Frontiers in bioengineering and biotechnology · 2026
Longitudinal periapical radiographic evaluation of apexification, vital pulpotomy, and revascularization in immature permanent teeth: a retrospective comparative study.
СтатьяНазвание и аннотация: Перевод в очереди
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Sun Xiaona, Zhu Kailing
Аннотация
BACKGROUND: Immature permanent teeth pose therapeutic challenges due to immature root development; primary approaches include apexification, vital pulpotomy and revascularization, with few systematic imaging studies on their efficacy.
AIM: This study systematically compares the radiographic outcomes of apexification, vital pulpotomy, and pulp revascularization in managing immature permanent teeth, assessing root development and periapical healing to inform clinical decision-making.
METHODS: This retrospective cohort analysis employed propensity score matching (PSM) to evaluate treatments for immature permanent teeth. Patients treated between January 2022 and December 2024 were categorized into three groups: apexification (n = 51), vital pulpotomy (n = 50), and revascularization (n = 51) after 1:1 nearest-neighbor matching. Primary outcomes were resolution of clinical signs and symptoms and periapical lesion healing; secondary outcomes were root development (increase in root length and canal wall thickness) and apical closure. Outcomes were assessed radiographically using pre- and postoperative periapical radiographs and cone-beam computed tomography (CBCT) at 6- and 12-month follow-ups.
RESULTS: After PSM, baseline characteristics were balanced (P > 0.05). At the 12-month follow-up, the revascularization group demonstrated significantly greater increases in both root length (1.8 ± 0.4 mm) and canal wall thickness (0.35 ± 0.05 mm) compared to the other interventions (P < 0.05). While apical closure rates were comparable between revascularization (88.2%) and vital pulpotomy (82.0%), both significantly outperformed apexification (56.9%, P < 0.01). Similarly, treatment success rates were higher in revascularization (88.5%) and vital pulpotomy (92.0%) than in apexification (76.5%, P < 0.05). Revascularization achieved superior periapical lesion healing (95.0%) versus both apexification (76.9%) and vital pulpotomy (72.0%) (P < 0.05). Complication rates showed no significant intergroup differences (P > 0.05).
CONCLUSION: Revascularization demonstrated superior efficacy in promoting root maturation, followed by vital pulpotomy and apexification. It is recommended to choose a personalized treatment plan according to the condition of the affected teeth.
AIM: This study systematically compares the radiographic outcomes of apexification, vital pulpotomy, and pulp revascularization in managing immature permanent teeth, assessing root development and periapical healing to inform clinical decision-making.
METHODS: This retrospective cohort analysis employed propensity score matching (PSM) to evaluate treatments for immature permanent teeth. Patients treated between January 2022 and December 2024 were categorized into three groups: apexification (n = 51), vital pulpotomy (n = 50), and revascularization (n = 51) after 1:1 nearest-neighbor matching. Primary outcomes were resolution of clinical signs and symptoms and periapical lesion healing; secondary outcomes were root development (increase in root length and canal wall thickness) and apical closure. Outcomes were assessed radiographically using pre- and postoperative periapical radiographs and cone-beam computed tomography (CBCT) at 6- and 12-month follow-ups.
RESULTS: After PSM, baseline characteristics were balanced (P > 0.05). At the 12-month follow-up, the revascularization group demonstrated significantly greater increases in both root length (1.8 ± 0.4 mm) and canal wall thickness (0.35 ± 0.05 mm) compared to the other interventions (P < 0.05). While apical closure rates were comparable between revascularization (88.2%) and vital pulpotomy (82.0%), both significantly outperformed apexification (56.9%, P < 0.01). Similarly, treatment success rates were higher in revascularization (88.5%) and vital pulpotomy (92.0%) than in apexification (76.5%, P < 0.05). Revascularization achieved superior periapical lesion healing (95.0%) versus both apexification (76.9%) and vital pulpotomy (72.0%) (P < 0.05). Complication rates showed no significant intergroup differences (P > 0.05).
CONCLUSION: Revascularization demonstrated superior efficacy in promoting root maturation, followed by vital pulpotomy and apexification. It is recommended to choose a personalized treatment plan according to the condition of the affected teeth.