Clinical and Radiographic Outcomes of Traumatized Immature Permanent Necrotic Teeth after Revascularization/Revitalization Therapy

Abstract

Introduction: Revascularization treatment is rapidly becoming an accepted treatment alternative for the management of
endodontic pathology in immature permanent teeth with necrotic dental pulps. However, the success and timing of clinical
resolution of symptoms, and radiographic outcomes of interest, such as continued hard tissue deposition within the
root, are largely unknown.
Methods: In this prospective cohort study, 20 teeth were treated with a standardized revascularization treatment
protocol and monitored for clinical and radiographic changes for 1 year. Standardized radiographs were collected at
regular intervals, and radiographic changes were quantified.
Results: All 20 treated teeth survived during the 12- month follow-up period, and all 20 also met the clinical criteria for
success at 12 months. As a group, the treated teeth showed a statistically significant increase in radio- graphic root width and
length and a decrease in apical diameter, although the changes in many cases were quite small (such that the clinical
significance is unclear). The within-case percent change in apical diameter after 3 months was 16% and had increased to
79% by 12 months, with 55% (11/20) showing complete apical closure. The within-case percent change in root length
averaged less than 1% at 3 months and increased to 5% at 12 months. The within-case percent change in root
thickness averaged 3% at 3 months and 21% at 12 months.
Conclusions: Although clinical success was highly predictable with this procedure, clinically meaningful
radiographic root thickening and length- ening are less predictable after 1-year of follow-up. Api- cal closure is the most
consistentradiographic finding.(J Endod 2014;40:1946–1952).