Tuesday, September 8, 2009

Apexification with Calcium Hydroxide & MTA Fill

This 15 year old patient has a history of trauma to #8. Trauma occurred at an age before apical closure occurred. Tooth was diagnosed with necrotic pulp and symptomatic apical periodontitis. Note the large periapical lesion.

Traditional apexification using Ca(OH)2 was used.

Tooth debrided to the apex, NaOCl irrigation.

Ca(OH)2 placed.

3 month check shows resorption of Ca(OH)2, but apex still open. Apical lesion almost completely healed.

Ca(OH)2 placed again.

10 month re-evaluation. Apical barrier present, so it was time to obturate. This is a great view of the apical barrier that has formed.

Tooth was obturated with MTA. If this tooth ever needs apical treatment, a simple resection will be done without retropreparation or retrofilling.