Treatment of immature permanent teeth with regenerative procedures or apicification: a systematic literature review

Abstract

Objective: to perform a systematic literature review to evaluate the success rates of treatment of immature permanent teeth with apical periodontitis after traditional procedures, like apexification or regeneration/pulp revascularization procedures. Material and Methods: an eletronic search was executed in PubMed and Cochrane database, using specifics medical terms. Articles published between January 200 to July 2015 were evaluated. Others publications in the reference section of each relevant article were analyzed from a manual search and were added to the selected articles list. Results: at first instance, a total of 114 titles and resumes were identified after an eletronic search in both eletronic databases, using the specific combination of terms and keywords. An additional study was identified as relevant after a reference list search. After the framing in the inclusion/exclusion criteria, only two articles were selected. The included studies demonstrates resolution of clinical signs, symptoms and periapical radiolucencies to both treatments. On the other hand, these studies were divergent in relation to the length increase and root thickness after regenerative therapy; while one of the studies presented more favorable outcomes to regenerative therapy, the other one showed no differences between the two tested therapies. Conclusion: although there are few studies performing a direct comparison between conventional therapies and regenerative therapies, the present systematic review indicates that revascularization protocols offers the potential to treat permanent teeth with incomplete root formation, with the disappearance of the signals, symptoms and an increased possibility of continuing root formation.