19 [78{\%}] revascularization and 12/12 apexification; nonsignificant difference). A greater incidence of adverse events was observed in the revascularization group (8/19 [42{\%}] vs 1/12 [11{\%}] in apexification) (risk ratio = 5.1; P =.04; 95{\%} confidence interval, 0.719-35.48). Although more revascularization cases than apexification cases showed an increase in radiographic root area and width, the effect was not statistically significant. Conclusions In this study, revascularization was not superior to other apexification techniques in either clinical or radiographic outcomes. Studies with large subject cohorts and long follow-up periods are needed to evaluate outcomes of revascularization and apexification while accounting for important covariants relevant to clinical success.",
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T1 - Radiographic and clinical outcomes of the treatment of immature permanent teeth by revascularization or apexification

T2 - A pilot retrospective cohort study

AU - Alobaid, Adel S.

AU - Cortes, Lina M.

AU - Lo, Jeffery

AU - Nguyen, Thuan T.

AU - Albert, Jeffery

AU - Abu-Melha, Abdulaziz S.

AU - Lin, Louis

AU - Gibbs, Jennifer

PY - 2014

Y1 - 2014

N2 - Introduction This retrospective cohort study compared clinical and radiographic outcomes of endodontic treatment performed in immature nonvital permanent teeth by apexification (calcium hydroxide or apical barrier with mineral trioxide aggregate) versus revascularization. Methods A comprehensive chart review was performed to obtain a cohort of previously completed cases with recalls. Clinical and radiographic data were collected for 31 treated teeth (19 revascularization and 12 apexification) with an average follow-up time of 17 months and a recall rate of 63%. Tooth survival, success rate, and adverse events were analyzed. Changes in radiographic root length, width, and area were quantified. Results The majority of treated teeth survived throughout the study period, with 30 of 31 (97%) teeth surviving (18/19 [95%] revascularization and 12/12 apexification). Most cases were also clinically successful, with 27 of 31 (87%) meeting criteria for success (15/19 [78%] revascularization and 12/12 apexification; nonsignificant difference). A greater incidence of adverse events was observed in the revascularization group (8/19 [42%] vs 1/12 [11%] in apexification) (risk ratio = 5.1; P =.04; 95% confidence interval, 0.719-35.48). Although more revascularization cases than apexification cases showed an increase in radiographic root area and width, the effect was not statistically significant. Conclusions In this study, revascularization was not superior to other apexification techniques in either clinical or radiographic outcomes. Studies with large subject cohorts and long follow-up periods are needed to evaluate outcomes of revascularization and apexification while accounting for important covariants relevant to clinical success.

AB - Introduction This retrospective cohort study compared clinical and radiographic outcomes of endodontic treatment performed in immature nonvital permanent teeth by apexification (calcium hydroxide or apical barrier with mineral trioxide aggregate) versus revascularization. Methods A comprehensive chart review was performed to obtain a cohort of previously completed cases with recalls. Clinical and radiographic data were collected for 31 treated teeth (19 revascularization and 12 apexification) with an average follow-up time of 17 months and a recall rate of 63%. Tooth survival, success rate, and adverse events were analyzed. Changes in radiographic root length, width, and area were quantified. Results The majority of treated teeth survived throughout the study period, with 30 of 31 (97%) teeth surviving (18/19 [95%] revascularization and 12/12 apexification). Most cases were also clinically successful, with 27 of 31 (87%) meeting criteria for success (15/19 [78%] revascularization and 12/12 apexification; nonsignificant difference). A greater incidence of adverse events was observed in the revascularization group (8/19 [42%] vs 1/12 [11%] in apexification) (risk ratio = 5.1; P =.04; 95% confidence interval, 0.719-35.48). Although more revascularization cases than apexification cases showed an increase in radiographic root area and width, the effect was not statistically significant. Conclusions In this study, revascularization was not superior to other apexification techniques in either clinical or radiographic outcomes. Studies with large subject cohorts and long follow-up periods are needed to evaluate outcomes of revascularization and apexification while accounting for important covariants relevant to clinical success.

KW - Apexification

KW - clinical outcomes

KW - clinical success

KW - endodontics

KW - maturogenesis

KW - radiographic outcomes

KW - radiographic root area

KW - regenerative endodontics

KW - revascularization

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