TY - JOUR
T1 - Continued root maturation despite persistent apical periodontitis of immature permanent teeth after failed regenerative endodontic therapy
AU - Lin, Louis M.
AU - Kim, Sahng G.
AU - Martin, Gabriela
AU - Kahler, Bill
N1 - Publisher Copyright:
© 2018 Australian Society of Endodontology Inc
PY - 2018/12
Y1 - 2018/12
N2 - 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.
AB - 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.
KW - apical periodontitis
KW - continued root maturation
KW - immature permanent teeth
KW - necrotic pulp
KW - persistent apical periodontitis
KW - regenerative endodontic therapy
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U2 - 10.1111/aej.12252
DO - 10.1111/aej.12252
M3 - Article
C2 - 29336522
AN - SCOPUS:85040610550
SN - 1329-1947
VL - 44
SP - 292
EP - 299
JO - Australian Endodontic Journal
JF - Australian Endodontic Journal
IS - 3
ER -