Case Report/Clinical Techniques
Apexogenesis Treatment with a New Endodontic Cement: A Case Report

https://doi.org/10.1016/j.joen.2009.11.025Get rights and content

Abstract

Introduction

This article describes an apexogenesis report of an 8-year old boy referred to our clinic 4 weeks after an impact trauma to the maxillary left central incisor that caused a complicated crown fracture and pulpal exposure.

Methods

In the radiographic examination, the tooth was observed to be immature. After access cavity preparation, cervical pulpotomy was performed, and the remaining pulp was capped with calcium enriched mixture (CEM) cement. The crown was restored by using the fractured incisal segment on the next day.

Results

The radiographic and clinical examinations on the 6-month and 12-month follow-ups showed that the tooth remained functional, root development was completed, and the apex was formed. A calcified bridge was produced underneath the capping material. No further endodontic intervention was necessary.

Conclusions

Considering the healing potential of traumatized immature vital pulp, the use of CEM cement for apexogenesis might be an applicable choice; however, further clinical studies with longer follow-up periods are recommended.

Section snippets

Case Report

An 8-year-old boy was referred to our clinic with a history of prior impact trauma 4 weeks before his initial visit. The patient's chief complaint was sensitivity to cold beverage and pain in chewing. No spontaneous pain was reported by the patient. Clinical examination showed a complicated crown fracture with pulpal exposure on the left maxillary central incisor. The tooth was sensitive in percussion test but not in palpation. Radiographic examination showed that fractured tooth had immature

Discussion

VPT is a reasonable treatment for teeth with open apices and vital pulp (1). Caries and trauma are 2 main causes of pulpal exposures. Traumatic exposures such as crown fractures usually lead to pulp contamination by saliva and oral bacteria. It has been stated that partial pulpotomy is the treatment of choice after pulpal exposure of immature teeth with open apices (22). In the present case, however, considering the longer period of pulpal exposure, we performed cervical pulpotomy (21).

Studies

References (30)

  • C.F. Cox et al.

    Biocompatibility of surface-sealed dental materials against exposed pulps

    J Prosthet Dent

    (1987)
  • W.E. Andelin et al.

    Identification of hard tissue after experimental pulp capping using dentin sialoprotein (DSP) as a marker

    J Endod

    (2003)
  • D.E. Witherspoon

    Vital pulp therapy with new materials: new directs and treatment perspectives—permanent teeth

    J Endod

    (2008)
  • M. Rafter

    Apexification: a review

    Dent Traumatol

    (2005)
  • M. Cvek et al.

    Hard tissue barrier formation in pulpotomized monkey teeth capped with cyanoacrylate or calcium hydroxide for 10 and 60 minutes

    J Dent Res

    (1987)

    • Cited by (52)

    View all citing articles on Scopus
    View full text
    Copyright © 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.