Revascularization outcomes: a prospective analysis of 16 consecutive cases

Kahler, Bill, Mistry, Sonali, Moule, Alex, Ringsmuth, Andrew K., Case, Peter, Thomson, Andrew and Holcombe, Trevor (2014) Revascularization outcomes: a prospective analysis of 16 consecutive cases. Journal of Endodontics, 40 3: 333-338. doi:10.1016/j.joen.2013.10.032


Author Kahler, Bill
Mistry, Sonali
Moule, Alex
Ringsmuth, Andrew K.
Case, Peter
Thomson, Andrew
Holcombe, Trevor
Title Revascularization outcomes: a prospective analysis of 16 consecutive cases
Journal name Journal of Endodontics   Check publisher's open access policy
ISSN 0099-2399
1878-3554
Publication date 2014-03-01
Year available 2014
Sub-type Article (original research)
DOI 10.1016/j.joen.2013.10.032
Open Access Status Not yet assessed
Volume 40
Issue 3
Start page 333
End page 338
Total pages 6
Place of publication Philadelphia, PA, United States
Publisher Elsevier
Language eng
Subject 3500 Dentistry
Abstract Introduction: Recent reviews lament the lack of evidence on the efficacy of regenerative procedures to induce further root maturation despite claims of a paradigm shift in the way infected, necrotic immature teeth with arrested root development can be endodontically treated. The majority of reports are either case series or successful case reports where nonstandardized images may make interpretation uncertain. Methods: This prospective clinical study reports on preliminary outcomes of regenerative endodontic procedures carried out on 16 teeth, 3 mandibular premolars and 13 traumatized central incisors, after 18-month reviews. Qualitative analysis of resolution of periapical radiolucencies and apical closure was undertaken. Quantitative analysis compared preoperative and recall radiographs by using a geometrical imaging program that calculated percentage changes in root length and dentin wall thickness. Results: Qualitative assessment showed 90.3% resolution of the periapical radiolucency. Apical closure was assessed as incomplete in 47.2% and complete apical closure in 19.4% of cases. Quantitative assessment showed change in root length varying from 2.7% to 25.3% and change for root dentin thickness, of 1.9% to 72.6%. Conclusions: Patterns of continued root maturogenesis were variable at 18-month review. Reviews at 36 months showed continued root maturogenesis for 2 cases. Quantitative analysis can control for changes in angulation but may introduce other measurement errors. However, not all anterior teeth were suitable for Turbo Reg assessment because overlapping of the cementoenameijunctions and/or further eruption of teeth often precluded stable landmark positioning. Discoloration of the crown was a common consequence, with unaesthetic results in 10 of the 16 cases.
Formatted abstract
Introduction
Recent reviews lament the lack of evidence on the efficacy of regenerative procedures to induce further root maturation despite claims of a paradigm shift in the way infected, necrotic immature teeth with arrested root development can be endodontically treated. The majority of reports are either case series or successful case reports where nonstandardized images may make interpretation uncertain.

Methods
This prospective clinical study reports on preliminary outcomes of regenerative endodontic procedures carried out on 16 teeth, 3 mandibular premolars and 13 traumatized central incisors, after 18-month reviews. Qualitative analysis of resolution of periapical radiolucencies and apical closure was undertaken. Quantitative analysis compared preoperative and recall radiographs by using a geometrical imaging program that calculated percentage changes in root length and dentin wall thickness.

Results
Qualitative assessment showed 90.3% resolution of the periapical radiolucency. Apical closure was assessed as incomplete in 47.2% and complete apical closure in 19.4% of cases. Quantitative assessment showed change in root length varying from -2.7% to 25.3% and change for root dentin thickness of -1.9% to 72.6%.

Conclusions
Patterns of continued root maturogenesis were variable at 18-month review. Reviews at 36 months showed continued root maturogenesis for 2 cases. Quantitative analysis can control for changes in angulation but may introduce other measurement errors. However, not all anterior teeth were suitable for TurboReg assessment because overlapping of the cementoenamel junctions and/or further eruption of teeth often precluded stable landmark positioning. Discoloration of the crown was a common consequence, with unaesthetic results in 10 of the 16 cases. 
Keyword Regenerative endodontics
Revascularization
Traumatized teeth
Tri-antibiotic paste
TurboReg
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Dentistry Publications
Institute for Molecular Bioscience - Publications
 
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