Nayak Gurudutt, Hasan Mohammad Faiz
Department of Conservative Dentistry and Endodontics, Kanti Devi Dental College and Hospital, Mathura, Uttar Pradesh, India.
Restor Dent Endod. 2014 May;39(2):120-5. doi: 10.5395/rde.2014.39.2.120. Epub 2014 Mar 21.
Use of an apical plug in management of cases with open apices has gained popularity in recent years. Biodentine, a new calcium silicate-based material has recently been introduced as a dentine substitute, whenever original dentine is damaged. This case report describes single visit apexification in a maxillary central incisor with necrotic pulp and open apex using Biodentine as an apical barrier, and a synthetic collagen material as an internal matrix. Following canal cleaning and shaping, calcium hydroxide was placed as an intracanal medicament for 1 mon. This was followed by placement of small piece of absorbable collagen membrane beyond the root apex to serve as matrix. An apical plug of Biodentine of 5 mm thickness was placed against the matrix using pre-fitted hand pluggers. The remainder of canal was back-filled with thermoplasticized gutta-percha and access cavity was restored with composite resin followed by all-ceramic crown. One year follow-up revealed restored aesthetics and function, absence of clinical signs and symptoms, resolution of periapical rarefaction, and a thin layer of calcific tissue formed apical to the Biodentine barrier. The positive clinical outcome in this case is encouraging for the use of Biodentine as an apical plug in single visit apexification procedures.
近年来,使用根尖屏障治疗根尖孔开放的病例越来越普遍。Biodentine是一种新型的硅酸钙基材料,最近被引入作为牙本质替代物,用于原始牙本质受损的情况。本病例报告描述了使用Biodentine作为根尖屏障、合成胶原材料作为内部基质,对上颌中切牙牙髓坏死且根尖孔开放进行一次性根尖诱导成形术。根管清理和预备后,放置氢氧化钙作为根管内药物1个月。随后在根尖外放置一小片可吸收胶原膜作为基质。使用预成型手动充填器将5毫米厚的Biodentine根尖屏障放置在基质上。根管其余部分用热塑牙胶回填,用复合树脂修复髓腔,然后制作全瓷冠。一年的随访显示美学和功能恢复,无临床症状和体征,根尖周稀疏区消失,Biodentine屏障根尖处形成一层薄的钙化组织。该病例的积极临床结果鼓励在一次性根尖诱导成形术中使用Biodentine作为根尖屏障。