“REGENERATIVE ENDODONTIC TREATMENT IN NON-VITAL IMMATURE VERSUS MATURE PERMANENT INCISORS – A CLINICAL STUDYâ€

In Dentistry, it is always a primary concern topreserve the dentition. But when the pulp is necrotic or damaged, we try torestore it by artificial restorative materials. The endodontic procedures havesome major limitations in the tooth such as – Discoloration, Prone to fracture,devitalization of tooth. Overtime, these filling materials cause severedestruction to the tooth structure and its longevity is severely compromised. Therefore,we need to use natural method instead of artificial ones to maintain the vitalityof tooth. So, after the introduction of calcium silicate materials and tissueregeneration based approaches, we are looking forward to use these biologicalresources to preserve the tooth.

Pulp regeneration treatment has gained popularity inthe recent years. Firstly, it was performed by Nygaard-Ostby in1961. As per the American Association of Endodontists (AAE), the major aim ofrevascularization procedure is to eliminate the symptoms and encourage thenatural healing of the tooth. The regenerative treatment can be done both inteeth with mature roots (closed apices) and immature roots (open apices). Usually, when the immature permanent teeth undergo any trauma or infection, it isconventionally treated by apexification or revascularization. Apexification isa procedure to induce a calcific barrier at the root apex. Thereare many drawbacks of apexification which include: long and multiple treatmentsessions, stunted root development, unfavorable crown-root ratio, thinning ofroot canal walls which leads to brittle tooth structure and prone to fractureafter post-endodontic restoration.

On the other hand, revascularization procedure/pulpdentin regenerative therapy promotes the natural development of continuous rootformation and thickening of root canal walls as well as the apical closure.Thereby, eliminating the risk of root fracture. Revascularizationtreatment yields better results in case of pulpal necrosis due to traumaticinjuries as compare to other etiological factors due to absence of bacteriaassociated with caries. There are mainly three key factors forthe success of tissue regeneration, which involves namely, (a) Adult stem cells– have the capacity to form hard tissue (b) Signaling molecules cause cellularstimulation, proliferation and differentiation (c) A three dimensional (3-D)physical scaffold for viable growth and differentiation on the cellular levelin regenerative endodontic procedures.

Young tissue may react differently toregenerative treatment before and after the root formation in non-vital incisorswith etiologic of trauma. It may be due to the difference in size of apicalforamen, stage of maturogenesis at the time of trauma difference in type ofpulp developing structure and its microanatomy. So, the present study isplanned to know the effect of regenerative endodontic treatment in managementof traumatized, non-vital, immature versus mature permanent incisors.