Regenerative Endodontic Procedures for Traumatized Immature Permanent Teeth with Severe External Root Resorption and Root Perforation |
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| Institution: | 1. Key Laboratory of Oral Disease, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China;2. Department of Stomatology, Affiliated Hospital of Jining Medical University, Jining, China;3. School of Dentistry, University of Queensland, Brisbane, Australia;4. Department of Endodontics, College of Dentistry, New York University, New York, New York;1. The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;2. Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada;3. Department of Endodontics, University of Alabama at Birmingham, Birmingham, Alabama;1. Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Peking University, Beijing, China;2. Department of Dental Materials, Peking University School and Hospital of Stomatology, Peking University, Beijing, China;3. Dental Medical Devices Testing Center, Peking University School and Hospital of Stomatology, Peking University, Beijing, China;1. Faculty of Dentistry, National University of Singapore, Singapore;2. Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia;3. Guy''s and St Thomas'' NHS Trust, Dental Centre, St Thomas'' Hospital, London, United Kingdom;4. Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom;5. Paediatric Dentistry Department, School of Dentistry, University of Leeds, Leeds, United Kingdom;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. Dental Trauma Program, Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil;2. Department of Statistics-Institute of Exact Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil;3. Department of Dentistry, Pontifical University of Minas Gerais, Belo Horizonte, Brazil |
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| Abstract: | External root resorption (ERR) is often a complication of traumatic injury to the teeth. Traditionally, external inflammatory root resorption is treated with calcium hydroxide. The outcome of ERR, especially replacement resorption, is unpredictable. The purpose of the present case report was to describe regenerative endodontic procedures (REPs) for 1 replanted avulsed tooth with severe external root resorption and root perforation (tooth #9) and 1 extruded tooth (tooth #8). A 9-year-old girl was referred for the treatment of teeth #8 and #9 4 months after the initial trauma. Clinical examination showed that tooth #9 had a sinus tract present near the periapical area, was tender to percussion and palpation, and did not respond to pulp sensibility tests. Tooth #8 responded to pulp sensibility tests. Periapical radiographic and cone-beam computed tomographic examination showed that tooth #9 had a periapical radiolucent lesion and severe ERRs with a root perforation. Tooth #9 was diagnosed with a necrotic pulp and symptomatic apical periodontitis. Regenerative endodontic procedures (REPs) were initiated. Tooth #8 became nonresponsive to pulp sensibility tests and developed a periapical lesion 12 months after REPs of tooth #9 and was also treated with REPs. The clinical symptoms and apical lesions resolved for both teeth after REPs. The severe ERRs were arrested, and root perforation was repaired for tooth #9. Teeth #8 and #9 underwent canal obliteration by hard tissue formation after REPs and were in function at 18 months and 30 months, respectively. REPs may be used to manage traumatized immature permanent teeth with a necrotic pulp and apical periodontitis associated with severe ERR and root perforation. |
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| Keywords: | Avulsion calcium hydroxide external root resorption regenerative endodontic procedures |
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