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Carious exposure of an irreversibly inflamed vital pulp in a young permanent tooth presents a significant clinical challenge to maintain vitality. Direct pulp capping, partial pulpotomy and complete pulpotomy are the available procedures to treat young permanent tooth.
Currently, calcium hydroxide is the material of choice for apexogenesis. The present case report describes the successful apexogenesis of mandibular left first permanent molar using calcium hydroxide-chlorhexidine paste within 7 months and also discussed prognostic and technique guidance.
Partial pulpotomy for immature permanent teeth: It's present and future. Pediatr Dent ; Walton RE, Torabinejad M. Management of incompletely formed roots. In: Principles and Practice of Endodontics. Philadelphia, Pa: W. Saunders; Bakland LK. Traumatic dental injuries. Baltimore: Williams and Wilkins; Hasselgren G. Treatment of the exposed dentin pulp complex. Essential Endodontology. Seltzer R, Bender IB. Philadelphia: J.
Lippincott; Cvek M. A clinical report on partial pulpotomy and capping with calcium hydroxide in permanent incisors with complicated crown fracture. J Endod ; Partial pulpotomy in young permanent teeth with deep carious lesions. Endod Dent Traumatol ; Review of calcium hydroxide. Int Endod J ; Intraradicular bacteria and fungi in root- filled, asymptomatic human teeth with therapy- resistant periapical lesion: a long-term light and electron- microscope follow up study.
Efficacy of calcium hydroxide: Chlorhexidine paste as an intracanal medication in bovine dentin. Physical and chemical properties of chlorhexidine and calcium hydroxide-containing medications. Therapeutic induction of root formation in the exposed incompletely formed tooth with vital pulp. Webber RT. Apexogenesis versus apexification. Dent Clin North Am ; Partial pulpotomy as a treatment alternative for exposed pulps in crown-fractured permanent incisors.
Camp JH. Pedodontic-endodontic treatment. Pathway of the Pulp. Elsevier: Mosby; Long-term followup of traumatized incisors treated by partial pulpotomy. Partial pulpotomy: Another treatment option for cariously exposed permanent molars. Mass E, Zilberman U. Clinical and radiographic evaluation of partial pulpotomy in carious exposure of permanent molars. Painful pulpitis; a clinical and microscopic study. Histological considerations of direct pulp capping agents. J Dent Res ; Pulpotomy of carious vital teeth with periapical involvement.
Caliskan MK. Success of pulpotomy in the management of hyperplastic pulpitis. Patterson SS. Pulp calcification due to operative procedures — Pulpotomy. Int Dent J ; Direct pulp capping treatment: A long-term follow-up. J Am Dent Assoc ; A retrospective study of direct pulp capping with calcium hydroxide compounds. Users Online: Apexogenesis of irreversible inflamed young permanent molar using calcium hydroxide gluconate pulpotomy: A case report with review of literature.
Figure 1: Intraoral periapical radiograph of 36 showed incompletely formed root apices Click here to view. Figure 2: Three-month radiograph showed continued root formation Click here to view.
Figure 3: Radiograph after 7 months showed complete root formation Click here to view. Figure 4: Postobturation radiograph of 36 Click here to view.
Related articles Calcium hydroxide carious exposure chlorhexidine gluconate gel complete pulpotomy young permanent tooth. Access Statistics. Sitemap What's New Feedback Disclaimer.
Apexification, apexogenesis and regenerative endodontic procedures: a review of the literature.
Reestablishing blood flow and allowing the continuation of root development are some of the objectives of pulp revascularization. This procedure is currently indicated for teeth with incomplete root formation as an alternative to the traditional treatment of apecification, which consists of inserting calcium hydroxide paste into the root canal for a determined time period in order to induce the formation of a calcified barrier. Although it is considered as the most classically employed therapy, the permanence of the paste for long time periods may lead to the weakening of the root due to hygroscopic properties, as well as proteolytic activities of calcium hydroxide. Therefore, there has been a permanent search for alternatives which allow the full development of immature teeth. Revascularization has emerged as such an alternative, and a range of treatment protocols can be found in the scientific literature. The aim of this paper is to accomplish a literature review concerning this issue. Conventional endodontic treatment consists in the development and application of techniques designed to accomplish the chemical-mechanical preparation of root canals in order to eliminate an infection, many times difficult to combat due to the complexity of the root canal system.
Pulp Revascularization: A Literature Review
Apexogenesis treatment with mineral trioxide aggregate: long-term follow-up of two cases. Private Practice, Midrand, South Africa. Apexogenesis is the treatment of choice for traumatized or carious teeth which, at the time of exposure, have a vital pulp and open apex. This article describes two cases of permanent teeth with carious exposures, treated with direct pulp capping procedures using mineral trioxide aggregate MTA. METHODS: Radiographic and clinical examination, including testing reaction to cold, showed that both teeth were immature and in a stage of reversible pulpitis. The caries was identified using caries detector dye and removed using a rotary bur. Sodium hypochlorite solution was applied to the exposed pulp to achieve haemostasis.
Apexification, Apexogenesis and Regenerative Endodontic Procedures: A Review of the Literature
Aim: Aim of this paper was to present the therapeutical approaches to the management of the immature apex and discuss the evolution of materials and techniques. Methods: A Medline search was performed limited to human studies published. The keywords searched were apexogenesis, apexification, pulp regeneration, revascularization. Results: Apexogenesis and apexification techniques using Calcium hydroxide or MTA give a high succes rate. Recent regeneration procedures may be helpful for apexification in non vital elements.