Clinical and Radiographic Outcome of Revasclarization of Immature Teeth with Necrotic Pulp Using Calcium Hydroxide and MTA

Background: Dental injuries can lead to harm to the pulp tissue in developing teeth. Revascularization therapy presents a viable treatment option for non-vital, immature permanent teeth that have experienced trauma. This prospective study aimed to assess the radiographic and clinical outcomes of immature teeth with a trauma history that were treated using regenerative endodontic procedures and mineral trioxide aggregate apexification techniques. Methods: This cohort study was conducted at the Dentistry Department of Bolan Medical College, Faculty of Dentistry, from August 21, 2021, to February 22, 2022, of forty-one patients with traumatized immature permanent maxillary incisors was included in this study. The patients were divided into two distinct groups: those who had previously received endodontic treatment and those who had not. The regenerative endodontic protocol group (Group 1) included twenty-four patients who directly approached the clinic and had not undergone endodontic treatment prior. In contrast, seventeen patients who had previously experienced endodontic intervention on their respective teeth were placed in the mineral trioxide aggregate apexification group (Group 2). The follow-up period for the patients extended to 24 months. Clinical success rates were evaluated, and both pretreatment and control radiographs were analyzed to compute the percentage increase in root dentin width and root length. Results: Following a 24-month follow-up period, the majority of cases exhibited positive periapical healing as indicated by the radiographic findings. In Group 1, there was a slight increase in both root length and root dentin width, alongside a noticeable narrowing of the apical opening. The radiographic assessment of two cases, which were accessible 11 years later, underscored the significance of long-term follow-up in evaluating the efficacy of the selected methods. Conclusion: The revascularization technique serves as a treatment alternative that yields favorable outcomes regarding root development in teeth affected by necrotic pulp due to trauma.