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 ◽  
...  

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.

2021 ◽  
Vol 10 (33) ◽  
pp. 2863-2866
Author(s):  
Akshay Khandelwal

Calcium hydroxide is used as an intracanal medicament in endodontics as it reduces intracanal microbial load and exudate discharge from infected teeth. Reports have shown that extrusion of calcium hydroxide periapically leads to an increased incidence of swelling, delayed periapical healing, nerve paraesthesia and other complications. Teeth with immature apex or those undergoing apical resorption are prone to higher chances of periapical medicament extrusion, especially under high pressure delivery systems. This case report discusses nonsurgical management of periapically extruded non-setting calcium hydroxide by an innovative technique which is less invasive and comfortable both for the clinician and the patient. Calcium hydroxide is widely used as an intracanal medicament for the treatment of pulpal and periapical diseases.1 The intracanal placement of calcium hydroxide can be done with a lentulospiral or a syringe-based delivery system.2 If extruded periapically, there is an increased incidence of swelling, delayed periapical healing, nerve paraesthesia and other complications.3 Case reports in the past have suggested surgical management of periapically extruded calcium hydroxide. The purpose of this case report is to discuss an orthograde nonsurgical management of periapically extruded calcium hydroxide based intracanal medicament containing barium sulphate during endodontic treatment.


2021 ◽  
Vol 9 (2) ◽  
pp. 84-87
Author(s):  
Priya Mendiratta ◽  
Pooja Srivastava ◽  
Bhavna Gupta

Management of immature non-vital teeth poses challenge for the clinician owing to the thin root canal walls and open apices which may show apical divergence. Apexification is the technique of inducing the apical closure with a root end filling material for non-vital immature young permanent teeth. Traditionally, Calcium hydroxide was the material of choice for apexification of immature permanent teeth but introduction of MTA has shown remarkable promise as an alternative to calcium hydroxide. This report presents a case of apexification of anterior two young permanent teeth with open apices using MTA and Gutta percha followed by esthetic build up using cast metal posts and full coverage restorations.


2020 ◽  
Vol 9 (6) ◽  
pp. 513-516
Author(s):  
Mailon Cury Carneiro ◽  
Fernanda Angelio Da Costa ◽  
Paula Gabriela Vieira Chicora ◽  
Marcos Sergio Endo ◽  
Vanessa Cristina Veltrini

O objetivo deste trabalho é relatar um caso clínico de uma extensa lesão periapical em maxila, tratada somente por uma abordagem endodôntica não cirúrgica, com expressivo reparo periapical. Paciente do sexo feminino, 52 anos, compareceu à clínica odontológica, com a queixa principal de “cisto crescendo na boca”. Os dentes 13, 14 e 15 apresentavam-se sem vitalidade pulpar. Os exames radiográficos mostraram duas áreas radiolúcidas, uniloculares, envolvendo os ápices dos dentes 13 e 15, ambos sem sinais de intervenção endodôntica. As áreas eram sugestivas de granuloma periapical e cisto periapical inflamatório, respectivamente. Realizou-se tratamento endodôntico dos dentes 13, 14 e 15. Após 11 meses, notou-se regressão significativa da rarefação óssea periapical, não sendo necessária qualquer intervenção cirúrgica. A paciente continuará em proservação até a remissão completa da lesão. O preparo químico-mecânico, associado ao emprego de medicação intracanal, pode ser suficiente para o reparo de lesões periapicais extensas. Sugere-se que o tratamento conservador seja sempre a primeira opção em casos semelhantes, de forma a se evitar cirurgias parendodônticas invasivas desnecessárias. Descritores: Endodontia; Cisto Radicular; Tratamento Conservador. Referências Hammouti J, Chhoul H, Ramdi H. Non-surgical management of large periapical cyst like lesion: case report and litterature review. J Oral Heal Dent Sci. 2019;3(1):1–7. Mitra A, Adhikari C. Management of large periapical lesions by non surgical endodontic approach - two case reports. 2017;2(5):97–104. Al Khasawnah Q, Hassan F, Malhan D, Engelhardt M, Daghma DES, Obidat D, et al. Nonsurgical clinical management of periapical lesions using calcium hydroxide-iodoform-silicon-oil paste. Biomed Res Int. 2018;2018:1-8. Schulz M, von Arx T, Altermatt HJ, Bosshardt D. Histology of periapical lesions obtained during apical surgery. 2009;35(5):634-42. Ramachandran Nair PN, Pajarola G, Schroeder HE. Types and incidence of human periapical lesions obtained with extracted teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81(1):93-102. Gutmann JL, Baumgartner JC, Gluskin AH, Hartwell GR, Walton RE. Identify and define all diagnostic terms for periapical/periradicular health and disease states. JOE. 2009;35(12):1658-74. Antoh M, Hasegawa H, Kawakami T, Kage T, Chino T, Eda S. Hyperkeratosis and atypical proliferation appearing in the lining epithelium of a radicular cyst. Report of a case. J Cranio-Maxillo-Facial Surg. 1983;21(5):210-13. Natkin E, Oswald RJ, Carries LI. The relationship of lesion size to diagnosis, incidence, and treatment of periapical cysts and granulomas. Oral Surg. 1984;57(1):82-94. Rathod DM, Mulay SA. Non-surgical treatment of large periapical lesion using various formulations of calcium hydroxide & nd: yag laser. Int J Curr Res. 2017;9(8):56668-72. Rosenberg PA, Frisbie J, Lee J, Lee K, Frommer H, Kottal S, et al. Evaluation of pathologists (histopathology) and radiologists (cone beam computed tomography) differentiating radicular cysts from granulomas. J Endod. 2010;36(3):423-28. Sant’ana Filho M, Rados PV. Lesões apicais. In: Silveira JOL, Beltrão GC. Exodontia. 1Porto Alegre: Missau; 1998. cap. 22, p. 275-85. Sood N, Maheshwari N, Gothi R, Sood N. Treatment of large periapical cyst like lesion: a noninvasive approach: a report of two cases. Int J Clin Pediatr Dent. 2015;8(2):133-37. Singh U, Nagpal R, Sinha D, Tuhin, Tyagi N. Iodoform based calcium hydroxide paste (metapex):an aid for the healing of chronic periapical lesion. J Adv Res Biol Sci. 2013;6(1):63-7. Dandotikar D, Peddi R, Lakhani B, Lata K, Mathur A, Chowdary UK. Nonsurgical management of a periapical cyst: a case report. J Int Oral Health. 2013;5(3):79-84. Calişkan MK. Prognosis of large cyst-like periapical lesions following nonsurgical root canal treatment: a clinical review. Int Endod J. 2004;37(6):408-16.  Kanmaz F, Altunbaş D, Zan R, Akpınar KE. Nonsurgical endodontic treatment of a large periradicular lesion. Turk Endod J. 2017;2(1):21–4. Öztan MD. Endodontic treatment of teeth associated with a large periapical lesion. Int Endod J. 2002;35(1):73–8. Barroso JAY, Uchimura JYT, Endo MS, Pavan NNO, Queiroz AF. Avaliação in vitro da influência da lima patência na manutenção do comprimento de trabalho. Rev Odontol UNESP. 2017;46(2):72-6. Madhusudhana K, Surada R, Kumar CS, Lavanya A. Non-surgical management of a large periapical lesion: a case report. Ann Essences Dent. 2017;9(2):22-5. Soares J, Santos S, Silveira F, Nunes E. Nonsurgical treatment of extensive cyst-like periapical lesion of endodontic origin. Int Endod J. 2006;39(7):566-75. Mohammadi Z, Shalavi S, Yazdizadeh M. Antimicrobial activity of calcium hydroxide in endodontics: a review. Chonnam Med J. 2013;48(3):133-40. Estrela C, Bammann LL, Pimenta FC, Pécora JD. Control of microorganisms in vitro by calcium hydroxide pastes. Int Endod J. 2001;34(5):341-45. Soares JA, Brito-Júnior M, Silveira FF, Nunes E, Santos SMC. Favorable response of an extensive periapical lesion to root canal treatment. J Oral Sci. 2008;50(1):107-11.


Author(s):  
Haider Al-Saffar

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.


2019 ◽  
Vol 829 ◽  
pp. 226-231
Author(s):  
Elvi Sahara ◽  
Rahmi Alma Farah ◽  
Myrna Nurlatifah Zakaria

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.


2013 ◽  
Vol 5 (2) ◽  
pp. 3-5
Author(s):  
R.S. Bassvanna ◽  
Chitra Gohil

ABSTRACT Management of non vital teeth with open apices isa challenge to the dental practitioners. In this clinical scenario, it is difficult to maintain the obturating material confine within the root canal without encroaching into periapical area. These kinds of cases cannot be managed by conventional endodontic treatment, and treatment of such cases with calcium hydroxide may take longer time for apical closure. But with this new material called BIODENTINE (Septodont) same treatment can be done in single visit with predictable result. Hence this case report present the use ofbiodentine to form an apical plug in open apex followed by complete root canal obturation using thermoplasticized guttapercha.


2012 ◽  
Vol 23 (5) ◽  
pp. 608-611
Author(s):  
Ronaldo Araújo Souza ◽  
Yara T. Corrêa Silva-Sousa ◽  
Suely Colombo ◽  
Maurício Lago ◽  
Marco Antonio Hungaro Duarte ◽  
...  

Besides the risk of filling material extrusion throughout the apex, a satisfactory apical seal can be difficult to achieve in canals with open apices or iatrogenic enlargements of the apical constriction. These situations pose a challenge to root canal filling. This paper describes the root canal filling of a maxillary right canine with an overinstrumented apex, complete loss of the apical stop, extensive canal transportation and apical periodontitis. A 5 mm calcium hydroxide apical plug was placed before root canal filling. The plug was made by soaking paper points with saline, dipping the points in calcium hydroxide powder and then applying it to the apex several times, until a consistent apical plug was obtained. The canal was then irrigated with saline in order to remove any residual calcium hydroxide from the root canal walls, dried with paper points and obturated with an inverted #80 gutta-percha cone and zinc oxide-eugenol based sealer by the lateral condensation technique. An 8-year radiographic follow-up showed formation of mineralized tissue sealing the apical foramen, apical remodeling and no signs of apical periodontitis.


2015 ◽  
Vol 18 (2) ◽  
pp. 115
Author(s):  
Lauren Grandi Dos Santos ◽  
Amanda Nunes Gallas ◽  
Josué Martos ◽  
Luiz Fernando Machado Silveira

The C-shape configuration in molars it’s an anatomical variation that difficult the diagnosis and treatment. The aim of this study was to report a case of C-shape endodontic configuration in mandibular second molar. The radiographic examination of one patient revealed the extent of caries in the mesial aspect of mandibular second molar, without the presence of periapical lesion and was clinically noted the C-shape configuration of the root canal, extending from the mesiobuccal to the distal canal. Endodontic therapy was performed and after the root canal obturation with gutta-percha cones and endodontic cement the tooth was restored. We conclude that the anatomical condition in C-shape, although it brings many difficulties for the endodontic treatment, does not preclude the tooth rehabilitation.


2020 ◽  
Vol 2 ◽  
pp. 120-123
Author(s):  
Munish Singla ◽  
Iyana Garg ◽  
Vandana Goyal ◽  
Harleen Kaur ◽  
Litik Mittal

Sterilization of root canal space is foremost for the success of the endodontic treatment which is usually carried out with intracanal irrigants and medicaments. Triple antibiotic paste (metronidazole, ciprofloxacin, and minocycline) is used to achieve sterilization and healing of periradicular area. In the present case report, the triple antibiotic paste was used for non-surgical management of periapical lesion for 3 weeks. After 3 weeks, the tooth became asymptomatic that was then obturated. Hence, it is confirmed that conventional root canal treatment, along with intracanal medicaments (triple antibiotic paste), can non-surgically manage the periapical lesions and further promotes healing.


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