RESUMO
The purpose of this report is to present conservative treatment for two immature premolars with apical periodontitis. A triple antibiotic paste was used to disinfect the root canal systems for revascularization. In both cases, residual vital pulp tissue was noted in the root canal system after the opening of each premolar. The canals in both cases were irrigated with copious sodium hypochlorite solution and medicated with a paste consisting of ciprofloxacin, metronidazole, and minocycline. The teeth were sealed with mineral trioxide aggregate and restored with composite resin. There were satisfactory outcomes after 18 months. The patients were asymptomatic, with radiographic evidence of complete resolution of radiolucency, continual thickening of dentinal walls, apical closure, and increased root length.
RESUMO
This retrospective study included 23 necrotic immature permanent teeth treated for either short-term (treatment period <3 months) or long-term (treatment period >3 months) using conservative endodontic procedures with 2.5% NaOCl irrigations without instrumentation but with Ca(OH)(2) paste medication. For seven teeth treated short-term, the gutta-percha points were filled onto an artificial barrier of mineral trioxide aggregate (MTA). For 16 teeth treated long-term, the gutta-percha points, amalgam, or MTA were filled onto the Ca(OH)(2)-induced hard tissue barrier in the root canal. We found that all apical lesions showed complete regression in 3 to 21 (mean, 8) months after initial treatment. All necrotic immature permanent teeth achieved a nearly normal root development 10 to 29 (mean, 16) months after initial treatment. We conclude that immature permanent teeth with pulp necrosis and apical pathosis can still achieve continued root development after proper short-term or long-term regenerative endodontic treatment procedures.
Assuntos
Necrose da Polpa Dentária/terapia , Polpa Dentária/fisiologia , Abscesso Periapical/terapia , Regeneração , Tratamento do Canal Radicular/métodos , Ápice Dentário/crescimento & desenvolvimento , Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Hidróxido de Cálcio/uso terapêutico , Criança , Dentina Secundária/metabolismo , Dentição Permanente , Combinação de Medicamentos , Feminino , Guta-Percha , Humanos , Masculino , Óxidos/uso terapêutico , Estudos Retrospectivos , Materiais Restauradores do Canal Radicular/uso terapêutico , Irrigantes do Canal Radicular/uso terapêutico , Silicatos/uso terapêutico , Hipoclorito de Sódio/uso terapêutico , Inquéritos e QuestionáriosRESUMO
An implant was removed 6 months after restoration because of peri-implant pathosis. The implant had been placed adjacent to the mandibular right second premolar and close to a periapical lesion of the endodontically treated adjacent first premolar. Along with removal of the failed implant and an apicoectomy of the problem tooth, guided bone regeneration was used to restore the alveolar ridge defect at the site of the failed implant. A replacement implant was placed 6 months later and successfully restored after healing.
