Primary molars with asymptomatic reversible pulpitis are commonly treated by pulpotomy procedure. Different pulpotomy materials used so far for pulpotomy that have been mentioned in the literature have been included in this article. This literature review includes all medicaments including natural alternatives. Many significant medicaments with their success rates have been mentioned in this paper. To increase the therapeutic success of pulpotomy procedure, it is necessary to identify a novel effective and preferably natural pulpotomy medicament.
The treatment of immature necrotic permanent teeth with wide open apices often poses a significant challenge for the clinician. The lack of an apical stop complicates the obturation and achievement of good apical seal in such teeth. The treatment of choice for necrotic teeth with immature root is apexification, which is induction of apical closure to produce more favorable conditions for conventional root canal filling. The most commonly advocated medicament is calcium hydroxide. But the disadvantages of long treatment time, tooth fracture risk and incomplete calcification of apical bridge have led to the development of newer biocompatible materials which can complete apexification in a single visit. Although different materials are available, Mineral Trioxide Aggregate (MTA) remains the material of choice for forming an immediate apical barrier because of its superior clinical properties and high success rate. This case series highlights the use of MTA for formation of hard tissue barrier in nonvital permanent teeth with open apices with demonstrated clinical and radiographic success.
The intimate relation between the apices of primary incisors and their successors explains the disruptive effect of intrusion injuries on permanent teeth, one of which is the disturbance of eruption. The ectopic eruption is a deviation of the tooth from its normal erupting path, making it to erupt in an abnormal position. The ectopic eruption has got multi-factorial etiology, and its management depends on the correction of the established etiological factor. The present case report describes correction of ectopically erupted permanent maxillary right central incisor encased within thickened maxillary labial frenum by orthodontic repositioning.
Endodontic treatment of immature necrotic permanent teeth is clinically challenging and poses a risk of inducing dentin wall fracture or extending gutta-percha into the periapical tissue during root canal filling. Pulp revascularization is a promising alternative for the treatment of such immature necrotic permanent teeth offering great potential to avoid the need for traditional apexification with calcium hydroxide or the need to achieve an artificial apical barrier with mineral trioxide aggregate. Pulp revascularization allows the stimulation of the apical development and the root maturation of immature teeth by physiologically strengthening the canal walls. The present case report describes the case of successful revascularization of the necrotic infected pulp space of an immature permanent maxillary central incisor induced in vivo by stimulation of a blood clot from the periapical tissues into the canal space. Thickening of the canal wall and complete apical closure were confirmed 15 months after the treatment.
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