TREATMENT OUTCOMES OF REGENERATIVE ENDODONTIC THERAPY IN IMMATURE PERMANENT TEETH WITH PULPAL NECROSIS

Abstract

Background: Regenerative endodontic therapy (RET) is emerging as a progressive approach in the management of immature permanent teeth diagnosed with pulpal necrosis. Traditional endodontic treatments, such as apexification, offer limited potential for continued root development in immature teeth. In contrast, RET aims to promote healing by encouraging the revascularization and regeneration of vital tissue, allowing for root maturation.

Objective: This study aims to evaluate the clinical and radiographic outcomes of RET in 215 patients, focusing on its effectiveness in resolving periapical pathologies, supporting root development, and restoring functional vitality. By assessing the outcomes of RET over a defined period, the study provides insight into its clinical success rate and potential limitations.

Methods: A cross-sectional observational study was conducted on a sample of 215 patients, each presenting with a single immature permanent tooth affected by pulpal necrosis. The selected patients ranged in age from 8 to 16 years, and each underwent regenerative endodontic therapy. The treatment protocol involved thorough disinfection of the root canal system, followed by the placement of a biocompatible scaffold material to promote tissue ingrowth. The canals were sealed using mineral trioxide aggregate (MTA), and coronal restoration was completed to ensure an airtight seal. Follow-up evaluations were conducted at 6, 12, and 24 months post-treatment. Clinical assessments included checks for pain, swelling, and other signs of infection, while radiographic assessments focused on periapical healing, root lengthening, and apical closure.

Results: The results of this study are based on hypothetical values. Out of the 215 patients treated with RET, 192 (89%) exhibited complete resolution of periapical radiolucency, indicating successful healing of periapical tissues. Radiographic follow-up showed continued root development in 167 (78%) of the teeth, with observable increases in root length and dentinal wall thickness. A positive response to pulp vitality tests was regained in 132 teeth (61%), suggesting a partial return of functional tissue. Clinically, 200 (93%) of the teeth were deemed successful, with patients reporting no pain, swelling, or signs of infection during the follow-up period. However, 15 patients (7%) experienced complications, such as reinfection or lack of sufficient healing, requiring retreatment or extraction. These findings indicate that RET is generally effective but not without potential challenges in a subset of cases.

Conclusion: This study supports the efficacy of regenerative endodontic therapy for treating immature permanent teeth with pulpal necrosis. The high rates of periapical healing, root development, and clinical success observed suggest that RET can be a viable alternative to traditional apexification procedures.