Outcome of Guided Pulpal Regeneration in Immature Molar Teeth with Chronic Apical Abscess: A Case Report and Mini-Review
-
Mohammad Mahdi Kiafar
,
Farzaneh Afkhami
,
Sholeh Ghabraei
,
Ove A Peters
,
Chun Xu
,
Seyyed Ali Abaee
Abstract
This case report describes guided pulpal regeneration (GPR) of two immature permanent molar teeth with chronic apical abscess, thin dentinal walls, and open apices. Both teeth were treated with an identical protocol in two sessions, with minimum instrumentation with hand files, irrigation with 1.5% sodium hypochlorite (NaOCl), and application of 1:1 mixture of ciprofloxacin and metronidazole as an intracanal medicament, blood clot as a scaffold, and mineral trioxide aggregate (MTA) as the capping material. At the one-year follow-up, both treated teeth were asymptomatic. However, the root development procedure was different even in different roots of the same tooth, varying from only an increased thickness of dentinal walls to complete closure of the apex along with an increase in root length and dentinal wall thickness. It is concluded that the outcome of GPR is not completely predictable, and may vary among teeth with similar initial conditions and treatment approaches.
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10. Glynis A, Foschi F, Kefalou I, Koletsi D, Tzanetakis GN. Regenerative Endodontic Procedures for the Treatment of Necrotic Mature Teeth with Apical Periodontitis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Endod. 2021 Jun;47(6):873-882.
11. Koç S, Del Fabbro M. Does the Etiology of Pulp Necrosis Affect Regenerative Endodontic Treatment Outcomes? A Systematic Review and Meta-analyses. J Evid Based Dent Pract. 2020 Mar;20(1):101400.
12. Hu X, Wang Q, Ma C, Li Q, Zhao C, Xiang K. Is Etiology a Key Factor for Regenerative Endodontic Treatment Outcomes? J Endod. 2023 Aug;49(8):953-962.
13. Tang Q, Jin H, Lin S, Ma L, Tian T, Qin X. Are platelet concentrate scaffolds superior to traditional blood clot scaffolds in regeneration therapy of necrotic immature permanent teeth? A systematic review and meta-analysis. BMC Oral Health. 2022 Dec 9;22(1):589.
14. Panda P, Mishra L, Govind S, Panda S, Lapinska B. Clinical Outcome and Comparison of Regenerative and Apexification Intervention in Young Immature Necrotic Teeth-A Systematic Review and Meta-Analysis. J Clin Med. 2022 Jul 5;11(13):3909.
15. Fang Y, Wang X, Zhu J, Su C, Yang Y, Meng L. Influence of Apical Diameter on the Outcome of Regenerative Endodontic Treatment in Teeth with Pulp Necrosis: A Review. J Endod. 2018 Mar;44(3):414-431.
16. Almutairi W, Al-Dahman Y, Alnassar F, Albalawi O. Intracanal calcification following regenerative endodontic treatment: a systematic review and meta-analysis. Clin Oral Investig. 2022 Apr;26(4):3333-3342.
2. Chaniotis A. Treatment Options for Failing Regenerative Endodontic Procedures: Report of 3 Cases. J Endod. 2017 Sep;43(9):1472-1478.
3. Justin MR, Patil PN, Sarda AS, Darade LD, Zanjad SR, Bowlekar R. Review on regenerative endodontics: Past concepts, current protocols and future strategies. IP Indian J Conserv Endod. 2021 Dec 15;6(4):205-11.
4. Asgary S, Parhizkar A, Samiei M. Management of an infected immature tooth with a talon cusp using regenerative endodontic treatment: A case report. J Clin Pediatr Dent. 2022 Nov;46(6):45-49.
5. Sachdeva GS, Sachdeva LT, Goel M, Bala S. Regenerative endodontic treatment of an immature tooth with a necrotic pulp and apical periodontitis using platelet-rich plasma (PRP) and mineral trioxide aggregate (MTA): a case report. Int Endod J. 2015 Sep;48(9):902-10.
6. Asgary S, Fazlyab M, Nosrat A. Regenerative Endodontic Treatment versus Apical Plug in Immature Teeth: Three-Year Follow-Up. J Clin Pediatr Dent. 2016;40(5):356-60.
7. Yoshpe M, Kaufman AY, Lin S, Ashkenazi M. Regenerative endodontics: a promising tool to promote periapical healing and root maturation of necrotic immature permanent molars with apical periodontitis using platelet-rich fibrin (PRF). Eur Arch Paediatr Dent. 2021;22(3):527-34.
8. Galler KM, Krastl G, Simon S, Van Gorp G, Meschi N, Vahedi B, Lambrechts P. European Society of Endodontology position statement: Revitalization procedures. Int Endod J. 2016 Aug;49(8):717-23.
9. Chrepa V, Joon R, Austah O, Diogenes A, Hargreaves KM, Ezeldeen M, et al. Clinical Outcomes of Immature Teeth Treated with Regenerative Endodontic Procedures-A San Antonio Study. J Endod. 2020 Aug;46(8):1074-1084.
10. Glynis A, Foschi F, Kefalou I, Koletsi D, Tzanetakis GN. Regenerative Endodontic Procedures for the Treatment of Necrotic Mature Teeth with Apical Periodontitis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Endod. 2021 Jun;47(6):873-882.
11. Koç S, Del Fabbro M. Does the Etiology of Pulp Necrosis Affect Regenerative Endodontic Treatment Outcomes? A Systematic Review and Meta-analyses. J Evid Based Dent Pract. 2020 Mar;20(1):101400.
12. Hu X, Wang Q, Ma C, Li Q, Zhao C, Xiang K. Is Etiology a Key Factor for Regenerative Endodontic Treatment Outcomes? J Endod. 2023 Aug;49(8):953-962.
13. Tang Q, Jin H, Lin S, Ma L, Tian T, Qin X. Are platelet concentrate scaffolds superior to traditional blood clot scaffolds in regeneration therapy of necrotic immature permanent teeth? A systematic review and meta-analysis. BMC Oral Health. 2022 Dec 9;22(1):589.
14. Panda P, Mishra L, Govind S, Panda S, Lapinska B. Clinical Outcome and Comparison of Regenerative and Apexification Intervention in Young Immature Necrotic Teeth-A Systematic Review and Meta-Analysis. J Clin Med. 2022 Jul 5;11(13):3909.
15. Fang Y, Wang X, Zhu J, Su C, Yang Y, Meng L. Influence of Apical Diameter on the Outcome of Regenerative Endodontic Treatment in Teeth with Pulp Necrosis: A Review. J Endod. 2018 Mar;44(3):414-431.
16. Almutairi W, Al-Dahman Y, Alnassar F, Albalawi O. Intracanal calcification following regenerative endodontic treatment: a systematic review and meta-analysis. Clin Oral Investig. 2022 Apr;26(4):3333-3342.
| Issue | Vol 23 (Continuously Published Article-Based) | |
| Section | Case Report | |
| Keywords | ||
| Apexification Dental Pulp Necrosis Guided Tissue Regeneration Outcome Assessment Health Care Periapical Abscess Regenerative Endodontics | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Kiafar MM, Afkhami F, Ghabraei S, Peters OA, Xu C, Abaee SA. Outcome of Guided Pulpal Regeneration in Immature Molar Teeth with Chronic Apical Abscess: A Case Report and Mini-Review. Front Dent. 2026;23.
