A necrotic immature mandibular second premolar with periapical involvement in a 13-year-old patient was treated. Instead of the standard root canal treatment protocol and apexification, antimicrobial agents were used in the canal, after which the canal was left empty. Radiographic examination showed the start of apical closure 5 months after the completion of the antimicrobial protocol. Thickening of the canal wall and complete apical closure was confirmed 30 months after the treatment, indicating the revascularization potential of a young permanent tooth pulp into a bacteria-free root canal space.

An immature permanent mandibular central incisor with periapical involvement in a 7-year-old boy was treated to promote revascularization. The tooth suffered from acute apical periodontitis after periodontal treatment by a general practitioner. An access cavity was prepared in the tooth and the cavity was left open until the next visit to achieve drainage through the canal. The root canal was not mechanically cleaned during the treatment period, but was irrigated with hydrogen peroxide and sodium hypochlorite. Calcium hydroxide compound was used for disinfection. At the fifth visit vital tissue appeared in the canal near the apical region, and calcium hydroxide compound was placed in contact with the soft tissue in the root canal. The access cavity was sealed with glass-ionomer cement followed by an adhesive composite resin filling. Radiographic examination 30 months after the initial treatment confirmed closure of the apex and thickening of the root wall. The case was observed for up to 13 years and root development was confirmed.

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The purpose of this study was to examine the age-related changes in human pulpal blood flow (PBF). Recordings were taken from 22 clinically healthy upper central incisors in 22 healthy participants (age: 8-75 years). A Moor blood flow monitor (type MBF3D) was used to measure PBF; and subjects' electrocardiogram (ECG), mean blood pressure (BP) and heart rate (HR) were also recorded. The resting PBF was significantly decreased with the increased age of the participants (Pearson's correlation coefficient, P < 0.001). The examined tooth crown was briefly(1 s) cooled using a dental coolant, and significant reductions in PBF were induced (one-way repeated measures anova, P < 0.05). The magnitude of the reduction (%) was significantly decreased with the increased age of the participants (Pearson's correlation coefficient, P < 0.05). The findings indicate that the hemodynamics in the human pulp is reduced with age.

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