European Journal of Molecular & Clinical Medicine

Endodontic therapy of a tooth with open apex and necrotic pulp presents multiple challenges during treatment. Microbial elimination from chronic lesions makes treatment all the more difficult. Apexification and pulp revascularization are the treatment options available. Apexification with calcium hydroxide has certain disadvantages and mineral trioxide aggregate (MTA) may be considered as a promising alternative.

Apexification aims to induce apical closure of the open root apex with a hard-tissue barrier, against which a root filling can be compacted. Despite the popularity of the apexification procedure, calcium hydroxide therapy has some disadvantages which mainly includes variability of treatment time, unpredictability of apical closure, difficulties with patient follow-up and delayed treatment. Mineral trioxide aggregate (MTA) is a potential apical barrier material with goodsealability and a high degree of biocompatibility. The present case report demonstrates the placement of an apical barrier using MTA along with conventional root canal treatment.

Aim:The present study was conducted evaluate the efficacy of revascularization procedures
for the management of traumatized immature, nonvital, infected permanent teeth.
Materials & Methods:24 adult patients age ranged 13-24 years of both genders with
immature necrotic permanent teeth were classified into 3 groups of 8 each. Group I used
platelet rich fibrin (PRF). Group II used blood clot and group III used sterile collagensponge
scaffold. Patients were recalled regularly and clinical and radiographic evaluation was
performed at 6 months and at 1 year.
Results:In group I, 20% teeth had good and 80% had excellent healing, in group II, 20% had
fair, 50% had good and 30% had excellent healing and in group III, 70% had good and 30%
had excellent healing. In group I, 90% teeth had fair and 10% had good root lengthening, in
group II, 20% had fair and 80% had good root lengthening and in group III, 71% had fair and
29% had good root lengthening. None of the group had excellent root lengthening. Apical
closure was good in 40% and excellent in 60% in group I, good in 25% and excellent in 75%
in group II and fair in 30%, good in 30% and excellent in 60% in group III. Dentinal wall
thickening in group I was fair in 30% and good in 70%, in group II, 50% had fair and 50%
had good and in group III, 30% had fair, 50% had good and 20% had excellent response.
Conclusion:Authors found that PRF and collagen was superior than blood clot in terms of
apical closure and healing. Regenerative healing with different scaffolds is useful method of
preserving immature non- vital permanent teeth.