Open Apex (open + apex)

Distribution by Scientific Domains


Selected Abstracts


Pulp and periodontal healing of laterally luxated permanent teeth: results after 4 years

DENTAL TRAUMATOLOGY, Issue 6 2008
Elena C. Ferrazzini Pozzi
Material and methods:, Patients presenting with lateral luxation of permanent teeth during 2001,2002 were enrolled in this clinical study. Laterally luxated teeth were repositioned and splinted with a TTS/composite resin splint for 4 weeks. Immediate (prophylactic) root-canal treatment was performed in severely luxated teeth with radiographically closed apices. All patients received tetracycline for 10 days. Re-examinations were performed after 1, 2, 3, 6, 12 and 48 months. Results:, All 47 laterally luxated permanent teeth that could be followed over the entire study period survived. In 10 teeth (21.3%), a prophylactic root-canal treatment was performed within 2 weeks following injury. The remaining 37 teeth showed the following characteristics at the 4-year re-examination: 19 teeth (51.4%) had pulp survival (no clinical or radiographic signs or symptoms), nine teeth (24.3%) presented with pulp canal calcification, and pulp necrosis was seen in another nine teeth (24.3%), within the first year after trauma. None of the teeth with a radiographically open apex at the time of lateral luxation showed complications. External root resorption was only seen in one tooth. Conclusions:, Laterally luxated permanent teeth with incomplete root formation have a good prognosis, with all teeth surviving in this study. The most frequent complication was pulp necrosis that was only seen in teeth with closed apices. [source]


Comparative in vitro study of the sealing efficiency of white vs grey ProRoot mineral trioxide aggregate formulas as apical barriers

DENTAL TRAUMATOLOGY, Issue 2 2008
Spyridon Stefopoulos
Recently conventional grey MTA has been replaced by a new white MTA formula. The aim of this study was to compare the root canal adaptation of white MTA to that of grey MTA when used as an apical barrier in teeth with open apices. We also examined whether a previous calcium hydroxide intracanal medication affects MTA's sealing ability and investigated the ability to remove calcium hydroxide from the root canal walls. Forty-nine teeth were prepared in a manner to simulate a divergent open apex of immature teeth. Four teeth were used in a preliminary experiment to demonstrate the inefficacy of calcium hydroxide removal from the canal walls in teeth with open apices. Four groups of 10 teeth each were created: groups A and B were treated with calcium hydroxide intracanal medication and then received an apical plug of grey and white MTA respectively. Groups C and D received an apical plug of grey and white MTA respectively without previous intracanal medication. Four teeth served as negative and one as a positive control. The marginal adaptation and sealing ability of the apical barrier were tested by means of a dye tracer (basic fuchsine) after longitudinal sectioning. It was found that MTA apical barrier resisted displacement during gutta-percha condensation. Calcium hydroxide pretreatment, adversely affected white MTA sealing ability (P < 0.05). [source]


Reattachment of subgingivally fractured central incisor with an open apex

DENTAL TRAUMATOLOGY, Issue 3 2007
Ece Eden
Abstract,,, A case report of a 6-year-old girl with a fractured maxillary left central incisor with an open apex is presented. The procedure used to repair the fracture included flap surgery with an intrasulcular incision and endodontic treatment. The patient was called for 3 months regular follow-up to check the root formation. At the end of 32 months just before the root was obturated by guttaperka, she fractured the same tooth. Flap surgery was repeated and the tooth was restored. The root canal was obturated with a root filling paste and guttaperka as the apex was closed. Examination 10 months after treatment revealed good periodontal health, aesthetics and normal function. [source]


Apexogenesis after initial root canal treatment of an immature maxillary incisor , a case report

INTERNATIONAL ENDODONTIC JOURNAL, Issue 1 2010
S. R. Kvinnsland
Abstract Aim, To present a case where a traumatized, immature tooth still showed capacity for continued root development and apexogenesis after root canal treatment was initiated based on an inaccurate pulpal diagnosis. Summary, Traumatic dental injuries may result in endodontic complications. Treatment strategies for traumatized, immature teeth should aim at preserving pulp vitality to ensure further root development and tooth maturation. A 9-year-old boy, who had suffered a concussion injury to the maxillary anterior teeth, was referred after endodontic treatment was initiated in tooth 21 one week earlier. The tooth had incomplete root length, thin dentinal walls and a wide open apex. The pulp chamber had been accessed, and the pulp canal instrumented to size 100. According to the referral, bleeding from the root made it difficult to fill the root canal with calcium hydroxide. No radiographic signs of apical breakdown were recorded. Based on radiographic and clinical findings, a conservative treatment approach was followed to allow continued root development. Follow-up with radiographic examination every 3rd month was performed for 15 months. Continued root formation with apical closure was recorded. In the cervical area, a hard tissue barrier developed, which was sealed with white mineral trioxide aggregate (MTA). Bonded composite was used to seal the access cavity. At the final 2 years follow-up, the tooth showed further root development and was free from symptoms. Key learning points, ,,Endodontic treatment of immature teeth may result in a poor long-term prognosis. ,,The pulp of immature teeth has a significant repair potential as long as infection is prevented. ,,Treatment strategies of traumatized, immature permanent teeth should aim at preserving pulp vitality to secure further root development and tooth maturation. ,,Radiographic interpretation of the periapical area of immature teeth may be confused by the un-mineralized radiolucent zone surrounding the dental papilla. [source]


Complex endodontic treatment of an immature type III dens invaginatus.

INTERNATIONAL ENDODONTIC JOURNAL, Issue 10 2008
A case report
Abstract Aim, To report the endodontic treatment of an immature maxillary central incisor with dens invaginatus. Summary, Dens invaginatus is a rare malformation of teeth, probably resulting from an infolding of the dental papilla during tooth development. The present case describes the complex endodontic treatment of a type III dens invaginatus in an immature maxillary central incisor with a necrotic pulp and abscess formation. The initial treatment goal was to achieve apexification of the pseudocanal root and conservative root canal treatment in the main canal. Following 1-year of treatment with calcium hydroxide dressings, radiography revealed a healing response, but no sign of a hard tissue barrier at the apex. Periapical surgery with the placement of a zinc oxide cement (IRM) root-end filling was considered successful at the 4-year follow-up. Key learning points ,,The complexity of the canal system and open apex in dens invaginatus present a challenge to endodontic treatment. ,,Correct diagnosis and treatment planning are fundamental to treatment of dens invaginatus. ,,Periapical surgery is indicated in cases of unsuccessful apexification in immature teeth with dens invaginatus and nonvital pulp. [source]


Comparative in vitro study of the sealing efficiency of white vs grey ProRoot mineral trioxide aggregate formulas as apical barriers

DENTAL TRAUMATOLOGY, Issue 2 2008
Spyridon Stefopoulos
Recently conventional grey MTA has been replaced by a new white MTA formula. The aim of this study was to compare the root canal adaptation of white MTA to that of grey MTA when used as an apical barrier in teeth with open apices. We also examined whether a previous calcium hydroxide intracanal medication affects MTA's sealing ability and investigated the ability to remove calcium hydroxide from the root canal walls. Forty-nine teeth were prepared in a manner to simulate a divergent open apex of immature teeth. Four teeth were used in a preliminary experiment to demonstrate the inefficacy of calcium hydroxide removal from the canal walls in teeth with open apices. Four groups of 10 teeth each were created: groups A and B were treated with calcium hydroxide intracanal medication and then received an apical plug of grey and white MTA respectively. Groups C and D received an apical plug of grey and white MTA respectively without previous intracanal medication. Four teeth served as negative and one as a positive control. The marginal adaptation and sealing ability of the apical barrier were tested by means of a dye tracer (basic fuchsine) after longitudinal sectioning. It was found that MTA apical barrier resisted displacement during gutta-percha condensation. Calcium hydroxide pretreatment, adversely affected white MTA sealing ability (P < 0.05). [source]