Mahesh Shakila, Gupta Alpa, Panda Bandana
Department of Microbiology, Manav Rachna Dental College, Faridabad, IND.
Department of Dentistry, Manav Rachna International Institute of Research and Studies, Faridabad, IND.
Cureus. 2024 Sep 12;16(9):e69280. doi: 10.7759/cureus.69280. eCollection 2024 Sep.
Apexification procedure on a necrotic, infected tooth with an open apex is achievable if the canal is adequately disinfected. This case report aims to add an endodontic case to the body of knowledge currently available on the application of concentrated growth factor (CGF). A 24-year-old man with a history of a fall 15 years earlier developed apical periodontitis and pulpal necrosis in his maxillary central incisor with an open apex. Following the preparation of the access cavity, a solution containing 20 mL of sodium hypochlorite solution (5.25%) and 10 mL of 0.2% chlorhexidine was used to irrigate the canal successfully, and paper points were used to dry it. The canal was covered with a calcium hydroxide dressing for 10 days. The patient's right antecubital vein yielded 10 mL of whole blood, from which CGF was made. After the removal of the intracanal dressing, the CGF was placed into the canal to act as apical matrix to stabilize the mineral trioxide aggregate. The canal underwent composite restoration after being obturated. One year later, the clinical examination showed that the tests for palpation and percussion were negative. Both the electric and cold pulp tests yielded positive results for the tooth. Regression of the periapical lesion was seen on radiographic evaluation. Our case report's findings lead us to the conclusion that, in certain circumstances, complete canal disinfection can be used to treat necrotic, infected immature teeth, and that CGF might make an excellent scaffold matrix for treating open apex cases.
如果根管得到充分消毒,对根尖孔开放的坏死、感染牙齿进行根尖诱导成形术是可行的。本病例报告旨在为目前关于浓缩生长因子(CGF)应用的牙髓病学知识体系增添一个病例。一名24岁男性,15年前曾有跌倒史,其上颌中切牙根尖孔开放,出现了根尖周炎和牙髓坏死。在制备开髓腔后,使用含20毫升次氯酸钠溶液(5.25%)和10毫升0.2%氯己定的溶液成功冲洗根管,并用纸尖吸干。根管内放置氢氧化钙敷料10天。从患者右肘前静脉采集10毫升全血制备CGF。去除根管内敷料后,将CGF放入根管作为根尖基质以稳定三氧化矿物凝聚体。根管充填后进行复合树脂修复。一年后,临床检查显示触诊和叩诊检查均为阴性。该牙齿的电活力测试和冷测均呈阳性结果。影像学评估显示根尖周病变有所消退。我们病例报告的结果使我们得出结论,在某些情况下,彻底的根管消毒可用于治疗坏死、感染的未成熟牙齿,并且CGF可能是治疗根尖孔开放病例的极佳支架基质。