title: Regenerative endodontic treatment of permanent teeth after completion of root development: a report of 2 cases.
abstract: BACKGROUND
  Clinical regenerative endodontic treatment has been focused on immature necrotic teeth, but it should be extended to mature teeth as an alternative to conventional endodontic treatment. There have been no clinical reports to attempt to revascularize pulp in the entire root canals of mature necrotic teeth. The present report describes the treatment of mature, necrotic, permanent incisors with apical periodontitis by using regenerative endodontic therapy.
  
  
  METHODS
  In this case report, modified regenerative endodontic procedures were used to enhance the probability of pulp revasuclarization in mature necrotic teeth. At the first appointment, the root canals were mechanically instrumented to the apices with a large apical size by using the step-back technique and irrigated copiously with antimicrobial solution. Intracanal medicaments (calcium hydroxide or ciprofloxacin) were placed in the root canals. At the following appointment, the root canals were irrigated with antimicrobial solution, and bleeding was induced into the root canals by passing hand files beyond apices. Collagen membranes were placed in the canals as a matrix against which mineral trioxide aggregate was placed. Glass ionomer was used to restore the teeth. The resolution of apical radiolucency and regression of clinical signs and symptoms were observed at recall appointments.
  
  
  CONCLUSIONS
  The present report presents modified regenerative endodontic procedures for mature necrotic permanent teeth. Further clinical studies with a large number of cases are needed to investigate the outcome of regenerative endodontic therapy for mature necrotic teeth.
authors.affiliation: Division of Endodontics, College of Dental Medicine, Columbia University, New York, NY 10032, USA.
authors.forename: Khimiya
authors.initials: K
authors.lastname: Paryani
authors.forename: Sahng G
authors.initials: SG
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D017607:Aluminum Compounds / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017610:Calcium Compounds / Q000627:therapeutic use; D002126:Calcium Hydroxide / Q000627:therapeutic use; D002648:Child; D002939:Ciprofloxacin / Q000627:therapeutic use; D003094:Collagen / Q000627:therapeutic use; D003782:Dental Pulp / Q000098:blood supply / Q000503:physiopathology*; D003786:Dental Pulp Cavity / Q000098:blood supply / Q000503:physiopathology; D003790:Dental Pulp Necrosis / Q000628:therapy*; D003793:Dental Restoration, Permanent / Q000379:methods; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements / Q000737:chemistry; D006801:Humans; D007180:Incisor / Q000503:physiopathology; D018919:Neovascularization, Physiologic / 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; D012390:Root Canal Therapy / Q000379:methods*; D017640:Silicates / Q000627:therapeutic use; D019227:Tooth Apex / Q000473:pathology; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
chemical_list: D017607:Aluminum Compounds; D000900:Anti-Bacterial Agents; D017610:Calcium Compounds; C488453:CollaCote; D004338:Drug Combinations; D005899:Glass Ionomer Cements; D010087:Oxides; D012387:Root Canal Filling Materials; D012388:Root Canal Irrigants; D017640:Silicates; C086631:mineral trioxide aggregate; D002939:Ciprofloxacin; D003094:Collagen; D002126:Calcium Hydroxide