Revascularization as a Contemporary Method of Root Apex Closure of Teeth with Incomplete Apex Formation (Description of the ClInical Case)

Abstract

Endodontic treatment of permanent teeth with incomplete apex formation is a challenge for both the dentist and the patient. The pulp chamber of this kind of teeth is wide and the apical opening is open. These teeth have thin walls, so there is a high risk of hard tissue fractures and contamination of the tooth cavity. All these factors may have a negative impact on the treatment prognosis.

Nowadays, revascularization is considered a new approach to the treatment of permanent teeth with unformed roots. Revascularization of immature teeth involves the invagination of undifferentiated cells of the periapical area towards the root canal.

A young male patient, 9, received severe mechanical trauma to his chin, lips and anterior teeth while riding a scooter. The patient had alveolar and marginal gingival hyperemia in the area of teeth 1.1 and 2.1, cyanosis, and retrusion of tooth 1.1. Tooth 1.1 was treated using revascularization in full compliance with the treatment protocol.

Six months after treatment, a repeated segmental CT-scan revealed no pathological changes in the periapical tissues. The scan showed restoration of the architectonics of periapical bone tissue and cortical plate of tooth 1.1 as well as apparent ossification of the root and closing of the apical part of the root canal. The root walls were thickened, with clear contours and pronounced integration into the alveolar bone.

A follow-up evaluation of the patient is scheduled a year after the end of the treatment.