Apexification of primary teeth: a treatment option.
ABSTRACT This article reports a case of apexification in a child aged 20 months, with early childhood caries, using calcium hydroxide paste in two primary upper central incisors. This method is a feasible option for treating immature deciduous teeth showing pulpal necrosis.
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ABSTRACT: The low number of clinical studies of traumatized teeth submitted to root canal treatment is completely out of proportion to the seriousness that dental trauma imposes on children in early years. This study evaluates the outcomes of root canal treatment (RCT) in traumatized primary incisors and identifies the predisposing factors associated with therapy success. This is a retrospective study conducted with all dental records of 704 patients who had one or more teeth with traumatic injuries. Patients with irreversible pulp changes in primary teeth leading to RCT with a 24 month follow-up met the inclusion criteria. Twenty-five maxillary incisors of 17 children were evaluated. The children's age at the time of therapy ranged from 24 to 72 months (mean 47.3). Pulp necrosis was the most common disorder (84.0%) and pre-operative periapical lesions were observed in 52.0%. Coronal discoloration was found in 48.0%. The roots were filled with ZOE paste (68.0%) or Guedes-Pinto paste (32.0%). Overall RCT success rate was 68.0%. The absence of pre-operative periapical lesions (p = 0.02) and pathological root resorption (p = 0.02) presented positive association with therapy success. Success was not associated to filling paste (p = 0.49), filling extent (p = 0.44), of discoloration (p = 0.39) nor the patients' age (p = 0.59). RCT was considered successful in 68.0% of the cases at the 24 month follow-up. Failure of RCT in traumatized primary incisors was associated with pre-operatory periapical lesions and pathological root resorption. The filling paste, the filling extent and the patient's age were unrelated with therapy success.The Journal of clinical pediatric dentistry 01/2012; 36(3):257-62. · 0.44 Impact Factor
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ABSTRACT: To perform a systematic review in which the clinical research question for primary teeth with irreversible pulpal pathosis was "how pulpectomies with zinc oxide eugenol (ZOE) paste performed compared to other materials in their clinical and radiographic outcomes after twelve months or more follow-up period. A literature survey of the electronic database (1950-2010) used the Medical Subject Headings and free text terms. Forty three references were retrieved and inclusion criteria were applied; 15 articles remained for full-text evaluation. From these, two were selected for data extraction regarding quality characteristics and results. Selected studies showed moderate or high risk of bias. The overall success of pulpectomy was 80.0% (Calcicur), 60.0% (Sealapex) and varied from 85.0% to 100.0% (ZOE) and 89.0% to 100.0% (Vitapex). Solely Calcicur presented success rate significantly lower when compared to ZOE and Vitapex. These pastes lead to overfilled canals and particles of extruded ZOE were still evident even after the evaluation period. Resorption of Vitapex, Calcicur and Sealapex within the root canal was also reported. In primary teeth with irreversible pulpal changes ZOE pulpectomies yielded similar outcome than Vitapex and Sealapex, although there was no agreement with regard to filling materials' resorption.The Journal of clinical pediatric dentistry 01/2011; 35(3):241-8. · 0.44 Impact Factor