scholarly journals Management of non-vital immature root canal of right maxillary central incisor with Metapex-MTA Coating: A Case Report

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

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.


2010 ◽  
Vol 04 (04) ◽  
pp. 468-474 ◽  
Author(s):  
Tahsin Yildirim ◽  
Nimet Gencoglu

Pulpal and periradicular pathosis are the result of microbial, mechanical, or chemical invasion. Microorganisms are the main irritants of pulpal and periapical tissues. The goal of the obturation is to obtain a fluid-tight seal of the root canal system from its coronal aspect through its apical extent to preserve from the irritants.. Root apices have morphological irregularities in teeth with periapical lesions. Therefore, it is more difficult to produce hermetically apical stop with conventional guttapercha obturation techniques. This case report describes the treatment and six years follow-up of the teeth with large periapical lesion using MTA as apical filling material. (Eur J Dent 2010;4:468- 474)


DENTA ◽  
2017 ◽  
Vol 11 (1) ◽  
pp. 88
Author(s):  
Yongki Hadinata W ◽  
Karlina Samadi

<p><strong><em>Background :</em></strong><em> 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. <strong>Purpose :</strong> To report the management of endodontic failure with nonsurgical treatment. <strong>Case :</strong> 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.. <strong>Treatment :</strong> 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. <strong>Conclusion :</strong> Nonsurgical endodontic retreatment always become the first choice to resolve endodontic failure for previously treated tooth.</em></p><p><strong><em>Keywords :</em></strong><em> endodontic failure, maxillary first premolar, nonsurgical endodontic retreatment</em></p><p><strong><em>Correspondence:</em></strong><em> Yongki Hadinata W., drg. PPDGS Ilmu Konservasi Gigi Fakultas Kedokteran Gigi Universitas Airlangga, Surabaya. Jl. Mayjen. Prof. Dr. Moestopo No. 47, Surabaya.</em></p>


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     


2021 ◽  
Vol 10 (12) ◽  
pp. e139101220061
Author(s):  
Ana Paula Fernandes Ribeiro ◽  
Julia Guerra de Andrade ◽  
Heitor César Maia ◽  
Caroline Loureiro ◽  
Gladiston Willian Lobo Rodrigues ◽  
...  

This study aims to report the clinical case of a 16 years-old male patient, who attended a private office reporting that at an accident suffered at the age of 10 years-old, which caused extrusive dislocation in both teeth 11 and 21. At that time, the teeth were repositioned, without an adequate follow-up. Upon physical and radiographic examination, the following features were observed: presence of recurrent sinus tract on the vestibular surface, area of ​​external cervical resorption, and a periapical lesion on tooth 21. Endodontic treatments (necropulpectomy) were performed on teeth 11 and 21, with the placement of a root canal dressing of calcium hydroxide and subsequent root canal filling. In addition, soft tissue flap folding was performed to treat the resorption area and to seal it with glass ionomer cement. A 7 months follow-up radiograph shows stabilization in the process of the tooth resorption and remission of the periapical lesion. In conclusion, the endodontic treatment with intracanal medication, and the sealing of the resorption area were successful to preserve the traumatized tooth. In addition, it is noteworthy that following up with the patient after the trauma episode is essential to monitor the pulp vitality of the tooth involved.


1998 ◽  
Vol 4 (1_suppl) ◽  
pp. 131-134
Author(s):  
T. Iwakoshi ◽  
H. Yamada ◽  
H. Yamamoto ◽  
Z. Shiozawa ◽  
S. Miyachi ◽  
...  

We report a new treatment for excessive spasticity using an endovascular technique. A 52-year-old woman with intractable spasticity of the hip joints and abdominal muscles was treated with an injection of 70% alcohol into Adamkiewicz's artery, which destroyed the spinal cord fed by Adamkiewicz's artery and cut the reflex arcs of excessive spasticity. Immediately after the treatment a significant change was noticed in muscle tonicity of the lower extremities, and intractable spasticity disappeared. Skin necrosis and muscle damage occurred because of the alcohol that leaked into the muscle branch of the subcostal artery. However, these complications could be treated by simple necrotomy. No recurrence was observed during the follow-up period. We believe this endovascular treatment will become a new strategy for excessive spasticity arising from spinal cord injury.


2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Shivani Utneja ◽  
Gaurav Garg ◽  
Shipra Arora ◽  
Sangeeta Talwar

Inflammatory external root resorption is one of the major complications after traumatic dental injury. In this case report, we describe treatment of a maxillary central incisor affected by severe, perforating external root resorption. An 18-year-old patient presented with a previously traumatized, root-filled maxillary central incisor associated with pain and sinus tract. Radiographic examination revealed periradicular lesion involving pathologic resorption of the apical region of the root and lateral root surface both mesially and distally. After removal of the root canal filling, the tooth was disinfected with intracanal triple antibiotic paste for 2 weeks. The antibiotic dressing was then removed, and the entire root canal was filled with mineral trioxide aggregate. The endodontic access cavity was restored with composite resin. After 18 months, significant osseous healing of the periradicular region and lateral periodontium had occurred with arrest of external root resorption, and no clinical symptoms were apparent.


2010 ◽  
Vol 35 (2) ◽  
pp. 145-148 ◽  
Author(s):  
Bahar Tezel ◽  
Serdar Uysal ◽  
Melek Turgut ◽  
Zafer Cehreli

This report describes the 24-month clinical and radiographic outcome of an unintentionally extruded mineral trioxide aggregate (MTA) apical plug. A 9 year old boy presented with a previously traumatized, immature central incisor; associated with a large periradicular lesion. During placement of MTA in the treatment of wide open apex, the material was inadvertently extruded into the periapical region upon a sudden movement of the child. No intervention was made, except for obturation of the remaining root canal two weeks later. The radiographic follow up at 12 and 24 months confirmed successful management through the non surgical approach, as evidenced by advanced healing of the periapical lesion and regeneration of the periradicular tissue in the absence of clinical symptoms.


2012 ◽  
Vol 1 (1) ◽  
pp. 46-50
Author(s):  
U Kulsum ◽  
F Farzana

A case is reported which states calcific metamorphosis of pulp in a mandibular left lateral incisor and concomitant pulp necrosis of both central incisors for a single trauma. There was a large periapical lesion associated with the teeth. Conventional endodontic treatment was performed on teeth with pulp necrosis, but the canal with calcific metamorphosis could not be negotiated with endodontic files. The periapical lesion was surgically removed and diagnosed as acute periapical abscess on histopathology. During the surgical procedure root apices of calcified tooth  as well as other teeth were removed and retrograde cavity was prepared and filled with glass ionomer cement i.e apicectomy was done. The bony defect was filled with calcium hydroxyappatite crystal. Six months later the teeth were asymptomatic and radiological follow-up showed gradual healing of the bony cavity. DOI: http://dx.doi.org/10.3329/birdem.v1i1.12396 Birdem Med J 2011; 1(1): 46-50


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