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12-year follow-up of regenerative endodontic treatment of immature permanent upper incisors with acute abscess
Department of EndodonticsManiglia-Ferreira, Claudio; Department of EndodonticsGurgel Filho, Eduardo Diogo; Department of EndodonticsGomes, Fabio de Almeida; Department of EndodonticsReis, Sthefanny Amaral; Department of Semiology and Clinics, Diagnostic Center for Oral DiseasesPappen, Fernanda Geraldo.
  • Department of EndodonticsManiglia-Ferreira, Claudio; Universidade de Fortaleza. School of Dentistry. Department of EndodonticsManiglia-Ferreira, Claudio. Fortaleza. BR
  • Department of EndodonticsGurgel Filho, Eduardo Diogo; Universidade de Fortaleza. School of Dentistry. Department of EndodonticsGurgel Filho, Eduardo Diogo. Fortaleza. BR
  • Department of EndodonticsGomes, Fabio de Almeida; Universidade de Fortaleza. School of Dentistry. Department of EndodonticsGomes, Fabio de Almeida. Fortaleza. BR
  • Department of EndodonticsReis, Sthefanny Amaral; Universidade de Fortaleza. School of Dentistry. Department of EndodonticsReis, Sthefanny Amaral. Fortaleza. BR
  • Department of Semiology and Clinics, Diagnostic Center for Oral DiseasesPappen, Fernanda Geraldo; Universidade Federal de Pelotas. School of Dentistry. Department of Semiology and Clinics, Diagnostic Center for Oral DiseasesPappen, Fernanda Geraldo. Pelotas. BR
Braz. dent. j ; 31(6): 680-684, Nov.-Dec. 2020. graf
Article in English | LILACS, BBO | ID: biblio-1132355
ABSTRACT
Abstract This case report discusses the endodontic treatment of a 7-year-old girl who suffered trauma (intrusion) to the immature upper central incisors secondary to a fall from a bicycle. Thirty days after the accident the patient was brought by her mother for clinical and radiographic assessment with a chief complaint of swelling and tenderness to percussion and palpation. Acute apical abscess associated with immature teeth were diagnosed. A decision was made to perform regenerative endodontic treatment. Access cavities were made and the root canals were disinfected by irrigation with 2.5% sodium hypochlorite. Final irrigation was performed with 17% EDTA. Due to pain and presence of secretions, 2% chlorhexidine gel was applied as an intracanal medicament. Seven days later, at the second visit, the root canals were once again disinfected and the canals of the right and left permanent upper central incisors were filled with double antibiotic paste (metronidazole/ciprofloxacin) and calcium hydroxide paste, respectively. Zinc oxide was mixed in both pastes. At the third visit, after 21 more days, the pastes were removed and the periapical areas were stimulated with a #80 K-file to encourage clot formation within the pulp cavities. A mineral trioxide aggregate (MTA) paste cervical plug was placed and the teeth were restored with glass ionomer cement. Radiographs and CBCT scans demonstrated complete root formations. The patient has been followed for 12 years, with evidence of clinical success throughout.
RESUMO
Resumo Este relato de caso discute o tratamento endodôntico de uma menina de 7 anos que sofreu trauma nos incisivos centrais superiores imaturos, após queda de bicicleta. Trinta dias após o acidente, a paciente foi levada pela mãe para avaliação clínica e radiográfica com queixa principal de inchaço e sensibilidade à percussão e palpação. Foram diagnosticados abscessos apicais agudos em ambos os dentes. Foi decidido por realizar o tratamento endodôntico regenerativo. Após acessos coronários, os canais radiculares foram submetidos à protocolos de antissepsia com auxílio de irrigação com hipoclorito de sódio a 2,5% e EDTA 17%. Devido à dor e presença de secreções, foi utilizada medicação intracanal com clorexidina gel 2% por 7 dias. Na segunda sessão, os canais radiculares foram novamente submetidos aos procedimentos de antissepsia e os canais dos incisivos centrais superiores permanentes direito e esquerdo foram preenchidos com pasta antibiótica dupla (Metronidazol / Ciprofloxacina) e pasta de hidróxido de cálcio, respectivamente. Em ambas as pastas foi adicionado o óxido de zinco. Na terceira sessão, após mais 21 dias, as pastas foram removidas e as regiões periapicais foram estimuladas com lima K nº 80 para incentivar a formação de coágulos sanguíneos no interior das cavidades pulpares. Tampões cervicais de MTA foram adaptados e os dentes restaurados com cimento de ionômero de vidro resinoso. Radiografias e tomografias computadorizadas demonstraram formações radiculares completas. A paciente é acompanhada há 12 anos, com evidências clínicas e radiográficas de sucesso.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Regenerative Endodontics / Incisor Type of study: Practice guideline / Observational study / Prognostic study / Risk factors Limits: Child / Female / Humans Language: English Journal: Braz. dent. j Journal subject: Dentistry Year: 2020 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal de Pelotas/BR / Universidade de Fortaleza/BR

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Full text: Available Index: LILACS (Americas) Main subject: Regenerative Endodontics / Incisor Type of study: Practice guideline / Observational study / Prognostic study / Risk factors Limits: Child / Female / Humans Language: English Journal: Braz. dent. j Journal subject: Dentistry Year: 2020 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal de Pelotas/BR / Universidade de Fortaleza/BR