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Abstract
This clinical study was conducted to evaluate and compare the efficiency of two different protocols: MTA apexification and regeneration in treating patients with necrotic, immature canals in anterior teeth regarding postoperative pain and continuation of root development. Twenty-four patients with anterior, necrotic, immature teeth with or without apical pathosis were treated and followed up clinically and radiographically for 9 months. The canals were disinfected without mechanical instrumentation using 20 ml of 5.25% NaOCl irrigation followed by a tri antibiotic paste consisting of 1 : 1 : 1 metronidazole, ciprofloxacin and doxycycline. The inner surface of the coronal access cavity was sealed with a layer of flowable composite. After a period of 20 days, the patients were randomly divided into two equal groups (n = 12), regeneration group and MTA apexification group, according to the treatment protocol. The clinical trial was double-blinded where the study participants and the assessor were blinded from knowing which intervention was received. Postoperative pain was assessed using the visual analogue scale (VAS) pre operatively, 4, 12, 24 and 48 hours post operatively and at 1, 3, 6 and 9 months intervals. Clinical evaluation of the resolution of swelling (if present) was also performed. Furthermore, standardized radiographs were taken at the same intervals for the assessment of the resolution of the periapical pathosis as well as the assessment of root development in terms of root length, dentin thickness and apical closure. All demographic data, clinical and radiographic findings and VAS scores obtained from patients were statistically analyzed. Results showed that there was no statistically difference between the two groups regarding the demographic data, clinical or radiographic findings