Radiographic differences observed following apexification vs revascularization in necrotic immature molars and incisors: a follow-up study of 18 teeth

Abstract

Purpose To evaluate the effectiveness of apexification versus revascularization in the treatment of necrotic immature teeth and determine which strategy affords the greatest radiological success rate. Methods An analysis was made of 18 teeth subjected to mineral trioxide aggregate (MTA) apical plugging and regenerative endodontic treatment, assessing healing of the apical lesions and the changes in root dimensions. Results Significantly greater root growth was observed with revascularization in terms of the percentage change in length (12.75% at 6 months) and dentin thickness (34.57% at 6 months) (p < 0.05). There were no significant differences between the two treatments in terms of the apical healing scores after 6 months of follow-up (p > 0.05). Conclusion Apexification with an MTA apical plug and pulp regeneration are reliable treatments for non-vital immature teeth. The radiographic outcomes are comparable between the immature teeth subjected to MTA apexification versus those subjected to revascularization. The results of the present study indicate a greater increase in root length and width with regenerative endodontic treatment.

Clinical Outcome and Comparison of Regenerative and Apexification Intervention in Young Immature Necrotic Teeth—A Systematic Review and Meta-Analysis

“…Eighteen articles [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] evaluated the clinical outcome of regenerative endodontic procedures (REP) and five articles [34][35][36][37][38] on the apexification procedure. Only nine articles [39][40][41][42][43][44][45][46][47] evaluated and compared the clinical outcome between regeneration and apexification procedure. MTA coronal barrier was sealed with a thin GI base, and final coronal restorations were placed at the same visit using acid etch composite resin.…”

“…Nine articles [39][40][41][42][43][44][45][46][47] compared the outcome between regeneration and apexification procedure, of which two articles [39,40] were RCTs, and seven articles [41][42][43][44][45][46][47] were NRCTs. In the RCTs, a total of 133 participants and 133 teeth were included.…”

“…Among fourteen NRCTs, four studies [29][30][31][32] investigated clinical outcome of the revascularization procedure, three studies [36,38] were on apexification and seven studies [41][42][43][44][45][46][47] compared regeneration versus apexification…”

“…In apexification NRCTs, one study [37] was assessed to be at moderate risk of bias and two studies [36,38] were assessed to be at serious risk. In regeneration versus apexification NRCTs, one study [47] was assessed to be a low risk of bias, five studies [42][43][44][45][46] were assessed to be a moderate risk, and one study [41] was at serious risk.…”

Comparison of Mineral Trioxide Aggregate and Biodentine for Open Apex Management in Children with Nonvital Immature Permanent Teeth: A Systematic Review

“…22,23 The root dentin thickened, the root length increased, and the vitality (sensitivity) was restored. [24][25][26] A vast diversity of materials have been used to induce apical barrier formation for the past two decades like calcium hydroxide, resorbable ceramic, freeze-dried cortical bone, freeze-dried dentin, dentinal shavings, mineral trioxide aggregate (MTA), bone morphogenetic protein, and biodentine. 4,27 Calcium hydroxide was first introduced by Kaiser for apical closure which was later popularized by Frank.…”