scholarly journals Apexification Management of Mandibular Second Premolar with a Blunderbuss Apex and Periapical Lesion of an Adult Patient

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Chenshuang Li ◽  
Zhong Zheng ◽  
Xiaohong Deng ◽  
Lan Zhang ◽  
Baoyan Wang ◽  
...  
Keyword(s):  
Case Report ◽  
Adult Patient ◽  
Calcium Hydroxide ◽  
Adult Population ◽  
Mineral Trioxide Aggregate ◽  
Adult Patients ◽  
Periapical Lesion ◽  
Hard Tissue ◽  
Tooth Position ◽  
Immature Teeth

Apexification is widely applied in teenager patients but rarely used in the adult population. Instead, artificial apical barrier with mineral trioxide aggregate (MTA) is clinically accepted, and spontaneous apical closure in nonvital immature teeth of adult patients has rarely been encountered while only apexification of the maxillary incisors in adult patients has been reported. The aim of this case report is to share a successful apexification application in the mandibular premolar with a blunderbuss apex and periapical lesion of an adult patient by using calcium hydroxide: radiographically, spontaneous hard tissue barrier has been established, and narrowing canal space and decreasing area of periapical shadow were documented without complications. Taken together, our study indicates that patient’s age and tooth position may not be the critical limitation for apexification.

scholarly journals Apexification Using Mineral Trioxide Aggregate and Modified Internal Matrix: A Case Report

2021 ◽  
Vol 33 (2) ◽  
Keyword(s):  
Case Report ◽  
Mineral Trioxide Aggregate ◽  
Tissue Formation ◽  
Enamel Hypoplasia ◽  
Hard Tissue ◽  
Radiographic Evidence ◽  
Radiographic Findings ◽  
Immature Teeth ◽  
Patient Reported ◽  
Treatment Alternatives

When pulpal necrosis occurs in immature teeth, one of the treatment alternatives is the creation of an artificial apical barrier through the placement of an apical plug. However, controlling the mineral trioxide aggregate (MTA) during placement has proven difficult. Several studies evaluated the use of resorbable barriers to act as an internal matrix to prevent accidental extrusion of MTA. The aim of this case report was to document the effectiveness of Surgicel as a modified internal matrix for proper placement of MTA during management of immature teeth with necrotic pulp using the apical plug technique. A 12-year-old female patient reported with the chief complaint of a badly mutilated lower right second premolar. The tooth suffered enamel hypoplasia and had a defective coronal structure. It was asymptomatic except for slight tenderness to percussion. Based on the clinical and radiographic findings, a diagnosis of pulpal necrosis with symptomatic apical periodontitis was made. The 3- and 6-month followup showed radiographic evidence of continued root and hard tissue formation. Based on these findings, we infer that Surgicel can be used as a modified internal matrix to prevent extrusion of the MTA into the periapical area and allow for proper MTA placement. Keywords: Apexification; Apical plug; Mineral trioxide aggregate; Calcium hydroxide; Surgicel; Modified internal matrix

Management of Non-Vital Open Apex in A Lateral Incisor Using Calcium Hydroxide and Reverse GP Cone Cold Lateral Compaction in A General Practice Setting

2021 ◽  
Author(s):  
Haider Al-Saffar
Keyword(s):  
Case Report ◽  
Calcium Hydroxide ◽  
Dental Trauma ◽  
Lateral Incisor ◽  
Incisor Tooth ◽  
Beneficial Effects ◽  
Immature Teeth ◽  
Gutta Percha ◽  
Regenerative Dentistry ◽  
Dental Practices

Although dental trauma is poorly managed by general dental practices, it is important to follow appropriate steps to achieve optimal results. This case report outlines the management of non-vital immature teeth with calcium hydroxide and reverse Gutta Percha (GP) cone cold lateral compaction to achieving endodontic success. Even though it is a disputed technique, if proper conditions are provided, the root development continues to preserve a functionally fit and sound tooth on the arch of a young adolescence, avoiding extensive surgical and prosthetic procedures to replace a potentially compromised tooth. This case report highlights the beneficial effects of both calcium hydroxide and Chlorhexidine-dygluconate (CHX), which are far to be obsolete in the field of apexification or even regenerative dentistry as a whole.The 11 years old male presents post-traumatic necrosis in the upper left lateral incisor (tooth 2.2) which is dressed with calcium hydroxide, achieving the disinfection of the root canal, remission of the apical periodontitis and complete root formation 1 year later. The importance of the use of biocompatible materials as calcium hydroxide and CHX are emphasized in this case in which, although, no modern regenerative procedures and materials were used, the results are more than satisfactory. This report will look into the management of a non-vital immature lateral incisor with a reverse GP cone lateral compaction to achieving a successful apical and canal seal radiographically.

Calcium Hydroxide as Intracanal Medicament in Pulp Necrosis with Periapical Lesion : A Case Report

2019 ◽  
Vol 829 ◽  
pp. 226-231
Author(s):  
Elvi Sahara ◽  
Rahmi Alma Farah ◽  
Myrna Nurlatifah Zakaria
Keyword(s):  
Case Report ◽  
Calcium Hydroxide ◽  
Tissue Repair ◽  
Cytoplasmic Membrane ◽  
Root Resorption ◽  
Periapical Lesion ◽  
Root Canal Preparation ◽  
Endodontic Infection ◽  
Infected Cyst ◽  
Lesion Index

Calcium hydroxide [Ca(OH)2] has been widely used as an intracanal medicament especially in treatment of periapical lesion. This case report will discuss about calcium hydroxide as intracanal medicament in a periapical lesion of an upper left central incisor. This case describes about treatment of periapical lesion with suspect of infected cyst with symptoms and root resorption. Root canal preparation was done by crown down technique using protaper hands universal from S1/27mm until F5/27mm. Calcium hydroxide paste was continuously applicated every 2 weeks as intracanal medicament until the periapical index (PAI) of lesion decrease, in this case PAI decreased from scale 5 until scale 2 during three months recall. Calcium hydroxide supports tissue repair, stimulates fibroblast formation and damage the cytoplasmic membrane of bacteria, denature their proteins or damage the DNA by its alkaline property. As conclusion, the use of calcium hydroxide successfully decrease the periapical lesion index in the periapical radiograph examination and can be considered as a simple and effective medicament for endodontic infection.

scholarly journals Pulp Revascularisation of a Non-Vital Immature Young Permanent Tooth - A Case Report and Literature Review

2021 ◽  
Vol 10 (11) ◽  
pp. 845-848
Author(s):  
Tanvi Sanjay Satpute ◽  
Jayeeta Sidharth Verma ◽  
Jimish Rajiv Shah ◽  
Aditya Kiran Shinde
Keyword(s):  
Case Report ◽  
Root Development ◽  
Root Canal ◽  
Mineral Trioxide Aggregate ◽  
Signs And Symptoms ◽  
Permanent Tooth ◽  
Duration Of Treatment ◽  
Pulp Tissue ◽  
Dental Tissues ◽  
Immature Teeth

Traumatic injuries to an immature permanent tooth may result in cessation of dentin deposition and root maturation. Novel revascularisation endodontic procedure (REP) has been considered as an option for treatment of immature teeth with damaged pulp tissue. The continuous development of the root and the root canal has been recognised as a major advantage of this technique over traditional apexification approach. Traditional apexification procedures may resolve pathology but have not been able to prove tooth survival due to absence of continued root development and risk of root fracture. A successful REP results in resolution of signs and symptoms of pathology, radiographic signs of healing, proof of continued root development as well as presence of pulp vitality due to the regeneration of pulp tissue in the root canal. Currently, repair rather than true regeneration of the ‘pulp-dentine complex’ is achieved and further root maturation is variable. According to Glossary of Endodontic terms published by American Association of Endodontists, REP’s are biologically based procedures designed to physiologically replace damaged tooth structures, including dentin and root structures, as well as cells of the pulp-dentin complex.1,2 Apexification treatment has been a routine procedure to treat and preserve such teeth for many decades.3 Apexification is the process by which a suitable environment is created within the root canal and periapical tissue to allow for the formation of a calcific barrier across the open apex. Calcium hydroxide [Ca(OH)2] has been the material of choice for apexification as Frank reported its capacity to induce physiological closure of immature pulpless teeth in 1966.4 However, this technique has several disadvantages, including the unpredictability of apical barrier formation and the long duration of treatment, which often requires multiple visits.5 A retrospective study by Jeruphuaan et al.6 has shown a higher survival rate with regenerative endodontic treatment when compared to both mineral trioxide aggregate (MTA) and Ca(OH)2 apexification. The first evidence of regeneration of dental tissues was in 1932 by G.L. Feldman, who showed evidence of regeneration of dental pulp under certain optimal biological conditions.7 In 1971, a pioneer study in regenerative endodontics conducted by Nygaard-Ostby concluded that bleeding induced within a vital or necrotic canal led to resolution of signs and symptoms of necrotic cases and in certain cases, apical closure.8 According to Windley et al. (2005), the successful revascularisation of immature teeth with apical periodontitis is mainly dependent upon: 1. Canal disinfection 2. Scaffold placement in the canal for the growing tissues 3. Bacteria-tight sealing of the access opening.9 The purpose of this case report is to illustrate the outcome of a revascularisation endodontic procedure in a non-vital immature young permanent central incisor.

scholarly journals The classical case of the treatment of an adult patient with the salt-losing form of congenital adrenal cortical dysfunction

2011 ◽  
Vol 57 (4) ◽  
pp. 25-27
Author(s):  
A I Sazonova ◽  
N V Molashenko ◽  
I S Iarovaia ◽  
N Iu Kalinchenko ◽  
E A Troshina
Keyword(s):  
Case Report ◽  
Adult Patient ◽  
Clinical Course ◽  
Classical Case ◽  
Adult Patients ◽  
Dynamic Observation ◽  
Cortical Dysfunction ◽  
Disease Analysis

This case report illustrates peculiarities of the clinical course of congenital adrenal cortical dysfunction in adult patients presenting with the salt-losing form of the disease. Analysis of this case confirmed the necessity of dynamic observation of adults with this pathology in order to avoid complications that are likely to develop in case of inadequate treatment.

scholarly journals Reparative Dentinogenesis Induced by Mineral Trioxide Aggregate: A Review from the Biological and Physicochemical Points of View

2009 ◽  
Vol 2009 ◽  
pp. 1-12 ◽  
Author(s):  
Takashi Okiji ◽  
Kunihiko Yoshiba
Keyword(s):  
Calcium Hydroxide ◽  
Healing Process ◽  
Mineral Trioxide Aggregate ◽  
Wound Healing Process ◽  
Direct Pulp Capping ◽  
Hard Tissue ◽  
Molecular Events ◽  
Points Of View

This paper aims to review the biological and physicochemical properties of mineral trioxide aggregate (MTA) with respect to its ability to induce reparative dentinogenesis, which involves complex cellular and molecular events leading to hard-tissue repair by newly differentiated odontoblast-like cells. Compared with that of calcium hydroxide-based materials, MTA is more efficient at inducing reparative dentinogenesis in vivo. The available literature suggests that the action of MTA is attributable to the natural wound healing process of exposed pulps, although MTA can stimulate hard-tissue-forming cells to induce matrix formation and mineralization in vitro. Physicochemical analyses have revealed that MTA not only acts as a “calcium hydroxide-releasing” material, but also interacts with phosphate-containing fluids to form apatite precipitates. MTA also shows better sealing ability and structural stability, but less potent antimicrobial activity compared with that of calcium hydroxide. The clinical outcome of direct pulp capping and pulpotomy with MTA appears quite favorable, although the number of controled prospective studies is still limited. Attempts are being conducted to improve the properties of MTA by the addition of setting accelerators and the development of new calcium silicate-based materials.

scholarly journals Mahkota Porselin Fusi Metal dengan Parallel Self-Threading Dowel Pasca Perawatan Saluran Akar Gigi Premolar Maksila

2016 ◽  
Vol 1 (1) ◽  
pp. 46
Author(s):  
Asri Riany Putri ◽  
Diatri Nari Ratih
Keyword(s):  
Treatment Outcome ◽  
Case Report ◽  
Root Canal ◽  
Root Canal Treatment ◽  
Radiographic Examination ◽  
Periapical Lesion ◽  
Pulp Chamber ◽  
Hard Tissue ◽  
Transverse Axis ◽  
Successful Treatment Outcome

Gigi premolar maksila merupakan gigi yang mendapat tekanan pengunyahan besar dan rentan mengalami fraktur terutama setelah dilakukan perawatan saluran akar (PSA). Gigi yang telah dilakukan PSA akan menjadi sangat rapuh dan rentan fraktur karena telah kehilangan kelembaban dan banyak jaringan kerasnya. Gigi premolar juga mendapat tekanan pengunyahan yang besar karena bentuk dan letaknya yang lebih dekat dengan aksis horizontal transversal. Penggunaan parallel self-threading dowel dan mahkota penuh porselen fusi metal akan mendistribusikan beban pengunyahan keseluruh bagian akar dan meningkatkan ketahanannya terhadap fraktur. Tujuan laporan kasus ini adalah untuk menunjukkan keberhasilan penggunaan parallel self-threading dowel dengan mahkota penuh porselen fusi metal sebagai restorasi pasca PSA pada gigi premolar kedua maksila nekrosis pulpa dengan lesi periapikal. Pasien wanita berusia 30 tahun dirujuk untuk PSA pada gigi premolar kedua kanan maksila nekrosis pulpa dengan lesi periapikal. Pasien merasakan sakit saat gigi digunakan untuk makan. Perkusi dan palpasi positif namun mobilitas normal. Pemeriksaan radiografik menunjukkan gambaran radiopak yang telah mengenai ruang pulpa dan radiolusensi pada periapikal gigi. PSA dan restorasi mahkota penuh dilakukan dengan parallel self-threading dowel. Parallel self-threading dowel dan mahkota penuh PFM sebagai restorasi akhir menunjukkan keberhasilan perawatan pada gigi premolar kedua maksila pasca PSA. ABSTRACT: Porcelain Fused to Metal Crown with Parallel Self-Threading Dowel Post Root Canal Treatment On Maxillary Premolar. Maxillary premolar teeth have great chewing forces and prone to fracture, especially after root canal treatment (RCT). Teeth that have RCT done will be very brittle and fracture prone because it has lost moisture and lost most of its hard tissue. Premolars also receive great chewing forces because its shape and location are closer to the horizontal transverse axis. The use of parallel self-threading dowel and full porcelain fused to metal crowns will distribute the load of mastication throughout the roots and improve resistance to fracture. The aim of this case report was to demonstrate the success of the use of parallel self-threading dowel with full porcelain fused to metal crown restoration aftera RCT on maxillary second premolar with pulp necrosis and periapical lesion. A 30-year-old female patient was referred for RCT on the maxillary right second premolar with pulp necrosis and periapical lesion. Patient felt pain when the tooth was used to eat. There was tenderness to percussion and palpation but the mobility was normal. A radiographic examination showed radiopaque image that entered pulp chamber and periapical radiolucency on tooth. RCT and full crown restoration with parallel self-threading dowel had been performed. Parallel self-threading dowel and full porcelain fused to metal crown as the final restoration after RCT on the maxillary second premolar showed a successful treatment outcome.

scholarly journals Nonsurgical Management of Large Periapical Lesion in Mature and Immature Teeth using Different Calcium Hydroxide Formulations: Case Series

2013 ◽  
Vol 14 (6) ◽  
pp. 1183-1188
Author(s):  
Prashant P Moogi ◽  
Reshma S Hegde ◽  
G Vinay Kumar ◽  
BR Prashant ◽  
Basanagouda Patil
Keyword(s):  
Calcium Hydroxide ◽  
Case Series ◽  
Periapical Lesion ◽  
Nonsurgical Management ◽  
Immature Teeth

ABSTRACT This case series evaluates the effectiveness of different calcium hydroxide formulations with various vehicles in management of large periapical lesion in mature and immature teeth. This will help clinicians to make informed judgments about which formulations of calcium hydroxide should be used for specific endodontic procedures. How to cite this article Kumar GV, Hegde RS, Moogi PP, Prashant BR, Patil B. Nonsurgical Management of Large Periapical Lesion in Mature and Immature Teeth using Different Calcium Hydroxide Formulations: Case Series. J Contemp Dent Pract 2013;14(6):1183-1188.

scholarly journals Non surgical management of large periapical lesion using mta: report of 2 cases

2015 ◽  
Vol 2 (6) ◽  
pp. 505
Author(s):  
MC Noushad ◽  
Mohammed Niyaz ◽  
Faizal C Peedikayil ◽  
CV Pradeep ◽  
Anish Sebastian ◽  
...  
Keyword(s):  
Case Report ◽  
Calcium Hydroxide ◽  
Surgical Management ◽  
Periapical Lesion ◽  
Histologic Response ◽  
Long Period ◽  
The Past ◽  
Gutta Percha ◽  
Periapical Healing ◽  
Open Apices

In the past, cases with open apices were often treated over several appointments, using calcium hydroxide, with the hope of creating a ‘‘calcific’’ barrier against which gutta percha could eventually be placed. The treatment could be as long and the prognosis is questionable. These roots were often thinner and, therefore, more brittle; extending treatment over a long period of time without providing a permanent restoration increased the chances of losing these teeth due to fracture. With the favorable histologic response of MTA, this material is the best current choice for this procedure. Completion of these cases in an effective and efficient way allows for permanent restorations to be done in a timelier manner, prolonging the longevity of these teeth. The following case report demonstrates the use of MTA as an obturating material to promote periapical healing with an open apex.

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