IJETSI

Title: NON-SURGICAL TREATMENT OF A TRAUMATIZED TOOTH WITH PERIAPICAL INJURY AND IMMATURE APICE USING MTA AS AN APICAL BARRIER: A CASE REPORT
Authors: Selena Gómez de la Garza, Violeta Cecilia Tinoco Cabriales, Juan Alberto Hernández Castillo, Bertha Luna García, Claudia Penélope Mora López & Mario Alberto Palomares Rodriguez
\|\| \|\|
Selena Gómez de la Garza: Graduate in Endodontic Master Degree, M.D, of the Dentistry Faculty, Autonomous University of Tamaulipas. Violeta Cecilia Tinoco Cabriales: Professor of the Dentistry Faculty, Autonomous University of Tamaulipas. Juan Alberto Hernández Castillo: Professor of the Dentistry Faculty, Autonomous University of Tamaulipas. Bertha Luna García: Professor of the Dentistry Faculty, Autonomous University of Tamaulipas. Claudia Penélope Mora López: Professor of the Dentistry Faculty, Autonomous University of Tamaulipas. Mario Alberto Palomares Rodriguez: Professor of the Dentistry Faculty, Autonomous University of Tamaulipas.

References [1] Andreasen, J. O. et al. Textbook and color atlas of traumatic injuries to the teeth. 5th. ed. New York: Wiley-Blackwell; 2018. [2] Mediero, A. et al. “Adenosine A2A receptor (A2AR) stimulation modulates expression of semaphorins 4D and 3A, regulators of bone homeostasis”. FASEB J. 2018; 32:1–29. [3] Bendo, C. B. et al. “Prevalence and associated factors of traumatic dental injuries in Brazilian schoolchildren”. J Public Health Dent. 2010; 70:313-318. [4] Noori, A. J. and Al-Obaidi, W. A. “Traumatic dental injuries among primary school children in Sulaimani city”. Dent Traumatol. 2009; 25:442-446. [5] Fakhruddin, K. S. et al. “Etiology and environment of dental injuries in 12- to 14-year-old Ontario schoolchildren”. Dent Traumatol. 2008; 24:305-308. [6] Petti, S. et al. “World traumatic dental injury prevalence and incidence, a meta-analysis-One billion living people have had traumatic dental injuries”. Dent Traumatol. 2018; 34(2):71–86. [7] Hecova, H. et al. “A retrospective study of 889 injured permanent teeth”. Dent Traumatol. 2010; 26(6):466–475. [8] Trope M. “Treatment of the immature tooth with a non-vital pulp and apical periodontitis”. Dent Clin N Am. 2010; 54(2):313–24. [9] Pitt Ford, T. R. et al. “Use of mineral trioxide aggregate for repair of furcal perforations”. Oral Surg Oral Med Oral Pathol Oral RadiolEndod. 1995; 79(6):756–763. [10] Huang, G. T. J. et al. “The hidden treasure in apical papilla: the role in pulp/dentin regeneration and bioroot engineering”. J Endod. 2008; 34(6):645–651. [11] Manzur, A. et al. “Bacterial quantification in teeth with apical periodontitis related to instrumentation and different intracanal medications: a randomized clinical trial”. J Endod. 2007; 33: 114-118.1 [12] Zmener, O. et al. “A in vitro study of the pH of three calcium hydroxide dressing materials”. Dent Traumatol. 2007; 23: 21-25. [13] Torabinejad, M. and Parirokh, M. “Mineral trioxide aggregate: a comprehensive literature review-part II: leakage and biocompatibility investigations”. J Endod. 2010; 36: 190-202. [14] Bakland, L. K. and Andreasen, J. O. “Will mineral trioxide aggregate replace calcium hydroxide in treating pulpal and periodontal healing complications subsequent to dental trauma? a review”. Dent Traumatol. 2012; 28:25-32.
Abstract: A clinical case is described of a 17-year-old patient who suffered a trauma at the age of 8, compromising the upper right incisor, which prevented complete apical closure and the presence of a periapical lesion. The patient reports having interrupted the root canal treatment one year ago, in the diagnostic periapical radiograph the endodontic treatment already started is confirmed and temporary crown filling material is observed, the presence perhaps of calcium hydroxide inside the root canal, incomplete apical formation and a periapical radiolucent lesion. Root canal treatment was resumed using K-type manual files until reaching a #140 apical caliber, 5.25% sodium hypochlorite was used as irrigant, Ultrapex (Ca(OH)2 + Iodoform) was placed as intracanal medication for several months. Two years after resuming treatment, the patient was asymptomatic, and in the control periapical radiograph it was possible to observe the considerable decrease in the periapical lesion, therefore it was decided to obturate using the classic lateral condensation technique, AH Plus sealant and previous at this stage, 4mm of MTA was placed as an apical barrier. Conclusions The importance of using intracanal medication in situations of dental necrosis with a periapical lesion of considerable size is shown through this clinical case. This case was caused due to dental trauma which, as we know, can evolve in very different ways and in many situations the dental prognosis ends up being very unfavorable. In addition, because it is an immature apex, the use of an MTA apical barrier was essential for containing the filling materials to avoid their extrusion into the periapical tissues and ensuring a better sealing in the apical third.

IJETSI is Member of