Regenerative Endodontics for Upper Permanent Central Incisors after Traumatic Injury: Case Report with a 3-year Follow-up

Abstract

The aim of this article is to describe a one-visit approach to attempt revascularization in the upper right and left central incisors after traumatic injury. A single-visit conservative revascularization approach can be used to promote root growth and maturation following traumatic dental injury and loss of pulpal tissues. An eight-year-old female patient presented in Dentalia Clinics, Jeddah, Kingdom of Saudi Arabia, in 2016 with traumatic dental injury. Upon clinical and radiographic examination, it was found that the trauma resulted in loss of pulp vitality in two upper central incisors. Local anesthesia was administered, and a rubber dam was placed. Access cavity was done for each tooth separately. 2% chlorhexidine followed by sterile saline was used for irrigation with no instrumentation. Mineral trioxide aggregate (MTA) was used as the sealing material after blood clot formation. Follow-up showed continuous root maturation in the right central incisor, at 6 months, one year, two years, and three years. Root canal treatment was done in 2019 due to the development of periapical lesion. The 6-month follow-up radiograph also showed loss of the crown of the left central incisor due to a second trauma with retained apical root fragment. The fragment was embedded inside the bone and showed continuous maturation during the three years. A single-visit regenerative endodontic approach showed successful results in revascularizing the upper permanent central incisor after loss of pulpal tissue. Immature permanent teeth can be treated by a single-visit revascularization procedure to promote root maturation and increase in radicular dentin length and width.