Asgary Saeed, Roghanizadeh Leyla
Iranian Center for Endodontic Research, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iran Endod J. 2023;18(3):165-167. doi: 10.22037/iej.v18i3.42508.
Minimally invasive vital pulp therapy (VPT) techniques have become increasingly popular for treating mature permanent teeth with irreversible pulpitis. However, in cases where less invasive VPT approaches, such as miniature pulpotomy, fail to provide symptom relief and desired outcomes, alternative treatment strategies need to be explored. This case report presents the successful application of tampon pulpotomy, a modified full pulpotomy technique, in a vital molar tooth with irreversible pulpitis, after a previous miniature pulpotomy failure. The tampon pulpotomy procedure involved the placement of an endodontic biomaterial ( calcium-enriched mixture cement) over the pulpal wound to stop bleeding and create a favorable environment for pulpal healing/regeneration. The patient was followed up for a period of 10 years, during which the tooth remained asymptomatic, functional, and exhibited normal periodontal ligament. This case report highlights the potential effectiveness of tampon/full pulpotomy as a retreatment option in cases where more conservative VPT techniques have shown limited success, offering a conservative approach to preserve tooth structure and pulpal vitality.
微创活髓治疗(VPT)技术在治疗患有不可逆性牙髓炎的成熟恒牙方面越来越受欢迎。然而,在一些侵入性较小的VPT方法(如微型牙髓切断术)未能缓解症状并达到预期效果的情况下,需要探索替代治疗策略。本病例报告展示了在先前微型牙髓切断术失败后,棉塞牙髓切断术(一种改良的全牙髓切断术技术)在一颗患有不可逆性牙髓炎的活髓磨牙上的成功应用。棉塞牙髓切断术包括在牙髓创口上放置一种牙髓生物材料(富钙混合水门汀)以止血,并为牙髓愈合/再生创造有利环境。对患者进行了为期10年的随访,在此期间该牙齿无症状、功能正常,牙周膜表现正常。本病例报告强调了在较为保守的VPT技术成效有限的情况下,棉塞/全牙髓切断术作为一种再治疗选择的潜在有效性,为保留牙齿结构和牙髓活力提供了一种保守方法。