Management of necrotic pulp of immature permanent incisor tooth: A regenerative endodontic treatment protocol: case report

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Date
2017Author
Moodley, Desigar S.
Peck, Craig
Moodley, Tashia
Patel, Naren
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Show full item recordAbstract
It is possible that a paradigm shift may be in the offing in
the approach to treatment of immature teeth with necrotic
pulp, away from traditional apexification procedures and
to a biologically-based endodontic protocol intended to
produce regeneration, based on the deliberate introduction
of bleeding into the canal space to provide a scaffold and
allow the ingress of stem cells.
Methods: A patient presented with a maxillary right central
incisor tooth with an open apex and periapical radiolucency.
The tooth was irrigated with sodium hypochlorite and then
dressed with tri-antibiotic paste consisting of ciprofloxacin,
metronidazole and amoxicillin. At a subsequent visit a
blood clot was produced in the canal by irritating periapical
tissues and the canal then sealed with mineral trioxide
aggregate and glass ionomer cement.
Results: The patient was pain free, the draining sinus was
resolved in two weeks, root maturation continued and apical
closure occurred after two months. The tooth became
responsive to cold pulp vitality testing.
Conclusions: Continued root growth invoked by
regenerative endodontics may reduce the risks of fracture
and premature tooth loss otherwise associated with
traditional CaOH2 apexification procedures. Randomised,
prospective clinical trials and long term studies are required
before the technique becomes standard practice.
URI
http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162017000300005&lng=en&tlng=enhttp://hdl.handle.net/10566/4973