Revascularization of Immature Permanent Teeth with Periapical Lesion: Two Case Reports

Pulpal necrosis of an immature tooth caused by caries or trauma may lead to potential complications. Regenerative endodontic procedures are biologically based procedures which deals with the regeneration of pulp like tissue, more idealistically the pulp-dentin complex. These case reports describe the treatment of immature permanent teeth with periapical lesion which were treated with regenerative approach. The root canal was gently debrided of necrotic tissue and irrigated with 2.5% NaOCl, and then medicated with triple antibiotic paste. When the tooth was asymptomatic, bleeding was induced into the canal; blood clot was allowed to form and mineral trioxide aggregate (MTA) was placed over the clot. After 3, 6, 9 and 12 months, radiographical examination revealed resolution of the radiolucency and progressive thickening of the root wall and apical closure. Proper disinfection and use of a suitable scaffold and proper coronal seal led to successful outcome of revascularization in the patients.