To compare the effect of apexification, apical barrier technique and pulp revascularization on the treatment of immature permanent teeth with periapical periodontitis.

Immature permanent teeth with periapical periodontitis in 45 patients (caused by abnormal central cusp) at Nanjing Stomatological Hospital from April 2019 to August 2020 were collected. Clinical symptoms include percussive pain, odontoseisis, swelling, etc. X-ray showed periapical shadow, root tip which is not closed as well as not enough root length, etc. All of the 45 patients were divided into 3 groups (n = 15 each) according to the method of random number table, apexification group, apical barrier technique group, and pulp revascularization group. Reviewed every 3-6 mouths after treatment, and followed up for 1-2 years (at lease 1 year) . The data were analyzed with SPSS 26.0, the clinical efficacy of patients in 3 groups was compared by χ² test, and the comparison of root length and root tip width was applied by t test.

Clinical symptoms of three groups disappeared immediately after surgery. The cure rate of the apexification group (53.33%) and pulp revascularization group (80%) were higher than the apical barrier technique group (0%) one year after surgery, and the difference was statistically significant (P<0.001) . The cure rate of the pulp revascularization group was higher than the apexification group, but the difference was not statistically significant (P = 0.146) . In terms of root tip development, the root length of pulp revascularization group was (10.80 ± 1.01) mm, which in apexification group was (10.31 ± 1.08) mm. The root development of pulp revascularization group was more noteworthy than apexification group (t = 2.402, P<0.05) . The root tip width was (0.21 ± 0.09) mm in pulp revascularization group and (0.45 ± 0.08) mm in apexification group, and the root tip closure in pulp revascularization group was highly effective against apexification group (t = 11.201, P<0.001) .

Apexification, apical barrier technique, and pulp revascularization are all effective methods in the treatment of immature permanent teeth with periapical periodontitis, but the pulp revascularization is more effective in the closure of root tip and root development.