Comparative Evaluation of the Efficacy of Biologically-based Regenerative Endodontic Procedures in the Healing of...

Endodontic management of an immature nonvital tooth along with apical periodontitis poses many potential complications. A randomized clinical trial was conducted to assess the effectiveness of three different techniques: Gp I-revascularization with mineral trioxide aggregate (MTA) (as additional coronal plug below final restoration); Gp II-apexification with MTA (MTA as a direct apical plug); and Gp III-revascularization without using MTA (no MTA below final restoration).

A total of 28 patients with a mean age of 9.44 ± 2.55 years finally completed the study of 12 months duration. Maturogenesis was assessed by developing tooth to next Nolla's stage, visual examination of radiographs, and quantitative assessment of digitalized radiographs in three parameters, that is, root lengthening, root thickening, and narrowing of the apical foramen. A decrease in PAI score assessed healing of periapical periodontitis/radiolucencies.

About 100% clinical success was seen in all three groups, Gp I, Gp II, and Gp III, regarding the resolution of signs and symptoms of pain, tenderness, swelling, sinus, and mobility. On quantitative examination of digitalized radiographs, Gp I showed maximum maturogenesis. Maximum healing in minimum time was observed in Gp II <6 months' time interval.

This study highlights the effectiveness of MTA apexification and MTA revascularization in managing nonvital immature permanent teeth with apical periodontitis, aiding clinicians in tailored treatment decisions for improved patient outcomes.

There is no difference in efficacy between MTA apexification and MTA revascularization to treat nonvital immature permanent teeth.