Evaluation of root maturation after revitalization in immature permanent teeth with nonvital pulps by cone beam computed tomography and conventional radiographs.
OBJECTIVE
To investigate the response of immature permanent teeth with nonvital pulps after revitalization procedures using cone beam computed tomography imaging and conventional radiograph.


METHODS
Clinical records of patients who had undergone revitalization between 1997 and 2014 were collected. Seventeen patients attended the follow-up examination. Clinical examination and radiographic examination by means of CBCT imaging and conventional radiographs were conducted to evaluate treatment outcomes, especially the dimensional changes of the root and the pattern of root maturation. Statistical analysis was conducted using Fisher's exact test and Monte Carlo test to investigate the effect of potential outcome predictors.


RESULTS
For the follow-up period as far as 96 months, thirteen teeth (76%) were classified as a 'success'. Conventional radiographs showed various degrees of dimensional changes in the immature roots ranging from 0% to 73% changes. The mean percentage changes of root length and root wall thickness were 14.38 ± 20.92% and 13.82 ± 11.17%, respectively. CBCT images illustrated various patterns of root maturation including incomplete root development with wide-open apices and fully formed roots with various apical shapes. Root canal contents varied radiographically from empty canals to many degrees of unpredictable patterning of radiopaque deposits.


CONCLUSIONS
Revitalization in immature teeth with nonvital pulps resulted in unpredictable responses in terms of continued root development. Various types of root maturation and root canal contents were observed radiographically, which were different from typical root development.
Department of Restorative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
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Linsuwanont
Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
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Sinpitaksakul
Department of Restorative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
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T
Lertsakchai
D000293:Adolescent; D002648:Child; D054893:Cone-Beam Computed Tomography; D019229:Dentition, Permanent; D005260:Female; D006801:Humans; D008297:Male; D011861:Radiography, Dental; D012038:Regeneration; D012390:Root Canal Therapy; D014092:Tooth Root / Q000000981:diagnostic imaging / Q000254:growth & development* / Q000473:pathology; D019553:Tooth, Nonvital / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult
cone beam computed tomography; continued root development; immature permanent teeth with nonvital pulp; revitalization