Regenerative endodontic therapy: a follow-up of 47 anterior traumatised teeth
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ORIGINAL SCIENTIFIC ARTICLE
Regenerative endodontic therapy: a follow‑up of 47 anterior traumatised teeth M. E. C. Elfrink1,2 · J. S. C. Heijdra1,3 · J. B. Krikken1,4 · W. H. Kouwenberg‑Bruring1,5 · H. Kouwenberg1,5 · K. L. Weerheijm1,6 · J. S. J. Veerkamp1,6 Received: 1 June 2020 / Accepted: 6 November 2020 © European Academy of Paediatric Dentistry 2020
Abstract Purpose To collect long-term survival data in anterior traumatised teeth on the outcome of Regenerative Endodontic Treatments (RET) with a network of dentists working in different clinics to overcome the problem of anecdotical evidence. Methods The seven dentists from Paediatric REsearch Project (PREP) performed RET treatments following the same protocol in five different secondary dental care clinics in the Netherlands. Treatment resulting in pain, apical problems, sinus tracts, resorption or fracture were considered as failure of treatment. Results 47 teeth in 38 children were treated between January 2009 and September 2017 and had at least 6 month follow-up (mean 35 months). Apical closure was seen in 27 teeth (25 cases) and root length growth in 6 teeth (6 cases). Thickening of the root walls was seen in 20 teeth (20 cases) and obliteration of the root canal in 30 teeth (25 cases). Of 38 teeth with apical inflammation at the start of treatment, no radiographic sign of apical inflammation was visible at 3 months in 13 of 28 teeth; taking up to 42 months for radiographic signs of apical inflammation to be not visible. Nineteen of 35 teeth showed discoloration at the beginning of treatment. After 18 months two teeth showed signs of ankylosis, but were still functional. After 36 months one more tooth showed signs of new apical inflammation and 2 months later it was extracted. Conclusions With three failures in 47 treated teeth, RET seems to be a promising treatment for difficult to treat anterior traumatised teeth with an open apex. Keywords Pulp revascularization · Regenerative endodontic therapy · Triple antibiotic paste · Teeth with incomplete root formation · Anterior teeth · Dental trauma
Introduction
* M. E. C. Elfrink [email protected]; [email protected] 1
Paediatric REsearch Project (PREP), Barneveld, Nederland
2
Mondzorgcentrum Nijverdal, Nijverdal, The Netherlands
3
Tandartspraktijk Puntgaaf, Barneveld, The Netherlands
4
Kindermondzorgcentrum Snoet, Amsterdam, The Netherlands
5
Tandartsenpraktijk Kouwenberg-Bruring, Doetinchem, The Netherlands
6
Kindertand, Amsterdam, The Netherlands
Dental trauma is common—global prevalence is 10–15%; especially in young children (1–3 years-of-age) learning to explore their gross motor skills (e.g., walking, riding a bike etc.) (Tewari et al. 2019). But trauma also occurs commonly in children between the age of 6 and 10 years due to contact sports and adventurous behaviour (Shayegan et al. 2007; Tewari et al. 2019). In Belgium there is no reported sex difference in the prevalence of dental trauma (Shayegan et al. 2007). Although in Germany, boys are affe
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