(PR14) An Evaluation of Treatment Outcomes of Regenerative Endodontics, Apexification, and Modified Apexification: A Retrospective Study

Abstract: Current endodontic treatment options for immature permanent teeth with necrotic pulp/apical periodontitis include apexification and regenerative endodontic procedures (REPs). Apexification and REPs have proven to be highly predictable, but they are not without disadvantages. Immature permanent teeth undergoing apexification procedures can lack continuation of root development and REPs are contraindicated in teeth requiring a post/core. Due to these limitations, Modified Apexification was introduced in 2020. This procedure attempts to promote continuation of root development while providing restorative space by using a barrier 2-3mm short of the open apex. The aim of this observational retrospective study was to compare treatment outcomes, variables, and survival in teeth treated with apexification, REPs, and modified apexification between January 1st, 2014 and March 31st, 2020. Eligible subjects were identified through axiUm treatment codes at NYU College of Dentistry. Comprehensive chart review and radiographic analysis was conducted by 4 postgraduate residents. One hundred and twenty cases were included. Preliminary data analysis was conducted for 24 cases with minimum 1 year follow-up (mean/median:14/17 months). Presently, the success (healed/healing) and survival rates across all 3 treatment modalities are 91.3% and 100%, respectively. Using a paired T-test, at 12 months, there was a significant difference in apical diameter reduction between REPs (-1.1mm) and apexification/modified apexification (-0.4mm) (p < 0.05). Complete results regarding root length/area change, success, and survival will be available by the time of poster presentation. Preliminary results indicate that all 3 procedures are viable treatment options and regeneration results in apical closure.