Apice closure in Pulp Revascularization Therapy. Case report and literature review

Background: Endodontic Regenerative Procedures, especially pulp revascularization therapy, have become a real option for the treatment for immature permanent teeth with open apices. This sort of approach has saved many teeth that otherwise would have been extracted. The technique is simple and effective, and can be accomplished by any odontologist. Objective: This article aimed to make a literature review to give support for a case report of an Endodontic Regenerative Procedure of a twelve-year-old male patient with immature open apice of tooth 21. Methodology: Articles were researched concerning pulp revascularization to reach root end formation. On line searches were accomplished, whose database include BVS/BIREME, Web of Science, PUBMED Central, Science Direct, Higher Level Personnel Improvement Coordinator (CAPES), The Cochrane Library, and PROSPERO). Results: the articles researched showed that Endodontic Regenerative Procedures are efficient in stimulating root end formation. The case report described matched the results offered by the articles, showing an immature open apice tooth that had its root end completely formed after pulp revascularization therapy. Conclusion: Pulp revascularization therapy is an efficient and practical treatment for immature teeth with open apices.

Mechanisms Involved in Apice Closure of Pulpless Teeth – Literature Review

Background: Unfinished root formation has always offered challenges in endodontics due to technical difficulties and weakened teeth resistance during the lifetime of an individual. Pulp revascularization therapy appeared as a solution for apical closure and root maturation. The existence of oral stem cells involved in the process associated with traditional resident cells requires adequate blood supply given by induced controlled injury deliberately accomplished into the periapical zone. Objective: The aim of this work was to research, through literature review, the main mechanisms involved in the process of apical closure through the technique of pulp revascularization. Conclusion: Apice closure in pulpless teeth seems to happen as a result of professional intervention and biological activity. The success rate depends on the role of traditional local immune cells and stem cells associated with adequate blood supply to finish root formation.

Observation of apexification and pulp revascularization results of non-vital human immature mandibular premolar

This article describes different results of two methods in treating non-vital human immature mandibular premolar, including the histologic findings of a human immature mandibular premolar with apexification treatment in an 8-year follow-up and the radiographic results of pulp revascularization treatment in a 2-year follow-up.

Different Approaches to the Regeneration of Dental Tissues in Regenerative Endodontics

(1) Background: The regenerative procedure has established a new approach to root canal therapy, to preserve the vital pulp of the tooth. This present review aimed to describe and sum up the different approaches to regenerative endodontic treatment conducted in the last 10 years; (2) Methods: A literature search was performed in the PubMed and Cochrane Library electronic databases, supplemented by a manual search. The search strategy included the following terms: “regenerative endodontic protocol”, “regenerative endodontic treatment”, and “regenerative endodontics” combined with “pulp revascularization”. Only studies on humans, published in the last 10 years and written in English were included; (3) Results: Three hundred and eighty-six potentially significant articles were identified. After exclusion of duplicates, and meticulous analysis, 36 case reports were selected; (4) Conclusions: The pulp revascularization procedure may bring a favorable outcome, however, the prognosis of regenerative endodontics (RET) is unpredictable. Permanent immature teeth showed greater potential for positive outcomes after the regenerative procedure. Further controlled clinical studies are required to fully understand the process of the dentin–pulp complex regeneration, and the predictability of the procedure.

Maturogenesis by Pulp Revascularization in an Immature Necrotic Permanent Tooth in a Pediatric Patient: A 15 Month Follow-up Case Report

Endodontic treatment of immature necrotic permanent teeth is clinically challenging and poses a risk of inducing dentin wall fracture or extending gutta-percha into the periapical tissue during root canal filling. Pulp revascularization is a promising alternative for the treatment of such immature necrotic permanent teeth offering great potential to avoid the need for traditional apexification with calcium hydroxide or the need to achieve an artificial apical barrier with mineral trioxide aggregate. Pulp revascularization allows the stimulation of the apical development and the root maturation of immature teeth by physiologically strengthening the canal walls. The present case report describes the case of successful revascularization of the necrotic infected pulp space of an immature permanent maxillary central incisor induced in vivo by stimulation of a blood clot from the periapical tissues into the canal space. Thickening of the canal wall and complete apical closure were confirmed 15 months after the treatment.