Revascularization of nonvital immature incisor with asymptomatic apical periodontitis

Abstract

Background: The management of immature central incisors with nonvital pulp is a challenge for dentists because the goals and criteria for successful root canal treatment are difficult to achieve. A necrotic immature root canal system accompanied by apical periodontitis cannot be disinfected by standard protocols with the aggressive use of endodontic files. This case report demonstrated the advantages of pulp revascularization as a treatment method for necrotic immature teeth based on clinical and radiographic outcomes. Case Report: The patient was an 11-year-old boy with a history of trauma to the upper left central incisor who was treated with a revascularization procedure. Clinical and radiographic evaluations showed nonvital pulp, asymptomatic apical periodontitis, and mucogingival swelling before treatment. At the 1-, 3-, and 6-month follow-up visits, the patient's teeth remained asymptomatic and well-functioning. There was a slight thickening of the tooth wall and loss of lesions, although total closure of the apical foramen was observable. Longer clinical and radiographic controls are needed to evaluate the success of this case.Conclusion: Revascularization is a procedure that promotes thickening of the dentinal wall and closure of the apical foramen, thereby preventing teeth from becoming weak. The minimum expectation of revascularization treatment is the absence of undesirable signs and symptoms, but the ultimate goal is full regeneration of the pulp complex and ideal root development.