• The Journal of the Korean dental association
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• v.54 no.8
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• pp.658-665
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• 2016

Treatment of immature permanent teeth with irreversibly damaged pulp has been challenging in dental practice because of the lack of apical constriction, thin dentinal walls, and short roots. This may lead to the extrusion of filling materials, and fracture of the root due to its more fragile feature during shaping of the root canal. Apexification with calcium hydroxide or MTA is one of the treatment options for these cases. Although favorable results of apexification have been reported, these treatment procedures do not guarantee the increase of root length and/or width even after a long term period. Thus, treated teeth are still prone to fractures. Recently, pulp revascularization has been proposed as an alternative treatment for immature teeth with necrotic pulp and periapical pathosis. Pulp revascularization allows the stimulation of the apical development and the root maturation. There have been many treatment protocols using various materials such as antibiotics and calcium hydroxide medicament. In this case report, literature review about pulp revascularization and two related cases are presented.

• The Journal of the Korean dental association
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• v.51 no.10
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• pp.542-550
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• 2013

The immature teeth with apical periodontitis present considerable challenges to clinicians. Therefore, new treatment protocols have been suggested to overcome the problems encountered in traditional methods. Regenerative treatment (revascularization) is one of such methods. Many case reports on the revascularization of infected immature teeth have been published, and in most of them, immature teeth with even a periapical abscess continued root formation after the disinfection of the root canal system. We now believe that this continued root formation is not an exceptional incident. As a result, it appeared that apexification has been giving way to a revascularization technique, which is a new option, in treating necrotic immature teeth. These new methods appear to be based on the healing potential of stem cells. The potential of healing or regeneration of stem cells, which are located around teeth, seems to be greater than we thought before. This review summarizes the current techniques for considering regenerative endodontic treatment procedures in treating the immature permanent tooth with pulp necrosis.

• The korean journal of orthodontics
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• v.34 no.3 s.104
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• pp.241-251
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• 2004

Previous studies have focused on the causes of root resorption after orthodontic treatment and treatment methods to reduce this phenomenon, and have been mainly associated with developed, mature roots. As parents become increasingly interested in their children's' dentition, orthodontists are performing fixed orthodontic treatment on patients of less than 10 years and before the completion of the immature root. Thus, the author evaluated the changes of root length and root form of maxillary immature incisors after orthodontic treatment, compared with those of mature teeth, and investigated the correlation according to gender, treatment duration, and displacement of incisors. The sample consisted of an immature root group of twenty-eight persons (between 8 and 10 years old) and a mature root group of thirty-one persons (between 11 and 15 years old). The crown and root length of the maxillary four incisors were measured with a periapical radiograph, changes in root length and crown-root ratio were calculated, and root form was classified according to a scoring system. The results were as follows. 1. The development of immature roots was not affected by orthodontic treatment and mostly showed normal root length and apical form. 2. Root length of immature teeth was sustained or became shorter, partially in long treatment duration or with open bite patients. Even though the teeth reached their normal root length, they demonstrated a blunt form. 3. Most of the mature roots showed mild resorption, and the form of mature roots was more blunt than the developed form of the immature roots (p<0.05). 4. The developed form of the immature roots was statistically related to treatment duration, while the form of the mature roots was significantly related to the displacement of incisors (p<0.05). 5. In contrast, other variables such as gender, classification of malocclusion, changes in overbite, and changes of U1 to SN showed no correlation with the root resorption of both groups.

• Journal of the korean academy of Pediatric Dentistry
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• v.40 no.2
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• pp.127-132
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• 2013

Traumatic injuries to immature permanent teeth are common and the results can be destructive. Although Hertwig's epithelial root sheath is usually sensitive to trauma, it may resist damage from trauma thereby retaining its vitality and continuing to calcify a root under favorable conditions. This case report describes two cases of trauma to immature permanent incisors. The first case presents an avulsed maxillary central incisor which has been replanted. The other case shows completely avulsed mandibular central incisors which have not been replanted. However, both cases subsequently show continued growing roots separated from the main roots. This report highlights the ability of the immature pulp tissue to continue to form dentin and the robustness of Hertwig's epithelial root sheath to initiate root development despite a traumatic injury.

• Restorative Dentistry and Endodontics
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• v.39 no.3
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• pp.230-234
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• 2014

This study describes the treatment of an immature permanent tooth with periapical lesion which was treated with regenerative approach using platelet rich plasma (PRP). The root canal of immature human permanent tooth with periapical lesion was gently debrided of necrotic tissue and disinfected with 2.5% NaOCl, and then medicated with triple antibiotic paste comprised of ciprofloxacin, metronidazole, and tetracycline. When the tooth was asymptomatic, PRP and mineral trioxide aggregate (MTA) were placed into the root canal. Six months after PRP treatment, radiographical examination revealed resolution of the radiolucency and progressive thickening of the root wall and apical closure. Our findings suggest that PRP can be used for the treatment of immature permanent teeth with periapical lesion, as part of a regenerative endodontic treatment procedure.

• The korean journal of orthodontics
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• v.53 no.3
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• pp.205-216
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• 2023

Objective: To investigate changes in the immature teeth of Sprague-Dawley rats during orthodontic treatment and to explore the changes in the peri-radicular alveolar bone through micro-computed tomography (CT). Methods: Twenty-five 26-day-old male Sprague-Dawley rats were included. The maxillary left first molar was moved mesially under a continuous force of 30 cN, and the right first molar served as the control. After orthodontic treatment for 7, 14, 21, 28, and 42 days, the root length, tooth volume, and alveolar bone mineral density (BMD) around the mesial root were measured through micro-CT. Results: The immature teeth continued to elongate after application of orthodontic force. The root length on the force side was significantly smaller than that on the control side, whereas the differences in the volume change between both sides were not statistically significant. Alveolar bone in the coronal part of the compression and tension sides showed no difference in BMD between the experimental and control groups. The BMD of the experimental group decreased from day 14 to day 42 in the apical part of the compression side and increased from day 7 to day 42 in the apical part of the tension side. The BMD of the experimental group decreased in the root apex part on day 7. Conclusions: The root length and volume of immature teeth showed continued development under orthodontic forces. Alveolar bone resorption was observed on the compression side, and bone formation was observed on the tension side.

• Restorative Dentistry and Endodontics
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• v.38 no.3
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• pp.178-181
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• 2013

Traumatic injuries to an immature permanent tooth may result in cessation of dentin deposition and root maturation. Endodontic treatment is often complicated in premature tooth with an uncertain prognosis. This article describes successful treatment of two traumatized maxillary central incisors with complicated crown fracture three months after trauma. The radiographic examination showed immature roots in maxillary central incisors of a 9-year-old boy with a radiolucent lesion adjacent to the right central incisor. Apexogenesis was performed for the left central incisor and revascularization treatment was considered for the right one. In 18-month clinical and radiographic follow-up both teeth were asymptomatic, roots continued to develop, and periapical radiolucency of the right central incisor healed. Considering the root development of these contralateral teeth it can be concluded that revascularization is an appropriate treatment method in immature necrotic teeth.

• The Journal of the Korean dental association
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• v.57 no.8
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• pp.464-473
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• 2019

For dental pulp treatment of immature permanent teeth, direct pulp capping or partial/cervical pulpotomy (apexogenesis) procedures can be used if the dental pulp is vital. MTA (Mineral Trioxide Aggregate) is regarded as the first choice dressing material for these procedures because its higher success rate. It can be also used successfully for devitalized dental pulp which has been treated by calcium hydroxide. This apexification procedure with MTA has a few advantage such as short treatment period and increase of resistance against root fracture. Recently, regenerative endodontic treatment was introduced for devitalized immature pulp. It can maintain pulp vitality and lead to continuing root development although the dental pulp was devitalized.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.2
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• pp.192-198
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• 2012

Revascularization of the pulp in a necrotic, infected immature tooth with apical periodontitis was attempting several years. Revascularization of partially necrotic pulp in an immature tooth is based on the concept that vital dental stem cells can survive pulpal necrosis. Revascularization procedure obtains longer and thicker roots in teeth with necrotic pulp diagnosis. Pulp revascularization for immature permanent molars can be possibly applied on cases having difficulty to use conventional root canal treatment due to abnormally thin root canal wall or severe root curvature. Also, when an uncooperative patient does not agree with sedative treatment the revascularization can be useful. And a patient with disability who is barely cooperative can be another indication of this treatment. In this case report, pulp revascularization using triple-antibiotics, metronidazole, ciprofloxacine and minocycline, was applied on the immature first permanent molar infected by caries.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.6
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• pp.657-664
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• 2008

Purposes: The aim of this study was to evaluate pulp healing, periodontal healing, root development of autotransplantation of immature third molars and show its viability in treatment of early loss of tooth in young patients Materials and methods: In this article we performed a retrospective study with 41 transplanted teeth in 36 patients. The Mean age at the time of surgery was 17 years(range $13{\sim}24$ years) and mean postoperative follow up period was 2.4 years(range $1{\sim}6$ years) We evaluated the survival rate, pulp healing, periodontal healing, root development of the above teeth Results: At the last examination 40 teeth among 41 transplants were still present so survival rate was 97.6%. The pulpal healing was found in 38 teeth of 41 transplants. The periodontal healing was found in 38 transplants. The continuous root development was seen in 38 transplants. Conclusions: From the above results, the autotransplantation of immature third molars was found to be a useful and reliable treatment method for early loss of teeth in adolescents and young adults.