Is Etiology a Key Factor for Regenerative Endodontic Treatment Outcomes?

J Endod. 2023 Aug;49(8):953-962. doi: 10.1016/j.joen.2023.05.021. Epub 2023 Jun 5.

Abstract

Introduction: This study aimed to evaluate treatment outcomes of regenerative endodontic treatment (RET) in nonvital immature permanent teeth due to developmental malformation and trauma, and to analyze the influence of etiology on the prognosis.

Methods: Fifty-five cases were included and divided into a malformation group (n = 33) and a trauma group (n = 22). Treatment outcomes were classified as healed, healing, and failure. Root development was evaluated in terms of root morphology and the percentage changes in root length, root width, and apical diameter during a follow-up period of 12-85 months (mean 30.8 months).

Results: The mean age and the mean degree of root development in the trauma group were significantly younger than that in the malformation group. The success rate of RET was 93.9% (81.8% healed, 12.1% healing) in the malformation group and 90.9% (68.2% healed, 22.7% healing) in the trauma group, showing no statistically significant difference. The proportion of type I-III root morphology in the malformation group (97%, 32/33) was significantly higher than that in the trauma group (77.3%, 17/22) (P < .05), whereas there was no significant difference in the percentage changes of root length, root width, and apical diameter between the 2 groups. Six cases (6/55, 10.9%) showed no significant root development (type IV-V) (1 in the malformation group and 5 in the trauma group). Six cases (6/55, 10.9%) revealed intracanal calcification.

Conclusions: RET achieved reliable outcomes regarding the healing of apical periodontitis and continued root development. The etiology seems to influence the outcome of RET. Malformation cases presented with a better prognosis than trauma cases after RET.

Keywords: Developmental malformation; dens evaginatus; immature permanent teeth; regenerative endodontics; trauma.

MeSH terms

  • Dental Pulp Necrosis / therapy
  • Humans
  • Periapical Periodontitis* / therapy
  • Regenerative Endodontics*
  • Root Canal Therapy / adverse effects
  • Treatment Outcome
  • Wound Healing