De-Deus G, Coutinho-Filho T
Department of Endodontics, Rio de Janeiro State University, Rio de Janeiro, Brazil.
Int Endod J. 2007 Aug;40(8):653-60. doi: 10.1111/j.1365-2591.2007.01269.x.
To present a case in which substantial periapical healing occurred with the use of white Portland cement (WPC) to create an apical plug in the root of an immature tooth.
Radiographic examination indicated an immature tooth (35) with a wide-open apex and a periapical radiolucency. The canal was mechanically cleaned using intracanal instruments and 5% NaOCl irrigation. Small pieces of resorbable collagen sponge were packed beyond the root apex with the aim of creating a periapical barrier for the compaction of filling material. WPC powder was then mixed with sterile water and delivered to the apical portion of the canal (approximately 3 mm). The patient was asked to return 1 week later for the continuation of treatment but he did return as planned. Seven months after the intervention the patient returned and another radiograph was exposed to reveal complete radiographic healing of the periapical region. The remainder of the canal was filled with thermoplastic gutta-percha. Clinical follow-up 1 year later revealed adequate clinical function, absence of clinical symptoms and no signs of periapical rarefaction.
The positive clinical resolution of this case is encouraging for the use of WPC as an apical plug in immature teeth with necrotic pulps and wide-open apices.
介绍一例使用白色波特兰水泥（WPC）在未成熟牙齿的牙根中形成根尖屏障后根尖周大量愈合的病例。
影像学检查显示一颗未成熟牙齿（35）根尖孔敞开且根尖周有透射区。使用根管内器械对根管进行机械清理，并用5%次氯酸钠冲洗。在根尖孔外填充小块可吸收胶原海绵，目的是为充填材料的压实创造根尖周屏障。然后将WPC粉末与无菌水混合并输送至根管根尖部（约3毫米）。要求患者1周后复诊继续治疗，但他未按计划复诊。干预7个月后患者复诊，再次拍摄X线片显示根尖周区域完全影像学愈合。根管其余部分用热塑性牙胶充填。1年后的临床随访显示临床功能良好，无临床症状，也无根尖周稀疏的迹象。
该病例的积极临床转归对于将WPC用作牙髓坏死且根尖孔敞开的未成熟牙齿的根尖屏障具有鼓舞作用。
