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- Title
Regenerative Endodontic Procedure on an Immature Necrotic Molar: A Case Report with a 5-Year Review.
- Authors
Almalki, Majed A.
- Abstract
Patient: Female, 7-year-old Final Diagnosis: Necrotic pulp and asymptomatic apical periodontitis Symptoms: No symptoms • asymptomatic Clinical Procedure: Regenerative endodontic procedure Specialty: Dentistry Objective: Unusual or unexpected effect of treatment Background: The regenerative endodontic procedure (REP) for managing necrotic immature permanent teeth has the advantage of promoting root growth over the traditionally used apexification techniques. However, there is limited evidence on the long-term outcome of standardized REPs performed on immature molars. This case report presents the 5-year clinical and radiographic outcomes of REP performed on an immature mandibular first molar. Case Report: A healthy 7-year-old girl with a carious right mandibular first molar was referred to the endodontic clinic for evaluation and treatment. Clinical examination showed large occlusal caries, no tenderness to palpation and percussion tests, and no response to cold and electric pulp tests. Radiographic examination showed deep caries, apical radiolucency related to the open apices, and wide root canal space. Accordingly, the tooth was diagnosed with necrotic pulp and asymptomatic apical periodontitis. The REP was performed following the American Association of Endodontics guidelines, which comprise minimal instrumentation, disinfection with sodium hypochlorite irrigant, use of triple antibiotic paste, induced intracanal bleeding, and application of a coronal mineral trioxide aggregate plug. The patient missed the scheduled follow-up appointments but presented at the clinic 5 years later with an asymptomatic tooth. Clinical and radiographic examination revealed no tenderness to percussion and palpation test, no response to cold test, positive response to electric pulp test, apical healing, apical closure, root lengthening, and canal wall thickening and calcification. Conclusions: While true pulp regeneration is unachievable, the REP, following the current protocol, is clinically successful in achieving root maturation and tooth retention.
- Subjects
REGENERATION (Biology); ENDODONTICS; TOOTH roots; DENTAL specialties; MOLARS; PERIODONTITIS; MOLAR pregnancy
- Publication
American Journal of Case Reports, 2024, Vol 25, p1
- ISSN
1941-5923
- Publication type
Case Study
- DOI
10.12659/AJCR.944179