title: Biologically based treatment of immature permanent teeth with pulpal necrosis: a case series.
abstract: This case series reports the outcomes of 8 patients (ages 9-4 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 NaOCI 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.
authors.affiliation: Department of Conservative Dentistry, Yonsei University School of Dentistry, Seoul, Korea.
authors.forename: Il-Young
authors.initials: IY
authors.lastname: Jung
authors.forename: Seung-Jong
authors.initials: SJ
authors.lastname: Lee
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Hargreaves
mesh_terms: D000293:Adolescent; D017607:Aluminum Compounds / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D056624:Apexification / Q000379:methods; D017610:Calcium Compounds / Q000627:therapeutic use; D002126:Calcium Hydroxide / Q000627:therapeutic use; D002648:Child; D002939:Ciprofloxacin / Q000627:therapeutic use; D003782:Dental Pulp / Q000502:physiology; D003790:Dental Pulp Necrosis / Q000628:therapy*; D003809:Dentin, Secondary / Q000033:anatomy & histology; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008911:Minocycline / Q000627:therapeutic use; D009805:Odontogenesis / Q000502:physiology; D010087:Oxides / Q000627:therapeutic use; D010485:Periapical Periodontitis / Q000628:therapy*; D012038:Regeneration / Q000502:physiology; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D012388:Root Canal Irrigants / Q000627:therapeutic use; D018915:Root Canal Preparation / Q000379:methods; D017640:Silicates / Q000627:therapeutic use; D012973:Sodium Hypochlorite / Q000627:therapeutic use; D019227:Tooth Apex / Q000502:physiology*; D019553:Tooth, Nonvital / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D017607:Aluminum Compounds; D000900:Anti-Bacterial Agents; D017610:Calcium Compounds; D004338:Drug Combinations; D010087:Oxides; D012387:Root Canal Filling Materials; D012388:Root Canal Irrigants; D017640:Silicates; C086631:mineral trioxide aggregate; D008795:Metronidazole; D002939:Ciprofloxacin; D012973:Sodium Hypochlorite; D008911:Minocycline; D002126:Calcium Hydroxide