REVASCULARIZATION IN MATURE PERMANENT TEETH WITH NECROTIC PULP AND APICAL PERIODONTITIS: CASE SERIES | ||||
| Alexandria Dental Journal | ||||
| Article 2, Volume 43, Issue 2, August 2018, Page 7-12 PDF (441.48 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/adjalexu.2018.57617 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Rasha A. Abou Samra1; Rania M. El Backly2; Hanaa M. Aly3; Samir R. Nouh4; Sybel M. Moussa5 | ||||
| 1MSc, Conservative Dentistry Department. Faculty of Dentistry, Alexandria University, Alexandria, Egypt. | ||||
| 2Lecturer of Endodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt | ||||
| 3Professor of Oral Biology, Faculty of Dentistry, Alexandria University. Alexandria, Egypt | ||||
| 4Professor of Veterinary Surgery, Faculty of Veterinary Medicine. Alexandria, Egypt | ||||
| 5Professor of Endodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt. | ||||
| Abstract | ||||
| INTRODUCTION: Revascularization procedures have been limited to immature teeth but application to mature teeth should be clinically investigated as an alternative to conventional root canal treatment. The translation of regenerative endodontic procedures into treating mature teeth is challenging and depends on efficient root canal disinfection, proper size of the apical foramen, the availability and delivery of stem cells into the root canal system. OBJECTIVES: Evaluation of revascularization in mature teeth after enlargement of the apical foramen to size 35 K-file. MATERIALS AND METHODS: Three necrotic incisors with mature roots and apical periodontitis in three patients ranging from 20–30 years old were treated by revascularization procedures. Access opening was performed. The canal was mechanically instrumented to the radiographic apex. The apical foramen was enlarged with a size 35 K-file. Triple antibiotic paste (0.1 mg/ml) was applied in the canal using a syringe. After three weeks, the medication was removed with 20 ml of 1.5% sodium hypochlorite followed by final irrigation with 20 ml of 17% EDTA. Bleeding was induced in the root canal and mineral trioxide aggregate (MTA) was placed approximately 3-4 mm below the CEJ. The tooth was restored with a layer of glass ionomer followed by composite resin. The patient was scheduled for follow up and evaluation of healing after 3 months, 6 months and 9 months. Resolution of apical periodontitis and regression of clinical signs and symptoms were observed during the follow up periods. RESULTS: After a follow-up period of 9 months, the three teeth demonstrated radiographic evidence of periapical healing with absence of clinical signs and symptoms. CONCLUSIONS: The present cases demonstrated a favorable outcome of the revascularization procedure in mature necrotic incisors with chronic apical periodontitis | ||||
| Keywords | ||||
| Mature teeth; necrotic pulp; apical periodontitis; Periapical healing; pulp tissue regeneration | ||||
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