The Endodontic treatment of an immature permanent tooth with pulp revascularization technique: a 3-year follow-up

Abstract

Aim: To report a clinical case where a pulp revascularization procedure was performed in an immature permanent tooth with necrosis and periapical lesion. Case report: A 7-year-old girl with a history of trauma seven months before presented pulp necrosis in the upper left central incisor (9) with incomplete root formation. After clinical and radiographic examinations, the diagnosis was a chronic periapical abscess—the proposed treatment of pulpal revascularization. Two consultations were performed according to the protocol proposed by the American Association of Endodontics (AAE). In the first consultation, access surgery was performed, and presentation protocol with sodium hypochlorite (NaOCl) 1% and EDTA 17%. Calcium hydroxide was used as an intracanal medication for 15 days. The intracanal medication was removed in the second appointment; a new disinfection protocol was performed, bleeding was induced with a #35 K-file and clot formation, buffer with mineral trioxide aggregate, and definitive restoration was performed. The follow-up of the case was carried out over periods of 30 days and later three years. Results: In the 3-year follow-up, the patient has no signs and symptoms of infection. In addition, a radiographic image demonstrates the healing of apical periodontitis with a formation of a mineralized barrier at the apical level. Conclusion: It is possible to consider the case successful. New consultations are necessary to observe the completion of the root formation process and the thickening of the root canal walls.