Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 16, 2023; 11(11): 2567-2575
Published online Apr 16, 2023. doi: 10.12998/wjcc.v11.i11.2567
Different endodontic treatments induced root development of two nonvital immature teeth in the same patient: A case report
Rong Chai, Xiu Yang, An-Sheng Zhang
Rong Chai, Xiu Yang, An-Sheng Zhang, Department of Stomatology, Xi'an International Medical Center Hospital Affiliated to Northwest University, Xi'an 710061, Shaanxi Province, China
Author contributions: Chai R performed the treatment, collected data, and wrote the manuscript; Yang X contributed to data collection; Zhang AS conceived the study, provided financial support, and reviewed the manuscript; and all authors read and approved the manuscript.
Supported by The Natural Science Foundation of Shaanxi Province, China, No. 2022JM-447.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: An-Sheng Zhang, MD, Associate Chief Physician, Department of Stomatology, Xi'an International Medical Center Hospital Affiliated to Northwest University, No. 777 Xitai Road, Hightech District, Xi'an 710061, Shaanxi Province, China. zhang.ansheng@000516.cn
Received: January 20, 2023
Peer-review started: January 20, 2023
First decision: February 20, 2023
Revised: March 1, 2023
Accepted: March 22, 2023
Article in press: March 22, 2023
Published online: April 16, 2023
Abstract
BACKGROUND

Pulp revascularization is a novel way to treat immature teeth with periapical disease, and the technique has become increasingly well established in recent years. By puncturing the periapical tissue, bleeding is induced, and a blood clot is formed in the root canal. The blood clot acts as a natural bioscaffold onto which mesenchymal stem cells from periapical tissue can be seeded and restore pulp vascularity, thus promoting root development as well as apical closure. Although the effect of pulp revascularization is ideal, there are certain requirements for the apical condition of the teeth. The apical barrier technique and apexification are still indispensable for teeth that cannot achieve ideal blood clot formation. In addition, a meta-analysis of several clinical studies concluded that pulp revascularization has no significant advantages over other treatments.

CASE SUMMARY

A 10-year-old girl complained of pain in the right upper and lower posterior teeth for 2 d. Clinical and radiological examinations revealed that both the right maxillary and mandibular second premolars were immature with periapical radiolucency. The right maxillary second premolar was treated by pulp revascularization, while the right mandibular second premolar was treated by conventional apical barrier surgery after revascularization failed. The purpose of this report is to compare the different root maturation processes induced by the pulp revascularization and apical barrier techniques in the same patient in homonymous teeth from different jaws. Twelve months of follow-up showed that the apical foramen of both teeth presented a clear tendency to close; however, the tooth treated with pulp revascularization showed a significant increase in root length as well as root canal wall thickness.

CONCLUSION

For the treatment of nonvital immature teeth, pulp revascularization showed a superior therapeutic effect in comparison with the apical barrier technique.

Keywords: Nonvital immature tooth, Central cusp deformity, Pulp revascularization, Apical barrier technique, Root canal, Case report

Core Tip: This report presents a case where pulp revascularization and the apical barrier technique were performed in the right maxillary and mandibular premolars. Twelve months of follow-up showed that both teeth were asymptomatic; however, the tooth treated with pulp revascularization showed a better outcome in root development.