Ulus Travma Acil Cerrahi Derg. Ahead of Print: UTD-31532 | DOI: 10.14744/tjtes.2024.31532

Clinical and Radiographic Evaluation of Two Different Apexification Protocols in Traumatized Immature Permanent Incisors

Gülhan Koyuncuoglu¹, Gamze Aren^2
1Private Clinic, Istanbul, Türkiye
²Department of Pediatric Dentistry, Istanbul Atlas University Faculty of Dentistry, Istanbul, Türkiye

Backround: Dental trauma can cause damage to the pulp tissue in immature teeth. Revascularization therapy is a possible option in the treatment of non-vital, immature permanent teeth with a history of trauma. The aim of this prospective study was to evaluate the radiographic and clinical results of immature teeth with a history of trauma treated by regenerative endodontic procedures and mineral trioxide aggregate apexification techniques.
Materials and Methods: 41 patients in a group of 45 patients aged between 7 and 12 years, with traumatized immature permanent maxillary incisors were included in the study. The patients were divided into two groups: those who had previously received endodontic treatment and those who had not. 24 patients who applied directly to the university clinic and had not received endodontic treatment before were included in the regenerative endodontic protocol group (group 1). 17 patients who had previously undergone endodontic intervention on their relevant teeth were included in the mineral trioxide aggregate apexification group (group 2). The patients were followed for a period of 24 months. While clinical success rates were evaluated, pre-treatment and control radiographs were evaluated to calculate the percentage increase in root dentin width and root length.
Results: After 24 months of follow-up, positive periapical healing was detected in radiographic findings in the majority of cases. In Group 1, a limited increase in root length and root dentin width was observed, while a narrowing in the apical opening was evident. The radiographic evaluation of two of the cases, which could be accessed 11 years later, emphasized the importance of long-term follow-up in the effectiveness of the chosen methods.
Conclusion: Revascularization method is a treatment option that has positive results in terms of root development in teeth with necrotic pulp as a result of trauma.

Keywords: Immature permanent teeth, regenerative endodontic protocol, mineral trioxide aggregate

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Travmalý Genç Sürekli Kesici Diþlerde Ýki Farklý Apeksifikasyon Protokolünün Klinik ve Radyografik Deðerlendirilmesi

Gülhan Koyuncuoglu¹, Gamze Aren^2
1Özel Klinik, Ýstanbul, Türkiye
²Pedodonti Anabilim Dalý, Ýstanbul Atlas Üniversitesi, Diþ Hekimliði Fakültesi, Ýstanbul, Türkiye

Amaç: Diþ travmasý, olgunlaþmamýþ diþlerde pulpa dokusuna zarar verebilir. Revaskülarizasyon tedavisi, travma öyküsü olan, non-vital, olgunlaþmamýþ sürekli diþlerin tedavisinde olasý bir seçenektir. Bu prospektif çalýþmanýn amacý, rejeneratif endodontik prosedürler ve mineral trioksit agregat apeksifikasyon teknikleriyle tedavi edilen travma öyküsü olan olgunlaþmamýþ diþlerin radyografik ve klinik sonuçlarýný deðerlendirmektir.
Gereç ve Yöntem: Yaþlarý 7 ile 12 arasýnda deðiþen, travmatize immatür sürekli üst kesici diþlere sahip 45 hastadan oluþan gruptan 41 hasta çalýþma kapsamýna alýndý. Hastalar daha önce endodontik tedavi görmüþ olanlar ve görmemiþ olanlar olmak üzere iki gruba ayrýldý. Üniversite kliniðine doðrudan baþvuran ve daha önce endodontik tedavi görmemiþ 24 hasta rejeneratif endodonti protokol grubuna (grup 1) dahil edildi. Daha önce ilgili diþlerine endodontik müdahale yapýlmýþ 17 hasta mineral trioksit agregat apeksifikasyon grubuna (grup 2) dahil edildi. Hastalar 24 ay süreyle takip edildi. Klinik baþarý oranlarý deðerlendirilirken, kök dentin geniþliði ve kök uzunluðundaki yüzde artýþ miktarýný hesaplamak için tedavi öncesi ve kontrol radyografileri deðerlendirildi.
Bulgular: 24 aylýk takip sonrasýnda vakalarýn çoðunda radyografik bulgularda pozitif periapikal iyileþme tespit edildi. Grup 1'de kök uzunluðunda ve kök dentin geniþliðinde sýnýrlý bir artýþ gözlenirken, apikal açýklýkta daralma belirgindi. 11 yýl sonra ulaþýlabilen iki olgunun radyografik deðerlendirmesi, seçilen yöntemlerin etkinliðinde uzun süreli takibin önemini vurgular tarzda idi.
Sonuç: Revaskülarizasyon yöntemi travma sonucu nekrotik pulpalý diþlerde kök geliþimi açýsýndan olumlu sonuçlarý olan bir tedavi seçeneðidir.

Anahtar Kelimeler: Genç sürekli diþler, rejeneratif endodontik protokol, mineral trioksit agregat

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