REGENERATIVE ENDODONTIC TREATMENT OF IMMATURE PERMANENT TOOTH WITH NECROTIC PULP: CASE REPORT

Abstract

Regenerative endodontic therapy is a treatment approach that aims to restore the functions of the pulp-dentin complex and promote root development in immature teeth with necrotic pulp. This method can potentially reduce the fracture risk in immature teeth by thickening the root canal walls and maintaining root growth. This case report presents a 24-month follow-up of an immature permanent tooth with necrotic pulp treated with a regenerative endodontic approach. As part of the regenerative endodontic treatment protocol, 1.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid were used as irrigation solution, and a dual antibiotic paste (1:1 ciprofloxacin: metronidazole) was applied as intracanal medication. After induction of bleeding into the root canal, a mineral trioxide aggregate was applied as a coronal plug on the formed blood clot, and the tooth was restored with composite material. At the 24-month clinical and radiographic follow-up, it was observed that the tooth responded positively to cold and electric pulp testing, and was not sensitive to percussion/palpation, periapical radiography showed healing of the periapical lesion and increased root growth. In conclusion, regenerative endodontic treatment can be considered a good alternative to traditional apexification treatment, especially in immature permanent teeth, to help thicken the root canal walls and restore the physiologic function of the tooth.

Keywords

• Immature Tooth
• MTA
• Necrotic Pulp
• Regenerative Endodontic Treatment

Regenerative Endodontic Treatment of Immature Permanent Tooth With Necrotic Pulp: Case Report

Abstract

Rejeneratif endodontik tedavi, nekrotik pulpalı immatür dişlerde pulpa-dentin kompleksinin işlevlerini yeniden kazandırmayı ve kök gelişimini desteklemeyi hedefleyen bir tedavi yaklaşımıdır. Bu yöntem, immatür dişlerde kök kanal duvarlarının kalınlaşmasını ve kök gelişiminin devam etmesini sağlayarak kırık riskini azaltma potansiyeline sahiptir. Bu olgu sunumunda, rejeneratif endodontik yaklaşımla tedavi edilen nekrotik pulpalı immatür daimî dişin 24 aylık takibi paylaşılmaktadır. Rejeneratif endodontik tedavi protokolü kapsamında irrigasyon solüsyonu olarak %1,5 sodyum hipoklorit ve %17 etilendiamintetraasetik asit kullanılmış, kanal içi medikaman olarak da ikili antibiyotik patı (1:1 siproflaksasin : metronidazol) uygulanmıştır. Kök kanalı içine doğru kanamanın indüklenmesinin ardından oluşan kan pıhtısı üzerine koronal tıkaç olarak mineral trioksit agregat uygulanmış ve diş kompozit materyal ile restore edilmiştir. 24 aylık klinik ve radyografik takiplerde dişin soğuk ve elektrik pulpa testine pozitif yanıt verdiği, perküsyon/palpasyona duyarlı olmadığı, periapikal radyografide periapikal lezyonun iyileştiği ve kök gelişiminde artış olduğu gözlenmiştir. Sonuç olarak, rejeneratif endodontik tedavi özellikle immatür daimî dişlerde, dişin kök kanal duvarlarının kalınlaşmasına yardımcı olması ve dişin fizyolojik işlevini yeniden kazandırmak amacıyla geleneksel apeksifikasyon tedavisine iyi bir alternatif olarak düşünülebilir.

Keywords

• İmmatür Diş
• MTA
• Nekrotik Pulpa
• Rejeneratif Endodontik Tedavi

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