Biologically based treatment of immature permanent teeth with pulpal necrosis: a case series.
This case series reports the outcomes of 8 patients (ages 9-14 years) who presented with 9 immature permanent teeth with pulpal necrosis and apical periodontitis. During treatment, 5 of the teeth were found to have at least some residual vital tissue remaining in the root canal systems. After NaOCl irrigation and medication with ciprofloxacin, metronidazole, and minocycline, these teeth were sealed with mineral trioxide aggregate and restored. The other group of 4 teeth had no evidence of any residual vital pulp tissue. This second group of teeth was treated with NaOCl irrigation and medicated with ciprofloxacin, metronidazole, and minocycline followed by a revascularization procedure adopted from the trauma literature (bleeding evoked to form an intracanal blood clot). In both groups of patients, there was evidence of satisfactory postoperative clinical outcomes (1-5 years); the patients were asymptomatic, no sinus tracts were evident, apical periodontitis was resolved, and there was radiographic evidence of continuing thickness of dentinal walls, apical closure, or increased root length.
Department of Conservative Dentistry, Yonsei University School of Dentistry, Seoul, Korea.
Il-Young
IY
Jung
Seung-Jong
SJ
Lee
Kenneth M
KM
Hargreaves
D000293:Adolescent; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002648:Child; D002939:Ciprofloxacin; D003719:Dens in Dente / Q000628:therapy; D003782:Dental Pulp / Q000098:blood supply*; D003790:Dental Pulp Necrosis / Q000188:drug therapy*; D019229:Dentition, Permanent; D005260:Female; D006801:Humans; D008297:Male; D008795:Metronidazole; D008911:Minocycline; D018919:Neovascularization, Physiologic; D010485:Periapical Periodontitis / Q000188:drug therapy; D012038:Regeneration; D012388:Root Canal Irrigants / Q000627:therapeutic use*; D012973:Sodium Hypochlorite; D019227:Tooth Apex / Q000254:growth & development*
D000891:Anti-Infective Agents, Local; D012388:Root Canal Irrigants; D008795:Metronidazole; D002939:Ciprofloxacin; D012973:Sodium Hypochlorite; D008911:Minocycline