Clinical evidence of pulp Revascularization in necrosed and immature teeth: a literature review / Evidências clínicas da Revascularização pulpar em dentes necrosados e imaturos: uma revisão de literatura

Abstract

Introduction: Endodontic treatment in teeth with incomplete root formation and necrotic pulp has been constantly studied and new approaches are being carried out, with revascularization being the most recent of them. Objective: This work is a literature review, which sought to elucidate the clinical aspects of pulp revascularization, about its longevity as a treatment modality. Methods: Articles from the last 7 years were used in the PUBMED, Scielo and VHL databases in English and Portuguese. Randomized clinical studies, clinical cases with follow-up, systematic reviews and meta-analysis were considered. Results and Discussion: Among the various recommendations, due to the clinical cases exposed, the importance of disinfection of root canal systems by the use of irrigating solutions with antimicrobial action, the use of intracanal medication, and calcium hydroxide can be used or the tri-antibiotic paste, both with the aim of eliminating bacteria present on dentin surfaces. Apical revascularization facilitates tooth root development, but it is uncertain how much root length and thickness, or apical closure, is achieved. However, regenerative techniques seem to have superior results, in these aspects, when compared to the Apexification technique. Among the clinical studies evaluated, it was observed that the revascularization technique with blood clot associated with the use of PRP and PRF as a scaffold was more effective for the longevity and success of the technique. Conclusion: After the reviewed articles, it can be concluded that the apical root closure technique, through the induction of the blood clot, is effective in enabling root strengthening and development, being safe, traumatic, and low cost and can be performed in any age, covering a significant number of patients with incomplete apex associated with pulp necrosis.