Title: Predictability of Continued Root Development After Regenerative Endodontic Procedures
Austin Le (Presenter)
New York University
Sharon Casey, New York University
Dani Fox, North Carolina State University
Natasha Flake, University of Washington
Asma Khan, University of North Carolina
Jennifer Gibbs, New York University
Objectives: Regenerative endodontic procedures (REPs) have the advantage over conventional apexification of supporting continued hard tissue maturation within the immature root with a necrotic pulp. However, it is unclear how often clinically meaningful root thickening or lengthening occurs, and whether clinical or patient factors can predict cases which will present with significant hard tissue changes. The objective of this study is to determine the rate of accomplishing significant clinical root development after REPs, and identify predictors of successful hard tissue maturation.
Methods: A comprehensive chart review was completed to identify a retrospective cohort of subjects with teeth with open apices that received REPs between 2005-2014, at 3 study sites. After meeting eligibility and minimal treatment quality criteria, the patient record was reviewed and relevant treatment data extracted, including radiographs, from eligible cases with an available 3-month or greater recall visit. Radiographs were analyzed using standardized procedure to measure the percent change in radiographic root area (RRA) over time. Predictors evaluated include: patient age, type of interim medication, presence of pre-operative periapical radiolucency, and etiology of pulp necrosis (trauma, caries, dens evaginatus).
Results: A total of 93 cases treated with REPs met eligibility requirement for the study with an average follow up of 32 months, and a recall rate of 65%. At the time of abstract submission, radiographic analysis had been completed on 47 cases, and 11 cases (23%) showed clinically meaningful hard tissue development (>25% change). The final data analysis will be presented, as well as the association between predictors and positive hard tissue growth.
Conclusions: The accomplishment of clinically meaningful continued root maturation is currently not predictable after REPs, and the identification of predictive factors is essential for informed treatment planning of these cases.