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Revitalization-a novel treatment protocol for an immature permanent tooth with chronic apical abscess

Author: 
Tarun Kumar Singh, Rachit Mathur, Deepak Passi, Surender Pal Singh, Jyoti Goyal, Shubha Ranjan Dutta, Purnima Singh and Deepak Bhagat
Subject Area: 
Health Sciences
Abstract: 

A growing body of evidence is demonstrating the possibility for regeneration of tissues within the pulp space and continued root development in teeth with necrotic pulps and open apexes. The immature root with a necrotic pulp and apical periodontitis presents multiple challenges to successful treatment. The purpose of this case report is to present the case of a patient wherein revascularization of the necrotic infected pulp space of an immature permanent maxillary central incisor tooth was induced in vivo by stimulation of a blood clot from the periapical tissues into the canal space. This was achieved after disinfection of the canal space with a topical antibiotic paste followed by a blood clot scaffold induced from the periapical tissues. This treatment approach offers clinicians great potential to avoid the need for traditional apexification with calcium hydroxide or the need to achieve an artificial apical barrier with mineral trioxide aggregate. Furthermore, this treatment approach can help rescue infected immature teeth by physiologically strengthening the root walls.

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