title: Radiographic and clinical outcomes of the treatment of immature permanent teeth by revascularization or apexification: a pilot retrospective cohort study.
abstract: BACKGROUND
  This retrospective cohort study compared clinical and radiographic outcomes of endodontic treatment performed in immature nonvital permanent teeth by apexification (calcium hydroxide or apical barrier with mineral trioxide aggregate) versus revascularization.
  
  
  METHODS
  A comprehensive chart review was performed to obtain a cohort of previously completed cases with recalls. Clinical and radiographic data were collected for 31 treated teeth (19 revascularization and 12 apexification) with an average follow-up time of 17 months and a recall rate of 63%. Tooth survival, success rate, and adverse events were analyzed. Changes in radiographic root length, width, and area were quantified.
  
  
  RESULTS
  The majority of treated teeth survived throughout the study period, with 30 of 31 (97%) teeth surviving (18/19 [95%] revascularization and 12/12 apexification). Most cases were also clinically successful, with 27 of 31 (87%) meeting criteria for success (15/19 [78%] revascularization and 12/12 apexification; nonsignificant difference). A greater incidence of adverse events was observed in the revascularization group (8/19 [42%] vs 1/12 [11%] in apexification) (risk ratio = 5.1; P = .04; 95% confidence interval, 0.719-35.48). Although more revascularization cases than apexification cases showed an increase in radiographic root area and width, the effect was not statistically significant.
  
  
  CONCLUSIONS
  In this study, revascularization was not superior to other apexification techniques in either clinical or radiographic outcomes. Studies with large subject cohorts and long follow-up periods are needed to evaluate outcomes of revascularization and apexification while accounting for important covariants relevant to clinical success.
authors: New York University College of Dentistry, New York, New York.
authors: Adel S
authors: AS
authors: Alobaid
authors: New York University College of Dentistry, New York, New York.
authors: Lina M
authors: LM
authors: Cortes
authors: New York University College of Dentistry, New York, New York.
authors: Jeffery
authors: J
authors: Lo
authors: New York University College of Dentistry, New York, New York.
authors: Thuan T
authors: TT
authors: Nguyen
authors: New York University College of Dentistry, New York, New York.
authors: Jeffery
authors: J
authors: Albert
authors: New York University College of Dentistry, New York, New York.
authors: Abdulaziz S
authors: AS
authors: Abu-Melha
authors: New York University College of Dentistry, New York, New York.
authors: Louis M
authors: LM
authors: Lin
authors: New York University College of Dentistry, New York, New York. Electronic address: jlg15@nyu.edu.
authors: Jennifer L
authors: JL
authors: Gibbs
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; D015331:Cohort Studies; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018919:Neovascularization, Physiologic / Q000502:physiology; D010087:Oxides / Q000627:therapeutic use; D010146:Pain / Q000209:etiology; D010865:Pilot Projects; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D018915:Root Canal Preparation / Q000379:methods; D012390:Root Canal Therapy / Q000379:methods*; D017640:Silicates / Q000627:therapeutic use; D019227:Tooth Apex / Q000000981:diagnostic imaging*; D014073:Tooth Bleaching / Q000379:methods; D014075:Tooth Discoloration / Q000209:etiology; D014082:Tooth Fractures / Q000209:etiology; D014092:Tooth Root / Q000000981:diagnostic imaging; D019553:Tooth, Nonvital / Q000000981:diagnostic imaging / 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; D017640:Silicates; C086631:mineral trioxide aggregate; D002126:Calcium Hydroxide
keywords: Apexification; clinical outcomes; clinical success; endodontics; maturogenesis; radiographic outcomes; radiographic root area; regenerative endodontics; revascularization