Česká Stomatologie a Praktické Zubní Lékařství (Sep 2017)
Assessment of Therapy of Necrotic Immature Permanent Teeth with Calcium Hydroxide Apexification and Maturogenesis
Abstract
Introduction and aim: The endodontic treatment of necrotic immature permanent teeth is one of the most demanding intervention in the field of endodontics. In the last two decades there was an emerging evidence supporting the use of regenerative medicine concepts which aims to regenerate pulpdentinal organ. The aim of our study was to compare clinical success rate and change in radiological root area and radiological length between Ca(OH)2 apexification and maturogenesis. Methods: Data of patients treated between years 2011 and 2015 at Institute of Dentistry and Oral Sciences in Olomouc who were younger than 16 years and simultaneously underwent endodontic treatment of immature permanent tooth were collected. From total of 54 patients, 17 were chosen according to designated criteria. Nine patients were treated by Ca(OH)2 apexification and 8 by maturogenesis. In the scope of follow-up, the control X-rays were taken and clinical examination was performed. The mathematical correction of control X-rays was carried out and percentual change in radiological root area and radiological length in comparison to diagnostic X-ray were determined. After assessment of normality of collected data with Wilk-Shapiro test, the null hypothesis was examined by student t-test and Wilcoxon signed-rank/rank-sum tests. The clinical outcome was tested by Fisher factorial test. Results: There was significant difference in comparison of change in radiological root area among teeth treated with Ca(OH)2 apexification and maturogenesis (p = 0.0041). The average change in radiological root area was 16% in cases treated with maturogenesis and 5.9% in cases treated with Ca(OH)2 apexification. No statistically significant differences were found in radiological length change (p = 0.939) and clinical success rate (p = 0.5459). Conclusion: According to our data there were no significant differences between maturogensis and Ca(OH)2 apexification in clinical success rates and change of radiological lengths. Significant difference was observed in the change of radiological root, which was higher in cases treated by maturogenesis.
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