Charles Pilipili, Nathalie Senger, Carine Defat, Alexandru George
Université Catholique de Louvain, Ecole de Médecine Dentaire et de Stomatologie, Service de Pédodontie et de Soins Dentaires aux Personnes Handicapées, Bruxelles, Belgique.
Rev Belge Med Dent (1984). 2004;59(3):163-9.
On non-vital deciduous molars, inter-radicular bone resorption is often an indication of extraction. The endodontic treatment of these teeth by means of zinc oxide-eugenol (ZOE) paste also showed its limits. To mitigate the deficiencies of this material, we suggested a preliminary treatment by means of calcium hydroxide (Ca(OH)2) for its anti-inflammatory and antiseptic properties as well as its ability to stimulate calcified tissues apposition or remineralisation. This study concerns 21 non-vital deciduous molars. X-rays excluded any lesion of the underlying permanent bony crypt (bone tissue) as well as any inflammation of the dental follicle. After preparation, root canals were filled by means of Pulpdent. An initial X-ray check was made 15 days and then every 3 months. After disappearance of the inflammatory resorption, root canal fillings were performed with ZOE paste. The remineralisation of the inter-radicular alveolar bone was observed for 14 deciduous molars, which were then filled using ZOE. The remineralisation period varies from 3 to 18 months depending on the scale of the lesion. Of the 7 failed treatments, 3 failed following downfall of the crown filling material, and 2 due to failure to keep appointments and late replacement of resorbed Ca(OH)2. On 2 teeth, the treatment did not stop the lesion forming. Calcium hydroxide (Ca(OH)2) give encouraging results in the treatment of inter-radicular alveolar bone resorption of non-vital deciduous tooth. Its fast resorption requires rigorous controls, frequent refills, and thus strong motivation on the part of the child and parents. It cannot, on any account, be considered as permanent filling material.
对于非活髓乳磨牙,根间骨吸收通常是拔牙的指征。用氧化锌丁香油(ZOE)糊剂对这些牙齿进行根管治疗也显示出了其局限性。为了减轻这种材料的不足,我们建议先用氢氧化钙(Ca(OH)₂)进行初步治疗,因为它具有抗炎和防腐特性,以及刺激钙化组织附着或再矿化的能力。本研究涉及21颗非活髓乳磨牙。X线检查排除了下方恒牙骨隐窝(骨组织)的任何病变以及牙囊的任何炎症。预备后,用Pulpdent充填根管。在15天时进行首次X线检查,然后每3个月检查一次。炎症性吸收消失后,用ZOE糊剂进行根管充填。观察到14颗乳磨牙的根间牙槽骨发生了再矿化,然后用ZOE进行充填。再矿化期根据病变程度从3个月到18个月不等。在7例治疗失败的病例中,3例是由于冠部充填材料脱落,2例是由于未按时复诊以及再吸收的Ca(OH)₂更换不及时。有2颗牙齿的治疗未能阻止病变形成。氢氧化钙(Ca(OH)₂)在治疗非活髓乳牙的根间牙槽骨吸收方面取得了令人鼓舞的结果。其快速吸收需要严格的控制、频繁的复诊,因此需要患儿及其家长有较强的积极性。无论如何,它都不能被视为永久性充填材料。