title: Clinical and radiographic outcomes of traumatized immature permanent necrotic teeth after revascularization/revitalization therapy.
abstract: BACKGROUND
  Revascularization treatment is rapidly becoming an accepted treatment alternative for the management of endodontic pathology in immature permanent teeth with necrotic dental pulps. However, the success and timing of clinical resolution of symptoms, and radiographic outcomes of interest, such as continued hard tissue deposition within the root, are largely unknown.
  
  
  METHODS
  In this prospective cohort study, 20 teeth were treated with a standardized revascularization treatment protocol and monitored for clinical and radiographic changes for 1 year. Standardized radiographs were collected at regular intervals, and radiographic changes were quantified.
  
  
  RESULTS
  All 20 treated teeth survived during the 12-month follow-up period, and all 20 also met the clinical criteria for success at 12 months. As a group, the treated teeth showed a statistically significant increase in radiographic root width and length and a decrease in apical diameter, although the changes in many cases were quite small (such that the clinical significance is unclear). The within-case percent change in apical diameter after 3 months was 16% and had increased to 79% by 12 months, with 55% (11/20) showing complete apical closure. The within-case percent change in root length averaged less than 1% at 3 months and increased to 5% at 12 months. The within-case percent change in root thickness averaged 3% at 3 months and 21% at 12 months.
  
  
  CONCLUSIONS
  Although clinical success was highly predictable with this procedure, clinically meaningful radiographic root thickening and lengthening are less predictable after 1-year of follow-up. Apical closure is the most consistent radiographic finding.
authors.affiliation: Faculty of Dentistry, Department of Endodontics, University of Benghazi, Benghazi, Libya.
authors.forename: Tarek Mohamed A
authors.initials: TM
authors.lastname: Saoud
authors.affiliation: Faculty of Dentistry, Department of Endodontics, Alexandria University, Alexandria, Egypt.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Zaazou
authors.affiliation: Faculty of Dentistry, Department of Endodontics, Alexandria University, Alexandria, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Nabil
authors.affiliation: Faculty of Dentistry, Department of Endodontics, Alexandria University, Alexandria, Egypt.
authors.forename: Sybel
authors.initials: S
authors.lastname: Moussa
authors.affiliation: Department of Endodontics, College of Dentistry, New York University, New York, New York.
authors.forename: Louis M
authors.initials: LM
authors.lastname: Lin
authors.affiliation: Department of Endodontics, College of Dentistry, New York University, New York, New York. Electronic address: jlg15@nyu.edu.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Gibbs
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D056624:Apexification / Q000379:methods*; D001777:Blood Coagulation; D002648:Child; D002939:Ciprofloxacin / Q000627:therapeutic use; D015331:Cohort Studies; D003782:Dental Pulp / Q000293:injuries*; D003789:Dental Pulp Exposure / Q000628:therapy; D003790:Dental Pulp Necrosis / Q000628:therapy; D003791:Dental Pulp Test; D003804:Dentin / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008911:Minocycline / Q000627:therapeutic use; D010486:Periapical Tissue / Q000473:pathology; D011446:Prospective Studies; D011859:Radiography; D018915:Root Canal Preparation / Q000295:instrumentation / Q000379:methods; D019227:Tooth Apex / Q000000981:diagnostic imaging* / Q000473:pathology; D014092:Tooth Root / Q000000981:diagnostic imaging* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D002939:Ciprofloxacin; D008911:Minocycline
keywords: Clinical outcomes; clinical research; endodontic outcomes; prospective cohort study; radiographic outcomes; regenerative endodontics; revascularization; revitalization