Regenerative endodontics - Biologically-based treatment for immature permanent teeth: A case report and review of the literature

Thomson, A. and Kahler, B. (2010) Regenerative endodontics - Biologically-based treatment for immature permanent teeth: A case report and review of the literature. Australian Dental Journal, 55 4: 446-452. doi:10.1111/j.1834-7819.2010.01268.x


Author Thomson, A.
Kahler, B.
Title Regenerative endodontics - Biologically-based treatment for immature permanent teeth: A case report and review of the literature
Journal name Australian Dental Journal   Check publisher's open access policy
ISSN 0045-0421
1834-7819
Publication date 2010-12-01
Sub-type Article (original research)
DOI 10.1111/j.1834-7819.2010.01268.x
Volume 55
Issue 4
Start page 446
End page 452
Total pages 7
Place of publication Oxford, United Kingdom
Publisher Wiley-Blackwell Publishing
Language eng
Formatted abstract
Background: A paradigm shift in the treatment of immature, necrotic teeth has occurred with biologically-based principles and regenerative endodontic protocols replacing traditional 'apexification' procedures. Preliminary research suggests that stem and progenitor cells from the pulp and/or periodontium contribute to continued root development when regenerative procedures are followed.

Methods: A mandibular premolar tooth with a chronic periapical abscess was irrigated with sodium hypochlorite with minimal instrumentation and then dressed with tri-antibiotic paste consisting of ciprofloxacin, metronidazole and amoxicillin. At a subsequent visit a blood clot was evoked in the canal by irritating periapical tissues and the canal sealed with mineral trioxide aggregate, glass ionomer cement and composite resin.

Results:
Resolution of apical periodontitis and the draining sinus, continued root maturation and apical closure occurred over an 18-month period. The tooth became responsive to pulp sensibility testing.

Conclusions:
It is important that dentists recognize the potential of regenerative endodontics in the treatment of necrotic, immature teeth. Initial management should involve irrigation with sodium hypochlorite only. Intra-canal medicaments, such as calcium hydroxide, are contraindicated as they inhibit further root growth. This report uses a variation of the tri-antibiotic paste currently recommended for regenerative procedures that avoided the discolouration of the crown associated with current protocols. Regenerative endodontics with continued root growth may reduce the risk of fracture and premature tooth loss associated with traditional 'apexification' procedures where the root remains thin and weak. © 2010 Australian Dental Association.
Keyword Regenerative endodontics
Revascularization
Tri-antibiotic paste
Discoloration
Q-Index Code CX
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published under Case Reports

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
ERA White List Items
School of Dentistry Publications
 
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Created: Sun, 09 Jan 2011, 10:10:49 EST