Advances in Revascularization of Young Permanent Teeth

Abstract

Treatment of immature permanent teeth with a necrotic pulp or an irreversible pulp inflammation have for long been limited to the creation of an apical calcified barrier to permit a correct apical seal thus arresting the tooth in its development stage. Revascularization has the potential to stimulate root development continuation. Objectives: Compare the different protocols available through the analysis of short and long term outcomes. Materials and methods: Research of scientific articles was conducted using PubMed for the period 2001 to 2021 using the following keywords: “pulp revascularization”, “pulp revitalization”. Case Studies (conducted on humans) from those articles were selected, analysed and organized in different tables. Results: Over the 142 analysed teeth, apexogenesis was observed in 84.5% of the cases, increase in root length in 50%, increase in root width in 63.4% and apical closure in 61.3%. Discussion: The etiology for the pathology was mainly trauma and nearly all the teeth presented with necrosis and periapical affectation. The protocols used were very different as were the results. It appeared that the successful outcomes of revascularization were not influenced by the protocols. Conclusion: The conducted systematic review established the potential of revascularization to promote increase in root length, increase in root thickness and apical closure. Comparing several protocols for revascularization and looking at the results did not allow to deduct the best one. The outcome revealed not to be predictable and not to depend on the protocol used.