Irrigation in Regenerative Endodontic Procedures

The developing dentition is at risk for pulpal necrosis due to trauma and developmental dental anomalies such as dens evaginatus. Loss of an immature permanent tooth in young patients with mixed dentition can be devastating, leading to loss of function, malocclusion, and inadequate maxillofacial development. These teeth traditionally have been treated with apexification procedures using either long-term calcium hydroxide treatment or immediate placement of a mineral trioxide aggregate (MTA) apical plug. Although these treatments often result in the resolution of signs and symptoms of pathosis, they provide little to no benefit for continued root development. Thus, immature teeth treated with these procedures are considered in a state of “arrested development,” and no further root growth, normal pulpal nociception, and immune defense should be expected.