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Case Reports
. 2018 Winter;13(1):139-142.
doi: 10.22037/iej.v13i1.19666.

Revascularization and Apical Plug in an Immature Molar

Leyla Roghanizadeh  1 , Mahta Fazlyab  2   3
Affiliations
Case Reports

Revascularization and Apical Plug in an Immature Molar

Leyla Roghanizadeh et al. Iran Endod J. 2018 Winter.

Abstract

Managing of necrotic permanent teeth with immature apices is a treatment challenges. Treatment of such teeth includes apexification, apical plug and more recently, revascularization technique with the probable advantage of continuation of root development. In the present case report the referred patient had discomfort with a necrotic immature mandibular first molar. Periapical radiography showed a rather large apical lesion around immature roots. Revascularization protocol using calcium-enriched mixture (CEM) cement was indicated for the mesial root. However, in distal canal apical plug technique was applied. At 2-year follow-up, both procedures were successful in relieving patient's symptoms. Dentin formation and increase in length of the mesial root was obvious. Apical plug and revascularization technique proved to be successful in management of necrotic immature teeth; moreover, revascularization carried the advantage of continuation of root development.

Keywords: Apexification; Apical Plug; CEM Cement; Calcium-enriched Mixture Cement; Endodontics; Regeneration; Revascularization.

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Conflict of interest statement

‘None declared’.

Figures

Figure 1
Figure 1
A) Permanent immature first molar, with chronic apical periodontitis, went under emergency treatment; B) Mesial canals treated by revascularization protocol; distal canal was treated using apical plug technique; C) Tooth was permanently restored with amalgam; D) two-year follow-up radiography: resolved periradicular lesions and continued development of mesial root
See this image and copyright information in PMC

References

    1. Lin J-C, Lu J-X, Zeng Q, Zhao W, Li W-Q, Ling J-Q. Comparison of mineral trioxide aggregate and calcium hydroxide for apexification of immature permanent teeth: A systematic review and meta-analysis. J Formos Med Assoc. 2016;115(7):523–30. - PubMed
    1. Andreasen JO, Farik B, Munksgaard EC. Long‐term calcium hydroxide as a root canal dressing may increase risk of root fracture. Dent Traumatol. 2002;18(3):134–7. - PubMed
    1. Nosrat A, Seifi A, Asgary S. Regenerative endodontic treatment (revascularization) for necrotic immature permanent molars: a review and report of two cases with a new biomaterial. J Endod. 2011;37(4):562–7. - PubMed
    1. Skoglund A, Tronstad L, Wallenius K. A microangiographic study of vascular changes in replanted and autotransplanted teeth of young dogs. Oral Surg Oral Med Oral Pathol. 1978;45(1):17–28. - PubMed
    1. Claus I, Laureys W, Cornelissen R, Dermaut LR. Histologic analysis of pulpal revascularization of autotransplanted immature teeth after removal of the original pulp tissue. Am J Orthod Dentofacial Orthop. 2004;125(1):93–9. - PubMed

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