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doi:10.1111/j.1365-2591.2011.01978.x

CLINICAL ARTICLE

Responses of immature permanent teeth with infected necrotic pulp tissue and apical periodontitis/abscess to revascularization procedures M. Y.-H. Chen1, K.-L. Chen1, C.-A. Chen1, F. Tayebaty2, P. A. Rosenberg2 & L. M. Lin2 1

Department of Endodontics, Chi Mei Medical Center, Yong Kang and Liouying, Tainan, Taiwan; and 2Department of Endodontics, New York University College of Dentistry, New York, NY, USA

Abstract Chen MY-H, Chen K-L, Chen C-A, Tayebaty F, Rosenberg PA, Lin LM. Responses of immature permanent teeth with infected necrotic pulp tissue and apical periodontitis/abscess to revascularization procedures. International Endodontic Journal, 45, 294–305, 2012.

Aim To report several types of response of immature permanent teeth with infected necrotic pulp tissue and either apical periodontitis or abscess to revascularization procedures. Methodology Twenty immature permanent teeth with infected necrotic pulp tissue and either apical periodontitis or abscesses from 20 patients were included. The teeth were isolated with rubber dam, and pulp chambers was accessed through the crowns. The canals were gently irrigated with 5.25% sodium hypochlorite with minimal mechanical debridement. Calcium hydroxide was used as an inter-appointment intracanal medicament and placed into the coronal half of the canal space. After resolution of clinical signs and symptoms, bleeding was induced into the canal space from the periapical tissues using K-files. The coronal canal space was sealed with a mixture of mineral trioxide aggregate (MTA) and saline solution. The access cavity was filled with composite resin. These immature permanent teeth with infected necrotic pulp tissue and apical periodontitis/abscesses were followed up from 6 to 26 months. Results Five types of responses of these immature permanent teeth with infected necrotic pulp tissue and apical periodontitis/abscess to revascularization procedures were observed: type 1, increased thickening of the canal walls and continued root maturation; type 2, no significant continuation of root development with the root apex becoming blunt and closed; type 3, continued root development with the apical foramen remaining open; type 4, severe calcification (obliteration) of the canal space; type 5, a hard tissue barrier formed in the canal between the coronal MTA plug and the root apex.

Correspondence: Dr. Louis M. Lin, Department of Endodontics, New York University, College of Dentistry, 345 East 24th Street, New York, NY 10010, USA (e-mail: Lml7@nyu.edu).

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International Endodontic Journal, 45, 294–305, 2011

ª 2011 International Endodontic Journal


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