A prospective clinical study of regenerative endodontic treatment of traumatised immature teeth with necrotic pulps using bi-antibiotic paste

Abstract

Aim

To evaluate the treatment outcomes of a revitalisation endodontic technique (RET) for the management of traumatised immature teeth with necrotic pulps in children.

Methodology

Fifteen healthy children (age range=7-10 years) with traumatised immature maxillary incisors with necrotic pulps treated with bi-antibiotic revitalisation endodontic techniques were prospectively assessed over approximately two years (mean=22 months). One operator undertook all treatments, clinical reviews and standardised radiographic exposures with radiographic analysis being carried out by two calibrated experienced clinicians. Crown colour change was assessed using an objective published methodology. Wilcoxon signed-rank test was used to compare root lengths, root dentinal widths and apical foramen widths over time.

Results

Inter-operator measurement reliability was consistently strong for all measurements. There was no significant difference in root lengths or root dentinal wall widths following RET. A significant difference in apical foramen widths was observed after 2 years (p=0.013) with resolution of clinical signs of infection in all cases. Despite omitting Minocycline and using Portland cement (Non Bismuth containing cement), a noticeable crown colour change (yellower, redder and lighter), as measured by an objective colour measurement system with ΔE=7.39, was recorded. Most patients, however, were satisfied with the aesthetic outcome.

Conclusions

Traumatised immature teeth with necrotic pulps treated with revitalisation endodontic techniques did not demonstrate continuation of root development or dentine formation when assessed by periapical radiographs. However, apical closure and periodontal healing was observed. A measurable change in crown colour (yellower, redder and lighter), with mostly no aesthetic concern to the patients/parents, was also observed.

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