Revascularization of an immature tooth with apical periodontitis using a single visit protocol: a case report.

Abstract

AIM:

To discuss the clinical and radiological outcome of a revascularization procedure which was completed in a single visit (using sodium hypochlorite 5% as the sole disinfectant) in an immature tooth with a necrotic pulp and apical periodontitis.

SUMMARY:

A 7-year-old girl was referred in pain following trauma to the maxillary anterior region some 6-7 weeks previously. The maxillary left central incisor tooth was diagnosed with a necrotic pulp and acute apical periodontitis. Under local anaesthesia and rubber dam isolation, an access cavity was prepared. The canal was irrigated with a 5% sodium hypochlorite solution and agitated with an ultrasonic file. A 17% EDTA solution was also used for a final rinse. Bleeding was induced into the canal space from the periapical tissues using a K-file. An MTA layer/barrier was placed directly onto the blood clot, and a further layer of GC Fuji IX cement was placed on top of the MTA to restore the access cavity. The tooth was reevaluated at 6 weeks, 3 months, 6 months, 1 year and 18 months. The tooth has remained symptom free. Radiographic examination shows progressive thickening of the root canal walls, root lengthening and apical closure.

KEY LEARNING POINTS:

Disinfection with 5% sodium hypochlorite followed by the induction of a blood clot into the root canal space may be sufficient to promote revascularization in certain circumstances. A single visit revascularization procedure is a potential treatment option.

• Authors: P McCabe
• Journal: International endodontic journal (Int Endod J) Vol. 48 Issue 5 Pg. 484-97 (May 2015) ISSN: 1365-2591 [Electronic] England
• PMID: 25066513 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Chemical References

• Glass Ionomer Cements
• Sodium Hypochlorite

Topics

• Child
• Dental Pulp Necrosis (diagnostic imaging, therapy)
• Female
• Glass Ionomer Cements (therapeutic use)
• Humans
• Neovascularization, Physiologic
• Periapical Periodontitis (diagnostic imaging, surgery)
• Periapical Tissue (blood supply)
• Root Canal Therapy (methods)
• Sodium Hypochlorite (therapeutic use)