Radiographic assessment of regenerative endodontic treatment of traumatised non-vital immature teeth.

Objectives: To evaluate the radiographic outcomes of the regenerative endodontic technique (RET) in managing traumatised non-vital immature teeth.
To compare two methods of radiographic assessment of continued root development; expert visual assessment and objective measurements of radiographic parameters.
Methods: Fifteen healthy children (age range=7-11 years) with traumatised non-vital immature upper incisors were included. RET using two antibiotics (ciprofloxacin and metronidazole), was used for treatment with an average follow up of 9.9 months. One operator undertook all treatments, reviews and standardised radiographs. Radiographic assessment of root length, dentinal wall thickness and apical foramen width at baseline and follow-up were assessed visually and measured using Infinitt digital radiographic assessment software, Seoul, Korea, by 2 experienced clinicians.
Results: When the radiographs were evaluated visually, it was agreed that only 2, 4 and 6 out of the 13 teeth showed any evidence of increased root length, increased dentinal thickness, and reduced apical foramen width (Kappa=0.278, 0.270, 0.870), respectively. However, when the radiographic parameters were objectively measured, inter-operator measurement reliability was excellent (overall intra-class correlation= 0.974 (95% CI 0.955-0.986)). No statistical significant differences were found in any of the measured parameters between pre and post-operative radiographs. Clinically 100% resolution of clinical signs and symptoms was found.
Conclusions: Our data showed that visual evaluation of radiographs was not as reliable as objective measurements with both methods showing no significant increase in root length and dentinal wall thickness. Most teeth treated with RET did not demonstrate any continuation of root development, but complete clinical healing was evident in all non-vital immature traumatised incisors.