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Root canal treatment of immature teeth is always
challenging.
The root canal instrumentation of thin walls
and obturation of the widely-opened apex are complicated.
In addition, risk of vertical root fracture due
to the thin dentine wall may lead to tooth loss.
Traditionally, immature teeth with apical periodontitis
were treated with is calcium hydroxide apexification.
Long term use of calcium hydroxide has a drawback
in weakening of the root dentine. Then, MTA apexification
was been introduced in the past decade to overcome
these complications. MTA is used as an apical
plug and the root canal can be filled and restored
at the following appointment.
However, the change of root fracture remains.
Recently, antibiotics (3Mix-MP) has been introduced
to treat non-vital immature permanent teeth as
regenerative endodontic treatment. Some case series
have been reported, but no clinical research have
been conducted. Our research shows the prevalence
of tooth survival were 77.27%, 97.74% and 100%
for calcium hydroxide apexification, MTA apexification
and regenerative treatment groups respectively.
The regenerative treatment group produced significantly
greater increases in percent changed of root length
and percent changed of dentin thickness than from
the calcium hydroxide apexification and MTA
apexification groups. Moreover, regenerative treatment
showed higher clinical and radiographic success
in the treatment of immature teeth with non-vital
pulp compared with calcium hydroxide apexification
and MTA apexification.
Histology of one case shows vascular tissue
growth in to pulp chamber.
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