Biodentine™ Partial Pulpotomy of a Young Permanent Molar with Signs and Symptoms Indicative of Irreversible Pulpitis and Periapical Lesion: A Case Report of a Five-Year Follow-Up

The purpose of this paper was to report the five-year success of Biodentine™ partial pulpotomy in a young permanent molar, with signs and symptoms indicative of irreversible pulpitis and periapical lesion, in a nine-year-old girl. Preoperative clinical examination revealed a large carious lesion of the left mandibular permanent first molar. The patient reported pain on percussion. The tooth responded positively to the electric pulp test and had lingering pain after cold testing. A periapical radiograph showed a deep carious lesion and periapical lesion. Based on the clinical and radiographical examination, the tooth had signs and symptoms indicative of irreversible pulpitis and periapical lesion. During caries removal, pulp exposure occurred, and 2-3 mm in depth of pulp tissue at the exposure site was removed. Haemorrhage was controlled within four minutes with 2.5% sodium hypochlorite-moistened cotton pellets. Biodentine™ was then applied as both a pulp dressing and a temporary restoration. At the following visit, composite resin was placed over the Biodentine™ as a final restoration. During a five-year follow-up, the tooth was asymptomatic, had positive responses to sensibility tests, and had no discolouration. Follow-up radiographs showed a dentine bridge and periapical healing.

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CERVICAL PULPOTOMY IN MATURE PERMANENT TOOTH WITH CARIOUS EXPOSURE: 3-YEAR-FOLLOW UP CASE REPORT

International Journal of Advanced Research ◽

10.21474/ijar01/13183 ◽

2021 ◽

Vol 9 (07) ◽

pp. 830-837

Author(s):

Doumari Bouchra ◽

◽

Drouri Sofia ◽

El Kharroubi Soukaina ◽

El Merini Hafsa ◽

...

Keyword(s):

Cost Effective ◽

Permanent Tooth ◽

Pulp Tissue ◽

Permanent Molar ◽

Mandibular Molar ◽

Clinical And Radiological Results ◽

Intact Root ◽

Irreversible Pulpitis

Objective. The objective of this case study is to manage irreversible pulpitis in a mature permanent molar with a conservative and cost-effective therapy, which is cervical pulpotomy. Summary. A cervical pulpotomy was performed on the second permanent mandibular molar with an irreversible pulpitis in a 30-year-old female patient.Taking the age of the patient and the condition of the underlying pulp tissue into account, cervical pulpotomy was planned to preserve the vitality of the intact root pulps using MTA. Follow-up examinations at 1 month, 3 months, 6 months, 1 year and 3 years revealed positive clinical and radiological results. The high success rate reported in this clinical case also in all systematic reviews for pulpotomy suggests that this procedure can offer an alternative to root canal treatment in teeth with irreversible pulpitis.

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Ledermix Pulp treatment in a permanent molar: A case report

Update Dental College Journal ◽

10.3329/updcj.v4i1.21164 ◽

2014 ◽

Vol 4 (1) ◽

pp. 31-37

Author(s):

Fahd AA Karima ◽

Asma Sultana ◽

Tazdik G Chowdhury ◽

Md Samsul Alam ◽

Mohammed Wahiduzzaman

Keyword(s):

Case Report ◽

Treatment Plan ◽

Carious Lesion ◽

Clinical Procedures ◽

Main Complaint ◽

Permanent Molar ◽

Indirect Pulp Treatment ◽

Patient Reported ◽

Pulp Vitality ◽

Pulp Treatment

This case report describes the Indirect Pulp Treatment (IPT) of deep carious lesion in a permanent molar with Ledemix. A 18 years old male patient reported discomfort associated with thermal stimulation on the mandibular right first permanent molar. Radiographically revealed a deep buccal carious lesion, very close to the pulp. periapical radiolucency and periodontal space thickening was absent. Pulp sensitivity was confirmed by thermal pulp vitality tests. Based on the main complaint and the clinical and radiographic examinations, the treatment plan was established to preserve pulp vitality. Clinical procedures consisted of removing the infected dentin and lining the caries-affected dentin with ledermix cement, the tooth was restored with composite cement. After 12 month follow-up, no clinical or radiographic pathological findings were found. DOI: http://dx.doi.org/10.3329/updcj.v4i1.21164 Update Dent. Coll. j: 2014; 4 (1): 31-37

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Case Report: Immediate pain relief after partial pulpotomy of cariously exposed young permanent molar using mineral trioxide aggregate and root maturation, with two years follow-up

F1000Research ◽

10.12688/f1000research.16381.1 ◽

2018 ◽

Vol 7 ◽

pp. 1616

Author(s):

Passant Nagi ◽

Nevine Waly ◽

Adel Elbardissy ◽

Mohammed Khalifa

Keyword(s):

Pain Relief ◽

Mineral Trioxide Aggregate ◽

Permanent Teeth ◽

Deciduous Teeth ◽

Carious Lesion ◽

Permanent Molar ◽

Initial Setting ◽

Deep Carious Lesion ◽

Carious Exposure

Carious exposure of immature first permanent molar is a widespread issue faced in paediatric dentistry. This may be the result of the early eruption of this molar, so parents may think it is replicable to the rest of the deciduous teeth. Preserving pulp vitality is the primary goal in treating those teeth to allow maturation of roots both in length and width. Mineral trioxide aggregate (MTA) is considered a perfect dressing material for pulpotomy (both partial and complete) due to its bio computability and sealing property. We present a case that describes treatment and two years follow-up of a symptomatic immature first permanent molar with a deep carious lesion. For treatment, we started with anaesthesia and rubber dam isolation. After that, the carious lesion was removed, and we performed partial pulpotomy, then applied MTA-Angelos on the fresh wound. Moistened cotton then was lightly packed over MTA for 15 minutes to allow initial setting, followed by application of glass ionomer and final restoration with composite. The following day, the tooth was asymptomatic with the patient reporting pain relief. After three months follow-up, the tooth normally responds to thermal test. After 12 months, a periapical radiograph of the tooth showed root maturation, and after 24 months also, the tooth was clinically and radiographically successful. MTA partial pulpotomy should be considered in the treatment of symptomatic young permanent teeth.

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Evaluation of LSTR 3 Mix MP Therapy for Healing of Periapical Pathosis of Nonvital Teeth

TAJ Journal of Teachers Association ◽

10.3329/taj.v33i2.51343 ◽

2020 ◽

Vol 33 (2) ◽

pp. 76-84

Author(s):

Md Ismail Hossain ◽

Md Nahid Khurram Choudhury ◽

Md Shamsul Alam ◽

Shahnaz Sultana Beauty ◽

Farid Uddin

Keyword(s):

Glass Ionomer Cement ◽

Clinical Signs ◽

Signs And Symptoms ◽

Periapical Lesion ◽

Pulp Chamber ◽

Uncertain Outcome ◽

Clinical And Radiological Outcome ◽

Clinical Signs And Symptoms ◽

Ionomer Cement

Context: LSTR 3 Mix MP therapy is one of the procedures for the management of nonvital tooth with periapical lesion. The principle of this therapy is the complete sterilization of the total pulp canal space, thereby healing of the periradicular lesion. Objectives: To assess the clinical and radiological outcome of ‘Lesion sterilization and Tissue Repair’ (LSTR) for endodontic treatment of nonvital teeth with periapical lesion. Materials and Methods: This descriptive, observational study allocated 40 nonvital teeth with periapical lesion treated by LSTR 3 Mix MP Therapy. In study subjects, a mixture of Metronidazole, Ciprofloxacin and Minocycline (3 Mix) in a proportion of 1:1:1 in ointment (Macrogol mixed with propylene glycol: MP) was placed at the orifice of the root canal or the bottom of pulp chamber after gaining access in the pulp chamber and removal of necrotic pulp, then sealed with Glass Ionomer cement and further reinforced by composite resin. The protocols for follow up examination were 3, 6 and 12 months post operatively. At the time of follow up examination a standard follow up chart was maintained. Results: Out of 40 cases, in 29 cases had good responses both clinically and radiologically and 8 patients came back with some complications. Out of these 8 patients, 6 patients had uncertain outcome and in 2 patients it was unacceptable. Conclusion: LSTR 3 mix MP therapy reduced clinical signs and symptoms successfully in teeth with periapical lesion and radiological improvement of the periapical index was also noted. TAJ 2020; 33(2): 76-84

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Evaluation of Conventional Root Canal Treatment for Healing of Periapical Pathosis of Nonvital Teeth

TAJ Journal of Teachers Association ◽

10.3329/taj.v33i1.49821 ◽

2020 ◽

Vol 33 (1) ◽

pp. 25-30

Author(s):

Md Ismail Hossain ◽

Monira Parveen ◽

Md Nahid Khurram Choudhury ◽

Tasnim Wakia ◽

Farid Uddin ◽

...

Keyword(s):

Root Canal ◽

Clinical Signs ◽

Signs And Symptoms ◽

Root Canal Treatment ◽

Periapical Lesion ◽

Nonsurgical Management ◽

Clinical And Radiological Outcome ◽

Root Canal System ◽

Clinical Signs And Symptoms

Background: Root canal Therapy is one of the procedures for the management of nonvital tooth with periapical lesion. The principle of this therapy is the complete sterilization of the total pulp canal space thereby healing of the periradicular lesion. Objectives: This experimental study assessed the clinical and radiological outcome of root canal treatment for nonsurgical management of nonvital teeth with periapical lesion. Materials and Methods: A total number of 40 infected teeth with periapical lesion were treated by conventional root canal treatment. Irritants from the root canal system was removed by mechanical instrumentation( Crown down Technique), chemical irrigation with NaOCL and by using Calcium Hydroxide as intracanal medicaments and fluid tight obturation both apically and coronally resulting repairs of inflamed periradicular tissues. The protocol for follow up examination will be 3, 6 and 12 months post operatively. At the time of follow up examination a standard follow up chart will be maintained. Results: Among 40 cases 32 cases could be treated as acceptable as their responses were good both clinically and radiologically and 5 patients came back with some complications among them 3 cases were uncertain and 2 cases were unacceptable. Conclusion: It was concluded that conventional root canal treatment reduced clinical signs and symptoms successfully in teeth with periapical lesion and radiologically. TAJ 2020; 33(1): 25-30

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Coronal Pulpotomy Technique Analysis as an Alternative to Pulpectomy for Preserving the Tooth Vitality, in the Context of Tissue Regeneration: A Correlated Clinical Study across 4 Adult Permanent Molars

Case Reports in Dentistry ◽

10.1155/2015/916060 ◽

2015 ◽

Vol 2015 ◽

pp. 1-12 ◽

Cited By ~ 1

Author(s):

Raji Viola Solomon ◽

Umrana Faizuddin ◽

Parupalli Karunakar ◽

Grandhala Deepthi Sarvani ◽

Sevvana Sree Soumya

Keyword(s):

Clinical Study ◽

Permanent Teeth ◽

Treatment Modalities ◽

Platelet Concentrates ◽

Pulp Tissue ◽

Old Patients ◽

Clinical And Radiological Outcome ◽

Permanent Molars ◽

Irreversible Pulpitis

Aim. (1) The aim of the clinical study revolves around the accurate diagnosis, proper case selection, and the management of acute irreversible pulpitis in permanent molars with closed apices using conservative and economical treatment modalities like vital pulpotomies with regenerative approaches over conventional root canal procedures. (2) To evaluate the use of autologous substances such as platelet concentrates and calcium silicate based materials in promoting the healing and regeneration of the inflamed pulp.Summary. Vital pulpotomy was performed on 5 carious involved, permanent molars diagnosed with acute irreversible pulpitis in 17- to 22-year-old patients. Taking into consideration the patient’s age and the condition of the underlying pulp tissue, PRF pulpotomy was planned in view of preserving the vitality of the intact radicular pulps. Regenerative procedures with second generation blood matrices were chosen to encourage the recovery of the inflamed pulps. The systematic follow-up examinations performed at 3, 6, 9, 12, 18, 22, and 24 months revealed a successful clinical and radiological outcome. Within the limits of the present clinical study and correlating the success across the treated clinical cases, we safely conclude the potential scope of regenerative pulpotomy approaches in acute irreversible pulpitis in adult permanent teeth.

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Stepwise Excavation in a Permanent Molar: 17-year Follow-up

Operative Dentistry ◽

10.2341/09-353-s ◽

2010 ◽

Vol 35 (4) ◽

pp. 482-486 ◽

Cited By ~ 3

Author(s):

F. F. Lima ◽

R. C. Pascotto ◽

A. R. Benetti

Keyword(s):

Clinical Relevance ◽

Signs And Symptoms ◽

Permanent Molar ◽

Carious Lesions ◽

Deep Carious Lesions ◽

Stepwise Excavation ◽

Pulp Exposure

Clinical Relevance Due to the risk of pulp exposure in deep carious lesions, stepwise excavation can be a conservative and successful option for selected cases, when signs and symptoms of a normal pulp are present.

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Evaluation of complete pulpotomy with Biodentine® on mature permanent molars with signs and symptoms of symptomatic irreversible pulpitis: 12 months follow-up.

Journal of Endodontics ◽

10.1016/j.joen.2021.12.008 ◽

2021 ◽

Author(s):

Anta Seck ◽

Diouma Ndiaye ◽

Seydina Ousmane Niang ◽

Fatou Leye Benoist ◽

Florence Fioretti ◽

...

Keyword(s):

Signs And Symptoms ◽

Permanent Molars ◽

Irreversible Pulpitis

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Periapical Healing After Direct Pulp Capping With Calcium-enriched Mixture Cement: A Case Report

Operative Dentistry ◽

10.2341/11-417-s ◽

2012 ◽

Vol 37 (6) ◽

pp. 571-575 ◽

Cited By ~ 9

Author(s):

S Asgary ◽

A Nosrat ◽

N Homayounfar

Keyword(s):

Cold Test ◽

Periapical Lesion ◽

Direct Pulp Capping ◽

Second Molar ◽

Pulp Capping ◽

Mandibular Molar ◽

Mandibular Second Molar ◽

Periapical Healing ◽

Caries Removal

SUMMARY This article describes a successful direct pulp capping of a mature symptomatic mandibular second molar in a 14-year-old girl. The patient was referred with sensitivity to cold beverages and pain on chewing on the second left mandibular molar. Clinical examinations revealed extensive coronal caries and sensitivity to percussion. Radiographically, the tooth was mature and had a widened apical periodontal ligament (PDL) and a narrow periapical lesion. The concluding diagnosis was symptomatic irreversible pulpitis with symptomatic apical periodontitis. Treatment included caries removal under rubber dam isolation, capping of exposure sites with calcium-enriched mixture (CEM) cement, and permanent coronal restoration. At three-, 10-, and 15-month follow-up, the tooth was functional, had normal response to cold test, and did not have sensitivity to percussion. The PDL space regained its normal width, and the periapical lesion healed.

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Nonsurgical Endodontik Retreatment of Maxillary First Premolar

DENTA ◽

10.30649/denta.v11i1.133 ◽

2017 ◽

Vol 11 (1) ◽

pp. 88

Author(s):

Yongki Hadinata W ◽

Karlina Samadi

Keyword(s):

Root Canal ◽

Radiographic Examination ◽

Periapical Lesion ◽

First Choice ◽

Periapical Abscess ◽

Dental Hospital ◽

Conservative Dentistry ◽

Previously Treated ◽

Endodontic Retreatment

Background : There are some factors can cause endodontic failure such as inadequate in cleaning or shaping step, non hermetic obturation, or poor restoration, which can cause bacteria multiply. Purpose : To report the management of endodontic failure with nonsurgical treatment. Case : 46-year-old woman came to Airlangga Dental Hospital Conservative Dentistry Department to treat her upper right tooth which show symptomatic pain in the last 2 weeks. The tooth has been treated and crowned with porcelain fused to metal about 10 years ago. Clinical examination show the presence of fistula on premolar buccal gingiva, react to percussion. Radiographic examination show not hermetic obturation in one root canal and radiolucency in the periapical area. The diagnosis for maxillary first premolar is previously treated tooth with chronic periapical abscess.. Treatment : Crown and post was removed from the tooth, and endodontic retreatment was done. Follow up 6 months after the retreatment show no reaction to percussion, and radiographic examination show no enlargement periapical lesion. Conclusion : Nonsurgical endodontic retreatment always become the first choice to resolve endodontic failure for previously treated tooth.Keywords : endodontic failure, maxillary first premolar, nonsurgical endodontic retreatmentCorrespondence: Yongki Hadinata W., drg. PPDGS Ilmu Konservasi Gigi Fakultas Kedokteran Gigi Universitas Airlangga, Surabaya. Jl. Mayjen. Prof. Dr. Moestopo No. 47, Surabaya.

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