Rewaskularyzacja miazgi niedojrzałych zębów stałych z martwiczą miazgą i ze zmianami okołowierzchołkowymi – przypadki kliniczne
Treating necrotic immature teeth is challenging because the thin dentinal walls and short roots make them more susceptible to fracture. The treatment of choice is apexification, which consists of inducing apical closure by using calcium hydroxide or mineral trioxide aggregate (MTA) [1, 2]. However, while apexification resolves the problem of apical periodontitis and induces apical closure, enabling definitive root canal therapy to be performed, it does not thicken the root walls or allow the root to continue to develop, leaving the tooth susceptible to fracture [3].
The protocols referred to as regenerative endodontic procedures are currently being revived as a new paradigm in conservative treatment. It was previously thought that regenerating the necrotic pulp of an immature tooth with periapical periodontitis was impossible; nowadays however we know that, in a suitable medium, this can be achieved using the technique known variously as revascularization [4, 5] or revitalization [6].
Proper disinfection of the canal, a suitable matrix for new tissue ingrowth, and an effective seal for the coronal access are vital for a satisfactory result [7], without forgetting the importance of a supply of dental stem cells so that revascularization can be successfully completed [2, 8]. So many articles have reported satisfactory results in necrotic immature teeth as a result of the revascularization technique, that the uncertainty that arose some years ago about whether it was possible to determine the success of this treatment has now [...]
którzy są subskrybentami naszego portalu.
i ciesz się dostępem do bazy merytorycznej wiedzy!
