Influence of Age and Apical Diameter on the Success of Endodontic Regeneration Procedures

Introduction: Treatment of immature permanent teeth with necrotic pulp and apical pathosis constitutes a challenge for endodontists. The present study was done to evaluate the effect of age-and apical diameter on the regenerative potential of young permanent immature teeth with necrotic pulps. Methods: Immature necrotic permanent maxillary incisors (n = 40) of patients 9-18 years old were divided into 2 groups according to the treatment protocol: group Y (younger age group), 9-13 years and group 0 (older age group), 14-18 years. Each group was further subdivided into 2 subgroups according to apical diameter, subgroup (n) (narrower diameter) between 0.5 and 1 mm and subgroup (w) (wider diameter) equal to or greater than 1 mm. Revascularization procedures were performed for all patients. Follow-up was done for up to 12 months. Standardized radiographs were digitally evaluated for increase in root length and thickness and decrease in apical diameter. Results: After the follow-up period, most of the cases demonstrated radiographic evidence of periapical healing. Group Y showed significant progressive increase in root length and width and decrease in apical diameter. Subgroup (w) representing wider apical diameter showed-significant progress as well. Conclusions: It was found that revascularization procedures can be implemented in any age ranging from 9 to 18 years; however, younger age groups were better candidates for revascularization procedure than older ones. Regarding the apical diameter, regeneration procedures were successful with apical diameters as small as 0.5 mm. However, teeth with preoperative wider diameters (>= 1 mm) demonstrated greater increase in root thickness, length, and apical narrowing.