Inducing Root Growth in Nonvital Immature Permanent Teeth Using Revascularization Procedures; a Comparative Study

                          Injury to immature permanent teeth may arrest root maturation leaving an open apex root and thin dentinal tubules prone to fracture. Apexification with calcium hydroxide was unable to induce pulp regeneration. Pulp revascularization is an emerging therapy in treatment of immature teeth allows root development. Sixty five permanent necrotic immature teeth of 7-13 years old children with signs and symptoms of periapical pathosis were involved in the study. Teeth were separated into two main groups regarding the disinfectant material Group 1, (triantibiotic paste) and Group 2 (calcium hydroxide paste); each group was classified into two subgroups A and B (MTA or Glass ionomer) regarding the sealing material. The disinfectant pastes were packed in the first visit and were irrigated in the second visit, apical bleeding was induced in the apical region. The sealing materials were placed in the coronal third of the root then composite restorations were done. Children were followed up each three month up to 18 months clinically. Statistical analysis was performed, regarding pain a statistical significant difference was recorded between the four groups at 15 month. There was a statistical significant difference at different follow up period in group 2B regarding swelling. Regarding discoloration, a statistical significant difference was recorded between the four groups at different follow up periods. Teeth discoloration was recorded in 13 (81.2%), 8 (50%), 12 (70.5%) and 5 (31.25%) teeth in 1A, 2A, 1B and 2B groups respectively. At 18 month Pain was recorded in one tooth in group 1A, two teeth in 1B and 2A groups and in five teeth in group 2B. Swelling was recorded in two teeth in1B group, in one tooth in 2A group and in three teeth in 2B group.