Regenerative endodontic treatment options for immature permanent teeth: a case report with 21-month follow-up

Abstract

The treatment of choice for necrotic teeth with incompletely formed roots is apexification with calcium hydroxide, which induces the formation of a hard tissue barrier at the apex, however, in the long term, this medicament may increase the brittleness of dentin walls because of its hygroscopic and proteolytic properties, in addition to the disadvantage of requiring multiple appointments. A treatment option for young permanent teeth with necrotic pulps is pulp regeneration, whose advantage lies in the stimulation of new tissue formation within the root canal. Pulp revascularization is based on the disinfection of the root canal system, often performed with irrigating solutions and intracanal medicaments, accompanied by induction of periapical bleeding and formation of a blood clot that will fill the root canal. The aim of this study was to present a case of avulsion of teeth 11 and 21, both with open apices, treated with replantation associated with regenerative endodontic therapy, but varying the intracanal medicaments used: calcium hydroxide in tooth 11 and double antibiotic paste in tooth 21. Pulp revascularization proved to be effective with both intracanal medicaments used, promoting symptom resolution and complete root development, including apical closure, even in the absence of a well-defined clinical