Revascularization. Adult patient case.
Case of revascularization in a tooth with chronic apical abscess in a tooth with incomplete root formation in an adult patient. Patient 18 years old, female, sought care due to a colleague's indication for endodontic treatment of tooth 11. History of trauma at age 6. She reported no symptoms and on clinical examination, a slight swelling was observed in the apical gingival region. Radiographic examination revealed a diffuse periapical radiolucent image and an incomplete root formation, in Nolla stage compatible with 7 to 8. Revascularization was chosen.
Preparation and decontamination with 2.5% sodium hypochlorite and final protocol with Easy Clean agitation and calcium hydroxide medication for 30 days were performed. In the second session, the MIC was removed with saline and EDTA and agitation, and then clot induction and covering with MTA and sealing was performed.
Case conducted by student Marcelo Buregio from class VI, specialization in endodontics at HPG Brasilia.
In: Pulp revascularization in necrotic permanent teeth with incomplete rhizogenesis Leticia Rodrigues SOUSA, Anny Gabrielle Silva PEREIRA, Izabela Pastor DA SILVA, Janielle Emanuelle Resende DE SANTANA, Laerte Oliveira BARRETO NETO Rev. odontol. UNESP, vol.50, nSpecial, p.0, 2021 Introduction:
The complete formation of the dental root occurs in a period of up to three years after the eruption of the permanent tooth. Immature teeth that suffer some kind of trauma can have their root development interrupted, resulting in a process called incomplete rhizogenesis. In these cases, endodontic treatment is a challenge. The difficulties encountered are: the young age of patients, fragile dentin walls and developing apex, making it difficult to fill the root canal system. In this context, pulp regeneration becomes an alternative that promotes the formation of new dentin tissue inside the root canal.
Objective: To review the literature on existing scientific evidence regarding pulp revascularization in necrotic permanent teeth. Materials and Methods: This study is a literature review, in which LILACS and Medline/Pubmed databases were consulted, using as descriptors "Dental Pulp" "Blood Coagulation" "Endodontics", and articles and dissertations in English and Portuguese were selected. Results: The revascularization technique initially consists of cleaning and disinfecting the root canal, since the process is only effective when the canal is completely free of infection.
The second step is to induce the formation of a blood clot that will fill the root canal. The blood cells will induce the formation of a revascularized tissue by providing growth factors to the stem cells of the papilla, triggering an accumulation of undifferentiated cells that will form new tissues, thus increasing the thickness of the canal, elongation of the root, closure of the apex and return of vitality. Conclusion: The technique treatment time is shorter, and can be completed in one or two sessions, with the cost-benefit being a favorable factor. The greatest advantage is the induction of the end of root development with thickening and, as a result, the strengthening of the root walls.
