title: Clinical complications in the revascularization of immature necrotic permanent teeth.
abstract: The purpose of this case series was to report on the use of a technique of revascularization for necrotic immature permanent teeth, several problems encountered, and solutions to those problems. Eighteen pulp revascularizations were performed in 2009 using the original protocol of revascularization  (adapted from the AAE/AAPD joint meeting in 2007 in Chicago). The protocol consisted of opening the canal and disinfecting it with sodium hypochlorite, sealing in a triple antibiotic paste for 2-6 weeks, re-opening, re-irrigating, creating a blood clot in the canal, and sealing with an MTA  barrier over the clot. Three problems were encountered during the treatment: (1) bluish discoloration of the crown; (2) failure to produce bleeding; and (3) collapse of the mineral trioxide aggregate (MTA) material into the canal. Modifications to solve these problems included: changing one  of the antibiotics, using a local anesthesia without epinephrine, and adding collagen matrix to the blood clot.
authors.affiliation: Pediatric Dentistry Program, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Basma
authors.initials: B
authors.lastname: Dabbagh
authors.forename: Emanuel
authors.initials: E
authors.lastname: Alvaro
authors.forename: Duy-Dat
authors.initials: DD
authors.lastname: Vu
authors.forename: Jean
authors.initials: J
authors.lastname: Rizkallah
authors.forename: Stephane
authors.initials: S
authors.lastname: Schwartz
mesh_terms: D000293:Adolescent; D017607:Aluminum Compounds / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D056624:Apexification / Q000379:methods; D001777:Blood Coagulation / Q000502:physiology*; D017610:Calcium Compounds / Q000009:adverse effects; D002433:Cefaclor / Q000627:therapeutic use; D002648:Child; D003094:Collagen / Q000627:therapeutic use; D003782:Dental Pulp / Q000098:blood supply*; D003790:Dental Pulp Necrosis / Q000209:etiology / Q000628:therapy*; D019229:Dentition, Permanent; D004338:Drug Combinations; D004837:Epinephrine / Q000009:adverse effects; D006801:Humans; D008911:Minocycline / Q000009:adverse effects; D018919:Neovascularization, Physiologic; D010087:Oxides / Q000009:adverse effects; D012387:Root Canal Filling Materials / Q000009:adverse effects; D012388:Root Canal Irrigants / Q000627:therapeutic use; D012390:Root Canal Therapy / Q000009:adverse effects* / Q000379:methods*; D017640:Silicates / Q000009:adverse effects; D012973:Sodium Hypochlorite / Q000627:therapeutic use; D014075:Tooth Discoloration / Q000139:chemically induced*; D018677:Tooth Injuries / Q000150:complications; D014662:Vasoconstrictor Agents / Q000009:adverse effects
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; D014662:Vasoconstrictor Agents; C086631:mineral trioxide aggregate; D002433:Cefaclor; D003094:Collagen; D012973:Sodium Hypochlorite; D008911:Minocycline; D004837:Epinephrine