The treatment of non-vital immature permanent teeth by filling of root canals with calcium hydroxide

Aim The aim of the present clinical study was to evaluate the endodontic method of treatment consisting of gentle preparation of the root canal and subsequent temporary filling with calcium hydroxide. The filling of the root canal with calcium hydroxide was repeated approximately at three-month intervals. Method The study consisted of a test group of 98 children with 103 non-vital single-root permanent immature teeth, 56 (54.4%) at developmental stage II and 47 (45.6%) at stage III. A control group consisted of 193 non-vital teeth treated by a periapical-surgical method. Treatment consisted of access cavity and instrumentation of the root canals, irrigation and dressing with non-setting calcium hydroxide proprietary paste. Dressings were replaced at 1-2 month and at 3 month intervals until an apical barrier formed. Root treatment was completed with gutta-percha and AH plus paste. Results Of the 103 non-vital immature teeth the treatment was successful in 97 cases. In four cases the treatment could not be finished because of failure to attend. A failure of endodontic treatment occurred in two cases. Continued development of the root was found in three children, and in all remaining cases the hard tissue barrier closed or narrowed the apical opening. Statistically significant earlier completion of treatment was found in the teeth treated in the stage II of development compared with stage III. Conclusion Endodontic treatment with calcium hydroxide is preferred over periapical surgical treatment for immature non-vital permanent teeth in children.