Endodontyczne leczenie regeneracyjne zakażonego niedojrzałego zęba wgłobionego, zdiagnozowanego za pomocą tomografii wiązki stożkowej
The one-year follow-up showed no clinical signs of pathology. Radiographic examination revealed complete healing of the periapical lesion, but apical closure was not observed (Figure 2). The tooth had a negative response to vitality testing. The vital pulp tissue in the invaginated canal had been removed during instrumentation; however, the main root canal was not exposed, the tooth had a negative response to vitality testing postoperatively, and the periapical lesion resolved. So we assume that it was a peri-invagination lesion. At the twenty-month examination, the control radiograph showed successful apical closure (Figure 3). At this follow-up examination, the tooth had a negative response to vitality testing.
Discussion
The treatment of an immature permanent tooth with periapical pathosis is a challenge in paediatric dentistry, especially in the case of dens invaginatus. The various treatment options include apexification [16], nonsurgical endodontic treatment [17], a combination of nonsurgical and surgical endodontic treatment [5], obturation of the invagination alone while maintaining pulp vitality [18], and the removal of the dens invaginatus from the root canal [19].
In the presented case, there was a large periapical lesion in the immature tooth with type III dens invaginatus. To promote root development, endodontic treatment should be performed. Apexification is the traditional treatment for necrotic teeth with open apices [16], but in this case, Ca(OH)2 medication was not sufficient to eliminate the infection, so traditional apexification [...]
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