Revascularisation: a case report

Treatment of the young permanent tooth with a necrotic root canal system and an incompletely developed root is very difficult and challenging. Although it is feasible to perform apexification procedures, the long term survival of these teeth is questionable due to thin, incompletely formed dentinal walls which may subsequently fracture. Regenerative endodontic procedures have emerged as a viable treatment alternative for these teeth. The purpose of this report is to present the case of a patient where revascularisation of an immature permanent maxillary central incisor with necrotic pulp space was successfully attempted. This was achieved after disinfection of the canal space with topical antibiotic paste followed by a blood clot scaffold induced from periapical tissues. This treatment approach offers clinicians great potential to avoid the need for traditional apexification with calcium hydroxide or the need to achieve an artificial apical barrier with mineral trioxide aggregate. Furthermore this treatment approach can help reinforce infected immature teeth by physiologically strengthening the root walls.