Endodontyczne leczenie regeneracyjne zakażonego niedojrzałego zęba wgłobionego, zdiagnozowanego za pomocą tomografii wiązki stożkowej
Case presentation
A 9-year-old female patient was referred to Bakirkoy Acibadem Hospital with a complaint of pain on her maxillary right lateral incisor. She suffered from mild swelling associated with the tooth. Clinically, the crown of the maxillary right lateral incisor was cone-shaped and without caries. The tooth was sensitive to percussion. The periodontal status was normal (probing depth 3 mm around the tooth). The tooth showed no mobility. The initial periapical radiographic examination revealed that the tooth showed an invagination (Oehlers’ type III) and a large periapical lesion. The tooth had a diagnosis of symptomatic apical periodontitis. A CBCT scan was taken to see a three-dimensional image of this complex anatomy (Figure 1). The tooth showed a positive response to electric pulp vitality test.
Regenerative endodontic treatment was recommended. After reviewing the risks, benefits, and treatment options with her parents, an informed assent and consent were obtained for performing the recommended procedure. Under local anaesthesia, rubber dam was placed and endodontic access was performed. A single canal orifice was exposed. The vital pulp tissue was seen in the invaginated canal but access to the main root canal was not possible. Because the invaginated canal was thin, it was instrumented up to a size 30 K-file (Dentsply-Maillefer) and irrigated with 2.5% sodium hypochlorite (NaOCl) solution. Calcium hydroxide (Ca(OH)2) (Sultan Chemists Inc., Englewood, NJ, USA) was then applied into the root canal.
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