Regenerative endodontic treatment of immature permanent teeth after mechanical instrumentation with XP-Endo Finisher

Abstract

Introduction: The traditional treatment of immature permanent teeth with necrotic pulp involves creating an apical barrier by using calcium hydroxide or an MTA plug for an extended period of time. A novel therapeutic approach called regenerative endodontic procedures (REP) is used to allow root development to continue. Aim: To investigate the response of immature permanent teeth and necrotic pulp to REP using a modified clinical protocol involving minimal mechanical instrumentation and irrigation with 10% citric acid. Materials and methods: We treated 30 immature permanent teeth with necrotic pulp in 28 patients aged 7-14 years using a modified protocol for regenerative endodontics. The protocol included mechanical instrumentation of the root canal with the appropriate file for 2 minutes in total and irrigation with 10% citric acid. Results: The root walls increased their thickness in 28 (93%) of the treated cases. In 16 (53%) cases, we found radiographic signs of continued root development; in six (20%), there was thickening of the canal walls and closure of the apex but no elongation; in four (13%), there was obliteration of the root canal; in two (7%), there was healing of the periapical lesion without any change in the length of the root walls or closure of the apex; and only two cases (7%) showed no signs of healing, but the teeth remained asymptomatic. Conclusions: The use of mechanical instrumentation with the appropriate files in REP shortens the clinical protocol, which is advantageous when treating children’s dental issues.