Late treatment of dental trauma using apexification technique

Abstract

Introduction: A 37 years old male patient was admitted to the clinic of endodontics. After anamnesis it was found that the tooth #11 had coronary open access and the presence of calcium hydroxide with dental trauma history. Radiographically, the tooth had incomplete root formation, thin and fragile dentin walls and foraminal divergence associated with periapical radiolucent image. Objective: To report a clinical case of apexification, performed with calcium hydroxide dressing. Methods: The treatment chosen was the apexification that began in the second session, after 15 days, through chemomechanical debridement of the entire root canal, with K files and irrigation with 2,5% sodium hypochlorite solution. Then, the calcium hydroxide paste (calcium hydroxide, iodoform and propylene glycol) was applied and changed every 15 days over four months. The radiographic exam demonstrated the complete closure of the foraminal opening and regression of periapical radiolucency. The root canal was filled using a cone made from the union of three master cones #60 and lateral condensation technique with Sealapex®. Results: Six months after the filling, tests revealed normal periapical tissues and absence of symptoms. Conclusion: It was concluded that the treatment of dental trauma associated with dental pulp necrosis and periapical lesions with successive changes of calcium hydroxide paste was adequate to obtain the regression of periapical lesion, formation of a mineralized barrier and promotion of patient's health.