Clinical Outcomes of Immature Teeth Treated with Regenerative Endodontic Procedures—A San Antonio Study |
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| Institution: | 1. Department of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas;2. Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia;3. OMFS IMPATH Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial surgery, University Hospitals Leuven, Leuven, Belgium;1. Department of Oral Health Sciences, Endodontology, Katholieke Universiteit Leuven, Leuven, Belgium;4. Department of Oral Health Sciences, Orthodontics, Katholieke Universiteit Leuven, Leuven, Belgium;6. Department of Translational Cell and Tissue Research, Katholieke Universiteit Leuven, Leuven, Belgium;2. Biomaterials, BIOMAT, Leuven, Belgium;3. Laboratory of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium;1. Advanced Specialty Education Programs in Endodontics, School of Dentistry, Loma Linda University, Loma Linda, California;2. Department of Endodontics, UCLA School of Dentistry, Los Angeles, California;3. Department of Advanced Oral Sciences and Therapeutics, Division of Endodontics, School of Dentistry, University of Maryland, Baltimore, Baltimore, Maryland;4. Advanced Specialty Education Programs in Oral and Maxillofacial Surgery, School of Dentistry, Loma Linda University, Loma Linda, California;1. Section of Endodontics, Division of Constitutive and Regenerative Sciences, UCLA School of Dentistry, Los Angeles, California;2. Dankook University, School of Dentistry, Cheonan, South Korea;3. Yonsei University, School of Dentistry, Seoul, Korea;4. Seoul National University, School of Dentistry, Seoul, Korea;1. Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand;2. Department of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas;1. University of Queensland School of Dentistry, Brisbane, Australia;2. Kingston Oral Health Centre, Brisbane, Australia;3. Department of Restorative Services, College of Dentistry, University of Kuwait, Kuwait City, Kuwait;4. Institute for Molecular Bioscience and ARC Centre for Engineered Quantum Systems, University of Queensland, Brisbane, Australia |
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| Abstract: | IntroductionFactors that influence clinical outcomes for regenerative endodontic procedures (REPs) are unknown. This retrospective study aimed to assess tooth healing, root development, pulp vitality, and esthetics post-REPs and categorize them into clinician- and patient-centered outcomes. Furthermore, this study identified significant predictors affecting such outcomes.MethodsImmature permanent teeth diagnosed with pulp necrosis treated with REPs between 2008 and 2018 with a minimum of 1-year follow-up were included. Outcomes included success and survival rates, changes in root development using 2-dimensional radiographic root area (RRA) and 3-dimensional measurements, pulp vitality, and tooth discoloration. Predictor variables of success included age, sex, etiology of pulp necrosis (PN), type of medicament, sodium hypochlorite (NaOCl) concentration, type of biomaterial used over the blood clot, and preoperative apical diagnosis. Statistical analyses included Cox proportional hazard analyses and generalized regression models.ResultsFifty-one teeth with an average of 2.1 years of follow-up satisfied the criteria. The survival rate was 92%. The success rate was 84.3% with age, etiology of PN, type of medicament, and NaOCl concentration being significant predictors of failure. Root development occurred in 91.4% of cases with age, sex, etiology of PN, type of medicament, NaOCl concentration, and apical diagnosis being significant predictors for RRA change. Positive pulp sensibility responses were associated with greater RRA change, and, finally, the type of biomaterial was a significant predictor for tooth discoloration after treatment.Conclusions: REPs provide a high survival rate. Patient and clinical factors may affect outcomes, and this knowledge may help to define the criteria for optimal treatment planning of REPs. |
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| Keywords: | Radiographic root area retrospective regenerative endodontics root development success survival volumetric analysis |
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