scholarly journals Revascularization of an Immature Tooth with Apical Periodontitis Using Calcium Hydroxide: A 3-year Follow-up

2015 ◽  
Vol 9 (1) ◽  
pp. 482-485 ◽  
Author(s):  
Mauro Henrique Chagas Silva ◽  
Celso Neiva Campos ◽  
Marcelo Santos Coelho

Root canal treatment of teeth presenting immature development is a great challenge for both the patient and the professional. The thinness of the root canal walls of immature teeth may lead to root fracture and thus the outcomes of such treatments are uncertain. Revascularization is based on root canal decontamination followed by the induction of blood migration from the periapical tissues and the development of new vascular tissue in the canal space. The principle of disinfection in regenerative endodontics is that it should be achieved with minimum root canal instrumentation; an intracanal medication is used to inhibit bacterial growth and appropriate sealing of the coronal portion is performed. The American Association of Endodontists (AAE) considerations for regenerative endodontics include calcium hydroxide as an alternative intracanal dressing. This material has also been claimed to diminish the possibility of dental staining during revascularization procedures. The relatively new treatment protocol has been widely reported in the last few years; however it should be performed only when other alternatives are not reasonable. This case report presents a 3-year follow-up of a case of revascularization of a maxillary central incisor using calcium hydroxide as a root canal disinfection dressing.

Author(s):  
Vinay Kumar Srivastava

Brief background: A tooth with Blunderbuss canal and periapical lesion is difficult to treat by traditional root canal procedures. The dentinal wall surrounding the Blunderbuss canal is very thin, fragile and prone to fracture with a slight blow/ trauma. Therefore, a new strategy is required to treat such a case. Materials and Methods: Canal was cleaned and irrigated with 5.25% NaOCl and 0.2% Chlorhexidine. It was temporized with Ca (OH) 2 for one week to obtain canal disinfection. After one week, Ca(OH) 2 was removed from the canal with a sterilized file and rinsed out with the help of saline. A 2-3mm thick Metapex layer was placed at the apical region of 11, followed by an MTA layer, once the apical MTA layer obtained sufficient strength; the rest of the canal was filled with MTA. Discussion: This new treatment procedure not only closes the open root apices but also provides strength to the dentinal wall. Metapex –MTA combination provides advantages of both the materials; like calcium hydroxide of Metapex stimulates odontoblast of residual apical pulp and MTA stimulates cementoblast cells to bring about root apex closure. Summery & Conclusion: Two year follow-up & a positive clinical outcome of this case were encouraging for the use of Metapex-MTA coating as an apical plug. The rest of the canal was filled with MTA to strengthen and supports the thin dentinal wall for better compliance with the occlusal forces. Key Words: Blunderbuss canal, MTA, Metapex


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.


1970 ◽  
Vol 6 (4) ◽  
pp. 497-501
Author(s):  
A Parolia ◽  
M Kundabala ◽  
N Shetty ◽  
ST Manuel

This case report describes delayed replantation of an avulsed maxillary central incisor in a 17-year-old male patient following an injury on fall one day earlier. Avulsed maxillary right permanent central incisor was replanted back into the socket after extra-oral root canal treatment. One year follow up showed validity of treatment, with no evidence of resorption in the replanted tooth. Key words: Replantation, Maxillary central incisor, Resorption doi: 10.3126/kumj.v6i4.1742     Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 497-501     


2018 ◽  
Vol 10 (1) ◽  
pp. 37-39
Author(s):  
Shahnaz Sultana Beauty ◽  
Shahana Dastagir Sunny ◽  
Md Ali Asgor Moral ◽  
Md Shamsul Alam

In dentistry,root resorption is the breakdown or destruction and subsequent loss of the root structure of a tooth caused by living body cells attacking part of the tooth. When the damage extends to the whole tooth is called tooth resorption. Severe root resorption is very difficult to treat and often requires the extraction of teeth. Root canal therapy has been shown to be a verysuccessful means of treating inflammatory resorption. It has been recommended to include a calcium hydroxide paste in the root canal therapy to enhance the success of the treatment out come. Calcitonin has also been suggested as an interim root canal medicament to assist in the inhibition of osteoclastic bone and dentin resorption. Calcitonin penetrates the dentinal tubules in the out word direction, thus exerting a direct effect DOI: http://dx.doi.org/10.3329/cdcj.v10i1.13833 City Dent. Coll. J Volume-10, Number-1, January-2013


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Alberto Nicodemo ◽  
Chiara Arrigoni ◽  
Andrea Bersano ◽  
Alessandro Massè

Congenital, traumatic, or extrinsic causes can lead people to paraplegia; some of these are potentially; reversible and others are not. Paraplegia can couse hip flexion contracture and, consequently, pressure sores, scoliosis, and hyperlordosis; lumbar and groin pain are strictly correlated. Scientific literature contains many studies about children hip flexion related to neurological diseases, mainly caused by cerebral palsy; only few papers focus on this complication in adults. In this study we report our experience on surgical treatment of adult hip flexion contracture due to neurological diseases; we have tried to outline an algorithm to choose the best treatment avoiding useless or too aggressive therapies. We present 5 cases of adult hips flexion due to neurological conditions treated following our algorithm. At 1-year-follow-up all patients had a good clinical outcome in terms of hip range of motion, pain and recovery of walking if possible. In conclusion we think that this algorithm could be a good guideline to treat these complex cases even if we need to treat more patients to confirm this theory. We believe also that postoperation physiotherapy it is useful in hip motility preservation, improvement of muscular function, and walking ability recovery when possible.


2002 ◽  
Vol 49 (1-2) ◽  
pp. 53-56
Author(s):  
Tatjana Brkanic ◽  
Slavoljub Zivkovic

The aim of this paper was to, on the basis of everyday clinical practice analize the effect of a homeopathic remedy, as a complementary remedy in endodontic therapy of endoperiodontal lesions and chronic apical periodontitis and to radiologically check its effect on the flow and speed of reparation of damaged periodontal tissues. Endodontic therapy was done according to the usual protocol for the therapy of infectious canals with root canal preparation, medication with calcium hydroxide points and hermetic obturation with AH-26 paste. During endodontic treatment patients were taking homeophatic remedy Hepar sulfuris per os three times daily. The remedy stimulates the natural defences mechanism of the organism. Radiological follow up after three months period showed obvious reductiont of radiologic radiolucency in periapical region.


2012 ◽  
Vol 06 (04) ◽  
pp. 385-388 ◽  
Author(s):  
Ronaldo Araújo Souza ◽  
João Costa Pinto Dantas ◽  
Paula Maciel Brandão ◽  
Suely Colombo ◽  
Maurício Lago ◽  
...  

ABSTRACTObjective: The purpose of this study was to evaluate if the apical third enlargement of root canal is the determinant factor for the repair of periapical lesions in endodontic treatment.Methods: Eighty upper and lower incisors, canines and premolars with periapical lesions were randomly divided in 2 groups and were treated by undergraduate students. Canals were instrumented with up to 3 files in group I (n = 40) and up to 4 files in group II (n = 40) 1 mm short of the apex and were filled with a calcium hydroxide dressing. After removing calcium hydroxide 14 days later, both groups were filled using the lateral condensation technique. In the 2-year follow-up, a few patients did not return, and some cases did not present conditions for accurate comparisons. Therefore, only 43 patients (24 in group I and 19 in group II) presented conditions for radiographic comparisons. Data were statistically analyzed using Fisher's exact test.Results: Comparison of the initial and follow-up radiographs showed that 22 out of 24 (91.67%) patients in group I and 17 out of 19 patients (89.47%) in group II showed repair. Statistical analysis revealed no significant differences between the groups (P>.05).Conclusion: The results of this study show that the apical third enlargement did not alter the outcome of endodontic treatment of teeth with periapical lesion performed by undergraduate students. (Eur J Dent 2012;6:385-388)


2019 ◽  
Vol 9 (1) ◽  
pp. 42-45
Author(s):  
Fahd AA Karim ◽  
Kazi Hossain Mahmud ◽  
Asma Sultana ◽  
Shirin Sultana Chawdhari ◽  
Moktadir Hossain ◽  
...  

A 15 year old boy was presented with pain in his upper anterior teeth. On clinical examination both the maxillary central incisor revealed slight discoloration and fracture of the crown. Radiographic evaluation revealed open apex of the left central incisor and apex of the right central incisor was fully developed. Apexification with MTA apical plug was carried out in left central incisor and conventional root canal treatment was done in right central incisor. In two months follow up both the tooth were clinically and radiographically asymptomatic and the healing of the apical area of the left central incisor was continued. These finding suggests that MTA can induce formation of apical barrier in the case of non-vital tooth with open apex. Update Dent. Coll. j: 2019; 9 (1): 42-45


2016 ◽  
Vol 40 (6) ◽  
pp. 445-449 ◽  
Author(s):  
Hugo Plascencia ◽  
Álvaro Cruz ◽  
Mariana Díaz ◽  
Ana Laura Jiménez ◽  
Rodrigo Solís ◽  
...  

Introduction: Revascularization/revitalization therapy is considered an alternative procedure for management of teeth with an immature apex and necrotic pulp, mainly when root development is interrupted in the early phases of formation. However, this clinical treatment protocol should be considered a permanent procedure? Method: A maxillary central incisor with a previous and successful RR treatment was intentionally filled with a biocompatible material with the periapical tissues due to the patient's lack of adherence to the follow-up protocol. Results: The 20-month follow-up showed absence of clinical, radiological and tomographic signs and symptoms of an endodontic re-infection. Conclusion: This case demonstrates that once the increased thickening of the canal walls, incrementing the root length, apical closure and the total resolution of the apical lesion are observed, the main canal of a previously treated tooth with an RR procedure can be filled.


2015 ◽  
Vol 18 (1) ◽  
pp. 17 ◽  
Author(s):  
Cari Maristela Pieper ◽  
Eliseu Aldrighi Münchow ◽  
Evandro Piva

<span>Periradicular lesions occur in non-vital teeth as the result of a chronic aggression by the presence of microorganisms into the root canal, which may appear as a radiolucent lesion in the radiographic exam; treatment varies according to surgical or nonsurgical methods. This case report describes the regression of a periradicular lesion using a nonsurgical endodontic treatment in association with intracanal calcium hydroxide-based medicament. After patient examination and radiographic analysis, a 13 mm (in maximum diameter) radiolucent lesion was observed in tooth number 12. The endodontic treatment was done and Calen-CMCP (S.S. White Artigos Dentários Ltda., Rio de Janeiro, RJ, Brazil) was placed into the root canal, which was changed after every two weeks during two months. It was observed a progressive centrifugal regression of the lesion after every renewing of the medicament. In addition, after six-year follow-up the tooth was still free of re-infection and bone tissue was completely regenerated. In conclusion, calcium hydroxide therapy can conservatively stimulate the regression of large periradicular lesions.</span>


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