Deciduous pulp tissue implantation into the root canal of mandibular incisor resulted in pulp revascularization: a case report with a 5-year follow-up

J Clin Pediatr Dent. 2024 May;48(3):171-176. doi: 10.22514/jocpd.2024.071. Epub 2024 May 3.

Abstract

To explore a new method to implant deciduous tooth pulp into the canal of young permanent teeth with necrotic pulps and apical periodontitis for the regenerative endodontic treatment of tooth no: 41 in a 7-year-old male. Briefly, 1.5% Sodium Hypochlorite (NaOCl) irrigation and calcium hydroxide-iodoform paste were used as root canal disinfectant at the first visit. After 2 weeks, the intracanal medication was removed, and the root canal was slowly rinsed with 17% Ethylene Diamine Tetraacetic Acid (EDTA), followed by flushing with 20 mL saline and then drying with paper points. Tooth no: 72 was extracted, and its pulp was extracted and subsequently implanted into the disinfected root canal along with induced apical bleeding. Calcium hydroxide iodoform paste was gently placed over the bleeding clot, and after forming a mineral trioxide aggregate (MTA) coronal barrier, the accessed cavities were restored using Z350 resin composite. The root developments were evaluated via radiographic imaging at 6 months, 1 year and 5 years after treatment. Imaging and clinical analysis showed closure of the apical foramen, thickening of the root canal wall, and satisfactory root length growth. Autologous transplantation might be useful to regenerate dental pulp in necrotic young permanent teeth.

Keywords: Autologous transplantation; Deciduous tooth; Pulp; Regeneration.

Publication types

  • Case Reports

MeSH terms

  • Aluminum Compounds* / therapeutic use
  • Calcium Compounds* / therapeutic use
  • Calcium Hydroxide / therapeutic use
  • Child
  • Dental Pulp Cavity
  • Dental Pulp Necrosis / therapy
  • Dental Pulp* / blood supply
  • Drug Combinations
  • Follow-Up Studies
  • Humans
  • Hydrocarbons, Iodinated
  • Incisor*
  • Male
  • Mandible / surgery
  • Neovascularization, Physiologic
  • Oxides / therapeutic use
  • Periapical Periodontitis / surgery
  • Periapical Periodontitis / therapy
  • Regenerative Endodontics / methods
  • Root Canal Filling Materials / therapeutic use
  • Root Canal Irrigants / therapeutic use
  • Root Canal Therapy / methods
  • Silicates / therapeutic use
  • Sodium Hypochlorite / therapeutic use
  • Tooth, Deciduous*

Substances

  • mineral trioxide aggregate
  • iodoform