Revascularization of traumatized immature incisors with different intracanal medicaments

• Published in: International dental journal 2024-10, Vol.74, p.S158-S158
• Main Author: Ulusoy, Nur Burcu
• Format: Article
• Language: English
• ISSN: 0020-6539
• DOI: 10.1016/j.identj.2024.07.1057

Pulp revascularization is the best treatment method to induce root development and thicken dentin walls of immature permanent teeth with necrotic pulp. A variety of medicaments have been used for root canal disinfection in this procedure, including double antibiotic paste (DAP) and Ca(OH). Two patients; Case 1 (8-year-old male) and Case 2 (9-year-old male) were referred to our clinic with a history of trauma to their immature anterior teeth which occurred 4 and 3 weeks ago, respectively. After intraoral and radiographic examinations, in Case 1, a periapical abscess and subgingival crown-root fracture of tooth #32 were detected. In Case 2, complex crown fracture of tooth #21 was assessed. In the first appointment, after root-canal entrance, irrigation with 6% NaOCl followed by 17% EDTA was implemented. Then, in Case 1 coronal root was filled with Ca(OH) (Metapaste, Biomed, USA) for 4 weeks. In Case 2, DAP(metronidazole and ciprofloxacin) was applied for 3 weeks. In the second appointment, after 17% EDTA irrigation and #15 K-file application, blood clots were covered with tricalcium silicate cement (Biodentine, Septodont, USA) in both patients. After 18 months, usual PDL and dentinal wall thickness were assessed in Case 1. In Case 2, root dentin was thickened, however, ankylosis was observed in 2-year follow-up. It is reported that the prognosis of PDL ingrowth and ankylosis results from dental trauma. Nevertheless, DAP may also increase its severity, which at high concentrations has a detrimental effect on the survival of stem cells. In regenerative procedures, intracanal medicaments may have an important role in healing patterns.