Revascularisation of immature teeth

One of the key aims of continuing professional development (CPD) is to allow the dental team to keep up to date with new techniques. This should ensure patients are given the choice of all available treatment options as well as ensuring the best long-term outcome is achieved. Last month’s research summary discussed the current guidance for the management of avulsed permanent teeth. Following on from this article, this month’s summary discusses a new technique which is being investigated in numerous paediatric departments across the UK, revascularisation. This new technique aims to revolutionise the management of non-vital immature teeth.

When permanent teeth erupt into the oral cavity their formation is not yet complete. If these ‘immature’ teeth lose vitality as a result of trauma, caries or dental anomalies their treatment is complicated by the presence of open apices and thin walls. Current treatment options involve repeatedly dressing the tooth with calcium hydroxide in an attempt to form a calcific barrier at the tooth’s apex, in a process known as apexification, or by the placement of mineral trioxide aggregate (MTA) at the apex creating an artificial apical barrier. Once an apical stop is achieved by either of these methods conventional root canal treatment with gutta percha can be completed. However, the immature tooth remains fragile with thin walls which are susceptible to fracture.