Apexification with Calcium Hydroxide vs. Revascularization

Abstract

Treatment of necrotic immature teeth has always been a real challenge for the clinician due to the open apex and weak root structure, which does not allow a conventional endodontic treatment. Several therapeutic options are possible to treat those teeth. Calcium hydroxide apexification is the oldest and most studied therapeutic option, but it has some disadvantages, including the long term of treatment, the possibility of reinfection, and the weakness of the wall. To solve these problems, several authors recommend the revascularization technique. This therapy allows the continuation of root edification with apical closure and thickening of the walls. The aim of our work is to compare the two therapeutic procedures, apexification with calcium hydroxide and revascularization, through a clinical case treated and followed up for 24 months at the pediatric dentistry department in Casablanca, Morocco.

The Differences of the Calcium Hydroxide and the Mineral Trioxide Aggregate in the Apical Closure of Immature, Non-Vital Permanent Teeth

“…(Hargreaves, 2013). The characteristics of odontoblasts (dentin) can be altered by calcium hydroxide, which makes these teeth more susceptible to root fracture (Sam L.Kahler BBio MedSc, 2018) (Hargreaves, 2013) (Martin Brüsehaber, 2016) (Demirci, 2020) MTA is a one-step method, which is the primary benefit of MTA material, and is gradually taking the place of the conventional use of calcium hydroxide to achieve apexification (Purra, 2016) (Yadav, 2015) (Boufdil, 2020). MTA has emerged as an effective, dependable choice to manage open apexes (G. Kandemir Demirci e. a., 2020).…”

Apicificação em dente imaturo traumatizado com fratura corono-radicular: relato de caso

“…O MTA vem sendo utilizado com grande frequência na técnica imediata por se constituir de um material com citotoxicidade mínima, baixo grau de inflamação, indução de tecido duro nos tecidos periodontais e capacidade superior de vedação através de adaptação marginal aprimorada, além de um menor tempo de tratamento requerido (Boufdil, Mtalsi, El Arabi & Bousfiha, 2020;Damle et al, 2016;Shaik et al, 2021). As desvantagens do MTA estão relacionadas à ausência de reforço das paredes dentinárias, seu alto custo, possibilidade de escurecimento dentário, facilidade de manipulação diminuída em relação ao hidróxido de cálcio, além da pequena quantidade de estudos que avaliam seu comportamento à longo prazo em dentes permanentes jovens (Boufdil, Mtalsi, El Arabi & Bousfiha, 2020;Kandemir Demirci, Kaval, Güneri & Çalışkan, 2020;Lin et al, 2016;Refaei, Jahromi & Moughari, 2020).…”

Regeneration of the Pulp Tissue: Cell Homing versus Cell Transplantation Approach: A Systematic Review

“…Even though the success rates of apexification are relatively high (between 74% and 100%) [ 6 ], there are some disadvantages to this technique [ 6 ]. First, there is no continued root development of the immature tooth, and the dentin walls remain thin and thus at risk for fracture and failure [ 6 , 7 ]. Second, the patient needs to come back for many appointments [ 7 , 8 ].…”

“…First, there is no continued root development of the immature tooth, and the dentin walls remain thin and thus at risk for fracture and failure [ 6 , 7 ]. Second, the patient needs to come back for many appointments [ 7 , 8 ]. Because of the long treatment period, the tooth is at risk for reinfection [ 9 ].…”