Pulp revascularization for immature replanted teeth: a case report

Aust Dent J. 2015 Sep;60(3):416-20. doi: 10.1111/adj.12342. Epub 2015 Jul 29.

Abstract

Immature avulsed teeth are not usually treated with pulp revascularization because of the possibility of complications. However, this therapy has shown success in the treatment of immature teeth with periapical lesions. This report describes the case of an immature replanted tooth that was successfully treated by pulp revascularization. An 8-year-old boy suffered avulsion on his maxillary left lateral incisor. The tooth showed incomplete root development and was replanted after 30 minutes. After diagnosis, revascularization therapy was performed by irrigating the root canal and applying a calcium hydroxide paste and 2% chlorhexidine gel for 21 days. In the second session, the intracanal dressing was removed and a blood clot was stimulated up to the cervical third of the root canal. Mineral trioxide aggregate was placed as a cervical barrier at the entrance of the root canal and the crown was restored. During the follow-up period, periapical repair, apical closure and calcification in the apical 4 mm of the root canal was observed. An avulsed immature tooth replanted after a brief extra-alveolar period and maintained in a viable storage medium may be treated with revascularization.

Keywords: Calcium hydroxide; immature teeth; pulp revascularization; storage medium; tooth avulsion.

MeSH terms

  • Aluminum Compounds / therapeutic use
  • Apexification / methods*
  • Calcium Compounds / therapeutic use
  • Calcium Hydroxide / therapeutic use
  • Child
  • Chlorhexidine / therapeutic use
  • Dental Pulp / blood supply
  • Dental Pulp / drug effects
  • Dental Pulp Cavity / drug effects
  • Drug Combinations
  • Follow-Up Studies
  • Humans
  • Incisor / injuries*
  • Male
  • Oxides / therapeutic use
  • Root Canal Filling Materials / therapeutic use
  • Root Canal Irrigants / therapeutic use
  • Root Canal Preparation / methods
  • Silicates / therapeutic use
  • Tooth Apex / drug effects
  • Tooth Avulsion / therapy*
  • Tooth Calcification / drug effects
  • Tooth Replantation / methods*

Substances

  • Aluminum Compounds
  • Calcium Compounds
  • Drug Combinations
  • Oxides
  • Root Canal Filling Materials
  • Root Canal Irrigants
  • Silicates
  • mineral trioxide aggregate
  • Calcium Hydroxide
  • Chlorhexidine