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J Endod. 2015 Sep;41(9):1571-5. doi: 10.1016/j.joen.2015.04.022. Epub 2015 Jun 10.

Pulp Revascularization on Permanent Teeth with Open Apices in a Middle-aged Patient.

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Paediatric Dentistry, School and Hospital of Stomatology, Peking University, Beijing, China.
VIP Dental Service and Geriatric Dentistry, School and Hospital of Stomatology, Peking University, Beijing, China.
Shenzhen Institute of Research and Innovation, The University of Hong Kong, Hong Kong, China; Comprehensive Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China. Electronic address:


Pulp revascularization is a promising procedure for the treatment of adolescents' immature permanent teeth with necrotic pulp and/or apical periodontitis. However, the ability to successfully perform pulp revascularization in a middle-aged patient remains unclear. A 39-year-old woman was referred for treatment of teeth #20 and #29 with necrotic pulp, extensive periapical radiolucencies, and incomplete apices. Pulp revascularization procedures were attempted, including root canal debridement, triple antibiotic paste medication, and platelet-rich plasma transplantation to act as a scaffold. Periapical radiographic and cone-beam computed tomographic examinations were used to review the changes in the apical lesions and root apex configuration. The patient remained asymptomatic throughout the 30-month follow-up. Periapical radiographic examination revealed no change in the apical lesions of either tooth at 8 months. The periapical radiolucency disappeared on tooth #20 and significantly decreased on tooth #29 by the 30-month follow-up, findings that were also confirmed by cone-beam computed tomographic imaging. No evidence of root lengthening or thickening was observed. Successful revascularization was achieved in a middle-aged patient's teeth.


Apical periodontitis; middle-aged patient; pulp revascularization

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