Abstract：
Pulp necrosis is the most common complication following dental trauma and is often associated with apical periodontitis. The management of these teeth is challenging in terms of large root canals, open apices, thin dentinal walls, and short roots. Over decades the conventional treatment for these teeth was calcium hydroxide apexification, a time-consuming procedure despite high success rates. Subsequently after the introduction of mineral trioxide aggregate and hydraulic calcium silicate materials single visit apical plug procedures became increasingly practiced with comparable success rates to the conventional apexification. The search continued afterward for a clinical procedure that may stimulate further root development and apical closure to avoid the long-term complication of root fracture after apexification. Regenerative procedures using stem cells derived from the apical papilla and blood clots as scaffolds were then introduced for the management of immature teeth, with variable protocols and success rates. This review will cover the evidence available and current position of regenerative endodontic procedures in traumatized immature teeth with apical periodontitis, in terms of clinical protocols, outcome, and potential prognostic factors.
摘要：
牙髓坏死是牙外伤后最常见的并发症，通常与根尖周炎有关。这些牙齿的管理在大根管方面具有挑战性，开放的顶点，薄的牙本质壁，短的根。几十年来，这些牙齿的常规治疗是氢氧化钙根尖整复术，一个耗时的过程，尽管成功率很高。随后，在引入矿物三氧化物骨料和水硬性硅酸钙材料后，单次访问根尖塞程序变得越来越实践，其成功率与常规根尖纯化相当。此后，继续寻找可能会刺激进一步的根部发育和根尖闭合的临床程序，以避免根尖化后根部骨折的长期并发症。然后引入使用根尖乳头和血凝块作为支架的干细胞的再生程序来管理未成熟的牙齿，具有可变的协议和成功率。这篇综述将涵盖现有证据和再生牙髓手术在患有根尖周炎的未成熟牙齿中的当前位置，就临床方案而言，结果,和潜在的预后因素。
