SP-52 - Outcomes of Apexification and Regenerative Endodontic Procedures in Immature Permanent Teeth: Predictability, Surprises, and Future Directions

Accepted Speaker(s)

• 

  Jennifer L. Gibbs, MS, DDS, PhD

  Member of the Faculty
  Harvard School of Dental Medicine

  Nothing to disclose
• 

  Asma Khan, Endodontist

  Associate Professor
  University of North Carolina, Chapel Hill

  Nothing to disclose
• 

  Natasha Flake, D.D.S.

  Associate Professor
  University of Washington

  Nothing to disclose

Endodontic management of immature permanent teeth with pulpal necrosis is challenging. It is critical that procedures are predictable, and that the affected teeth are preserved as long as possible for our young patients. Regenerative endodontic procedures (REPs) have the advantage over conventional apexification of supporting continued hard tissue maturation. However, it is unclear how frequently clinically meaningful root thickening or lengthening occurs, as well as whether clinical or patient factors can predict this outcome. In this presentation we will discuss results from a multi-centered clinical study, reporting the predictability of continued hard tissue development after REPs, and identification of specific factors that predict successful hard tissue maturation. We will also discuss the predictability of clinical success in teeth treated by REPs versus conventional apexification.

Learning Objectives:

• Describe how the etiology of pulp necrosis (trauma vs anatomical anomalies like dens evaginatus) affects continued hard tissue maturation after REPs.
• Describe how often clinically meaningful hard tissue maturation occurs after REPs, and how this could affect the long term survival of the treated tooth.
• Describe other hard tissue outcomes after REPs including resorption, intracanal calcifications, and canal obliteration.