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Tissue Engineering—Regeneration of the Pulpodentin Complex and Periradicular Tissues

(TC69) Revascularization Following Decompression: A Case Report on Regenerative Endodontics in a young adult patient

Thursday, April 3, 2025

1:00 PM - 4:00 PM EST

Presenter(s)

Farhad Tahmoresi, D.M.D.

Endodontics Resident
Nova Southeastern University College of Dental Medicine
PLANTATION, Florida, United States

Co-Author(s)

Arsalan Montazer, M.S.

Arsalan Montazer
Nova Southeastern University College of Dental Medicine
Parkland, Florida, United States
Catalina Mendez, D.D.S.

Dr
Nova Southeastern University College of Dental Medicine
Davie, Florida, United States

The Decompression procedure was first reported in 1800s. This procedure entails suturing a stent across the cystic cavity and oral mucosa, to reduce the size of a large periapical lesion by releasing the intraluminal pressure and facilitating bone formation, prior to proceeding with further treatment. Other treatment modalities encompass nonsurgical treatment such as regenerative endodontic procedure which was initially reported in 1961. This conservative technique can potentially be performed on immature permanent teeth to promote root development, thickening of the canal walls, and apical barrier formation in cases of pulp necrosis. This procedure hopefully prevents the need for extraction that can result from cracks/fractures due to thin dentinal walls. The goal is to resolve the clinical signs, symptoms and continued root formation in order to maintain the natural function of the tooth. The regenerative procedure involves disinfection of the root canal system, formation of a blood clot, and placing a coronal bioceramic plug to stimulate cell growth. Compared to traditional apexification procedure, revascularization potentially provides superior long-term benefits for the patient. This case report discusses a situation where a 22-year male presented with a necrotic tooth, an open apex, and a large periapical lesion. In this situation, both decompression and regenerative procedures were simultaneously utilized in order to stimulate both root formation and periapical healing. Periapical X-ray and CBCT were used to evaluate healing and root formation. In this case, short term healing was observed. Long-term follow-up and additional cases are needed to evaluate the outcome of this combined approach.