الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 135 |  |  |
| | | from | 135 | | |
Abstract
Summary & Conclusions
This study aimed to evaluate the effect of number of treatment visits and different irrigation methods on regenerative ability of pulp tissue. It included 32 patients of immature necrotic anterior teeth with no evidence of presence of periapical pathosis. Cases were divided randomly and equal into 2 groups; group I in which single visit regenerative treatment was used and group II in which multiple visit regenerative protocol was used. Each group was divided randomly and equal into 2 subgroups; Subgroup A in which the passive ultrasonic activation of irrigation was used and Subgroup B in which the conventional manual irrigation was used.
All cases of group I were treated using single visit approach in which the canal spaces were disinfected only by conventional irrigation protocol or by using passive ultrasonic activation of the irrigation, followed by induction of bleeding into the clean disinfected canals, which were then sealed by white MTA coronal plug and composite restoration. All cases of group II were treated using the antibiotic paste for three weeks, followed by induction of bleeding into the clean disinfected canals which irrigated either by conventional irrigation protocol or by using passive ultrasonic activation of the irrigation, which were then sealed by white MTA coronal plug and composite restoration.
Cases were followed on regular intervals up to 12 months clinically and radiographically.Clinical evaluation included history taking and clinical examination regarding presence or absence of pain, swelling or sinus tract.
Radiographic evaluation included measurement of change in root length, thickness and apical diameter of standardized radiographs. Data were collected and tabulated for statistical analysis.
Clinical follow up showed that all cases were asymptomatic, functional, and irresponsive to hot test throughout the follow up period. Some cases experienced mild pain or discomfort for few days postoperatively.
No statistically significant difference in root length nor thickness between all groups through the whole follow up period. Regarding the effect of time on change of root length, statistically significant difference was found after 12 months of follow up. Regarding the effect of time on root thickness, Statistical analysis showed that in groupIA “single visit with passive ultrasonic activation of irrigation” there was a significant difference between (Baseline-3 months) and (6-9 months) follow up periods. However, In group IB, IIA and IIB there was no significant difference between all follow up periods in each group. And also there was significant increase in root thickness at the end of whole follow up periods in all groups.
Statistical analysis showed that there was no statistically significant difference in degree of apical closure between all groups through the whole follow up period. Regarding the effect of time on apical closure, Statistical analysis showed that there was no significant difference between all follow up periods in group IA and IB. However, in group IIA and IIB there was a significant difference between (Baseline- 3 months) and (3-6 months).On the other hand, there was significant decrease in apical diameter at the end of whole follow up periods in all groups.
Conclusions:
Under the circumstances of this study, it can be concluded that:
1. Single visit approach of pulp revascularization as well as multiple visits approach are successful treatment optionsfor permanent anterior teeth with immature roots and necrotic pulp tissues in cases of absences of periapical lesions .
2. The use of passive ultrasonic activation of the irrigation in the cases of permanent anterior teeth with immature roots and open apex didn’t enhance the regenerative ability of the pulp tissues.
Recommendations:
Longer follow up period (>12 months) is needed for monitoring of complete root maturogenesis.