IADR Abstract Archives
Apexification or Regeneration? Treatment Choices in Immature Roots of Incisors
Objectives: The purpose of this report was to present the apexification and regeneration treatment of a child patient who had history of dental trauma to the maxillary central incisors with open apexes
Methods: A healthy 8-year-old girl with a history of trauma to the maxillary right and left central incisors was referred to our dental clinics of Marmara University, Istanbul, Turkey. The patient had a history bicycle injury 2 weeks ago and the crown fractures of #11 and #21 had been restored with composite restoration by a general dentist. The patient’s chief complains was pain. The patient reported pain on percussion clinically and radiographic examination showed immature root of teeth # 11, #21 with no apical pathosis. Root canal treatment was initiated with a canal irrigation of 20 ml of 5.25% NaOCl. Without instrumentation and gently dried with paper points. Mixture of triple antibiotic paste was placed in root canals. 2 weeks later, the treatment procedure was repeated due to respond to percussion test. Four weeks later, #11 was asymptomatic no longer tender to percussion or palpation so, after irrigation a sterile #20 K-file was used to induce bleeding within the root canal from the periapical tissues. MTA was replaced and the tooth restored temporarily and 1 week later restored with composite filling. However, tooth #21 was still tender to percussion. Apexification procedure was decided to perform on this tooth as an alternative approach. A creamy mixed of CaOH were replaced in several appointments for a year, after that period, the root length and thickness had increased and apical closure was evident on radiograph, so the root canal treatment was completed
Results: The case was followed clinically and radiographically for two years. At follow–up examination of #11 tooth was asymptomatic and functional and respond normally to cold and electrical pulp test but apical closure was not completed yet. Also, tooth #21 was asymptomatic with no periapical pathosis. The patient is under our observation
Conclusions: The regeneration treatment procedure can be considered as an alternative treatment to apexification in immature apices when diagnosed properly. We achieved a success clinically in this case but further clinical and radiographically examinations are needed for long-term follow-up.
Methods: A healthy 8-year-old girl with a history of trauma to the maxillary right and left central incisors was referred to our dental clinics of Marmara University, Istanbul, Turkey. The patient had a history bicycle injury 2 weeks ago and the crown fractures of #11 and #21 had been restored with composite restoration by a general dentist. The patient’s chief complains was pain. The patient reported pain on percussion clinically and radiographic examination showed immature root of teeth # 11, #21 with no apical pathosis. Root canal treatment was initiated with a canal irrigation of 20 ml of 5.25% NaOCl. Without instrumentation and gently dried with paper points. Mixture of triple antibiotic paste was placed in root canals. 2 weeks later, the treatment procedure was repeated due to respond to percussion test. Four weeks later, #11 was asymptomatic no longer tender to percussion or palpation so, after irrigation a sterile #20 K-file was used to induce bleeding within the root canal from the periapical tissues. MTA was replaced and the tooth restored temporarily and 1 week later restored with composite filling. However, tooth #21 was still tender to percussion. Apexification procedure was decided to perform on this tooth as an alternative approach. A creamy mixed of CaOH were replaced in several appointments for a year, after that period, the root length and thickness had increased and apical closure was evident on radiograph, so the root canal treatment was completed
Results: The case was followed clinically and radiographically for two years. At follow–up examination of #11 tooth was asymptomatic and functional and respond normally to cold and electrical pulp test but apical closure was not completed yet. Also, tooth #21 was asymptomatic with no periapical pathosis. The patient is under our observation
Conclusions: The regeneration treatment procedure can be considered as an alternative treatment to apexification in immature apices when diagnosed properly. We achieved a success clinically in this case but further clinical and radiographically examinations are needed for long-term follow-up.