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OR26 - Investigation of Root Resorption in Immature Permanent Teeth Treated with Apexification and Regenerative Procedures: A Retrospective Study

Wednesday, May 3, 2023

2:30 PM – 2:45 PM CT

Location: E353B (Level 3)

Presenter(s)

Anas BaHammam, B.D.S.

Resident
Harvard School of Dental Medicine
Boston, Massachusetts

Disclosure(s): No financial relationships to disclose

Co-Presenter(s)

OE

Ozge Erdogan, D.D.S.

Research Fellow
Harvard School of Dental Medicine
Boston, Massachusetts

Disclosure information not submitted.

Co-Author(s)

Jennifer Gibbs, D.D.S., Ph.D., M.A.

Head of the Division of Endodontics
Harvard School of Dental Medicine
Boston, Massachusetts

Disclosure information not submitted.
Natasha Flake, D.D.S., Ph.D., M.Sc.

Associate Dean of Predoctoral Clinical Education and Operations
University of Washington
Seattle, Washington

Disclosure information not submitted.
Asma Khan, B.D.S., Ph.D.

endodontist and a neuroscientist at university of Texas San Antonio Dental school
University of Texas at San Antonio
San Antonio, Texas

Disclosure information not submitted.
MM

Marie M. Mora, D.D.S.

Clinical Assistant Professor
New York University College of Dentistry
New York, New York

Disclosure information not submitted.
GP

Gyu Park, D.D.S.

Clinician
New Jersey, New Jersey

Disclosure information not submitted.
SC

Sharon Casey, M.S.

Researcher
Boston University
Boston, Massachusetts

Disclosure information not submitted.

Objectives: Evidence of the management of root resorption in permanent immature teeth is lacking, and an outcome study of these managements would be beneficial. In this multi-centered retrospective cohort study, we radiographically evaluated presence and progression of root resorption in immature permanent teeth that received regenerative endodontic procedures (REP) or apexification treatment (APEX).

Methods: A comprehensive retrospective chart review was completed to identify a cohort of subjects presented with necrotic immature permanent teeth that received either REP or APEX (with CaOH₂ or MTA) treatments between 2005-2014, at three study sites. Radiographic signs of resorption pre-operatively and post-operatively at recalls were recorded. In addition, etiology of the disease, stage of root development, treatment history, signs of radiographic and clinical healing/infection, and root development were recorded.

Results: Out of 211 records collected, 31 cases had presence of radiographic signs of resorption pre-operatively and/or post-operatively, a total of 14.7%. After treatment with REP, APEX (CaOH₂), or APEX (MTA), the resolved/healing rate was 67.8% with no significant difference between REP (43.8%) and APEX (CaOH₂) (37.5%), but lower success rate for APEX (MTA) (17.8%). Most important factors affecting resorption prognosis are type of trauma and root development stage. Most of the cases where root resorption radiographically enlarged over time or showed severe root resorption post-operatively had history of tooth avulsion.

Conclusions: Current treatment modalities for necrotic immature teeth can be effective in resolving root resorption. History of avulsion, and teeth at late stage of development had significantly worse resorptive outcomes and poor prognosis.