ASSESSMENT OF OUTCOMES 5 YEARS AFTER REGENERATIVE ENDODONTIC PROCEDURES.

Abstract: Introduction: Regenerative endodontic procedures (REPs) are biologically designed to replace lost structures such as dentin-pulp complex cells. REPs are based on three elements: stem cells, growth factors and the scaffolding that provides support for organization, proliferation, differentiation and vascularization.Aim: To assess the clinical and radiographic evolution of young permanent teeth diagnosed with necrosis which were treated using regenerative endodontic procedures (REPs).Materials and methods: This study had an experimental design. It secured Ethics Committee approvals 009/2017 and 018/2021. The study included young permanent teeth diagnosed with pulp necrosis in children aged 6 to 14 years, without systemic compromise. They were treated following the AAE protocol for REP. Mineral trioxide aggregate (MTA) or bioceramic sealer (Biodentine) was used to seal the cervical third of the root. Clinical and radiographic follow-up was performed at 3, 6, 12 and 18 months, and 2, 3, 4 and 5 years, considering clinical failure to be presence of pain or swelling in the area, and radiographic failure to be persistence of apical radiolucency. Discoloration was recorded photographically, and pulp sensitivity tests were performed. Data were analyzed using means, percentages and Fisher's test. Results: The sample consisted of 35 teeth: 19 in the MTA group (GM) and 16 in the Biodentine group (GB). Mean age was 9.70 ± 2.13 years. At 3 months, treatment was clinically and radiographically successful in 68% of GM and 94% of GB (p=0.09), increasing to 100% at 12, 18 and 24 months, without significant differences between groups . At 3 years, the success rate declined to 94% in GM, and at 5 years it was 67% in both groups. Regarding discoloration, the percentages were compared, finding a value of p = 0.04. Tertiary success (positive response to a pulp sensitivity test) percentages did not differ significantly between groups (p = 0.08). Conclusion: Although the outcomes of treatments using REP protocol are satisfactory at the time considered, further studies with longer terms and more patients are required.