Ashraf Hengameh, Rahmati Afsaneh, Amini Neda
Endodontic Department, Dental School, Shahid Beheshti University of Medical Science, Tehran, Iran.
Endodontic Department, Dental School, Hamedan University of Medical Science, Hamedan, Iran.
Iran Endod J. 2017 Winter;12(1):112-115. doi: 10.22037/iej.2017.23.
This article describes successful use of calcium-enriched mixture (CEM) cement and Biodentine in apexogenesis treatment in two 8-year-old patients, one with immature permanent molar diagnosed primarily with irreversible pulpitis and the other with partially vital maxillary central incisor. After access cavity preparation, partial pulpotomy in molar and full pulpotomy in central was performed, and the remaining pulps was capped with either Biodentine or CEM cement, in each tooth. The crowns were restored with composite filling material at the following visit. The post-operative radiographic and clinical examinations (approx. average of 16 months) showed that both treated teeth remained functional, with complete root development and apex formation. A calcified bridge was produced underneath the capping material. No further endodontic intervention was necessary. Considering the healing potential of immature vital pulps, the use of CEM cement and Biodentine for apexogenesis might be an applicable choice. These new endodontic biomaterials might be appropriate for vital pulp therapies in an immature tooth. However, further clinical studies with longer follow-up periods are recommended.
本文描述了在两名8岁患者的根尖诱导成形术治疗中成功使用富钙混合物(CEM)水泥和生物陶瓷的情况,其中一名患者的恒牙未成熟,初步诊断为不可逆性牙髓炎,另一名患者的上颌中切牙部分牙髓仍有活力。在开髓后,对磨牙进行了部分牙髓切断术,对中切牙进行了全牙髓切断术,每颗牙齿剩余的牙髓均用生物陶瓷或CEM水泥覆盖。在接下来的复诊中,用复合填充材料修复牙冠。术后影像学和临床检查(约平均16个月)显示,两颗治疗后的牙齿均保持功能,牙根完全发育且根尖形成。在覆盖材料下方形成了钙化桥。无需进一步的牙髓治疗干预。考虑到未成熟有活力牙髓的愈合潜力,使用CEM水泥和生物陶瓷进行根尖诱导成形术可能是一种适用的选择。这些新型牙髓生物材料可能适用于未成熟牙齿的牙髓治疗。然而,建议进行更长随访期的进一步临床研究。