Clinical and radiographic evaluation of two different apexification protocols in traumatized immature permanent incisors.

Background: Dental trauma can cause damage to the pulp tissue in immature teeth. Revascularization therapy is a possible option in the treatment of non-vital, immature permanent teeth with a history of trauma. The aim of this prospective study was to evaluate the radiographic and clinical results of immature teeth with a history of trauma treated by regenerative endodontic procedures and mineral trioxide aggregate apexification techniques.

Methods: Forty-one patients aged between 7 and 12 years with traumatized immature permanent maxillary incisors were included in the study. These patients were divided into two groups: those who had previously received endodontic treatment and those who had not. Twenty-four patients who applied directly to the university clinic and had not received endodontic treatment before were included in the regenerative endodontic protocol group (Group 1). Seventeen patients who had previously undergone endodontic intervention on their relevant teeth were included in the mineral trioxide aggregate apexification group (Group 2). The patients were followed for a period of 24 months. Clinical success rates were evaluated, and pre-treatment and control radiographs were analyzed to calculate the percentage increase in root dentin width and root length.

Results: After 24 months of follow-up, positive periapical healing was detected in the radiographic findings in the majority of cases. In Group 1, a limited increase in root length and root dentin width was observed, while a narrowing in the apical opening was evident. The radiographic evaluation of two of the cases, which could be accessed 11 years later, emphasized the importance of long-term follow-up in assessing the effectiveness of the chosen methods.

Conclusion: The revascularization method is a treatment option that has positive results in terms of root development in teeth with necrotic pulp as a result of trauma.