Treatment Outcomes of Apexification or Revascularization in Nonvital Immature Permanent Teeth: A Retrospective Study

Introduction: The purposes of this retrospective study were to evaluate the clinical and radiographic outcomes of mineral trioxide aggregate apexification and revascularization in nonvital immature permanent teeth and to analyze factors influencing treatment outcome. Methods: Forty-six cases (29 cases of apexification and 17 cases of revascularization) were recruited into this study. Patients' preoperative and postoperative information was analyzed. Treatment outcomes were categorized as a success or failure and functional retention. Further root development was assessed in terms of the percentage changes in root length and root width. Results: The success rates of mineral trioxide aggregate apexification and revascularization were 80.77% and 76.47% and functional retention was 82.76% and 88.24%, respectively. Revascularization provided significantly greater percentage changes in root width (13.75%) in comparison with mineral trioxide aggregate (MTA) apexification (-3.30%). The mean percentage change of increased root length was 9.51% in the revascularization group and 8.55% in the MTA apexification group. Interestingly, revascularization showed various degrees of increased root length ranging from 4% to 58%. Fracture was the main cause of failure in MTA apexified teeth. All failed revascularized teeth presented with signs and symptoms of apical periodontitis caused by persistent infection. Conclusions: MTA apexification and revascularization provide a reliable outcome in the aspects of resolution of the disease and tooth functional retention. None of these treatments provides satisfactory predictable further root development.