Mma Test Lab Report

APEXIFICATION

Apexification is defined as a method to induce a calcified barrier in a root with an open apex or the continued apical development of an incomplete root in teeth with a necrotic pulp(AAE,2003). Apexification can be achieved is two different ways: Long-term apexification with calcium hydroxide or Short-term apexification with MTA (One visit)

This technique is performed on teeth that are non vital due to traumatic injury, carious exposure and teeth with anatomical variations such as den invaginatus with immature teeth.

LONG-TERM APEXIFICATION WITH CALCIUM HYDROXIDE

Calcium hydroxide (CH) apexification requires multiple visits and hence patient and parent compliance is very important. CH is used for the formation of an apical

MTA reduces the time needed for the root canal treatment and restoration of the tooth. The preparation and disinfection of the root is done in first visit and MTA is placed at the apical region at the second visit. It is mandatory to do complete debridement and disinfection of the root canal and of the dentin walls as it is difficult to remove the MTA once it is set.

Advantages: (Simon et al., 2007)

1. Patient compliance less important
2. Reduced treatment time
3. Physical an mechanical properties of dentin is not lost
4. Allows early restoration of the tooth and thus minimizes the likelihood of root fracture

TECHNIQUE:

• Placement of MTA at the apical region is complicated than CH
• MTA is compacted apically 4-5 mm. Special carriers or endodontic pluggers are used to introduce the material apically and then compacted using hand condensation with indirect ultrasonic activation(Yeung et al., 2006)
• MTA is covered by wet cotton pellet or wet paper point and the tooth is sealed with a temporary filling
• After few days the root canal filling can be completed using GP and restored with permanent

Evidences report clinicians have used variety of medicaments to disinfect the canal space and they include triple antibiotic paste (1:1:1 mixture of ciprofloxacin/metronidazole/minocycline) or variation (Banchs and Trope, 2004; Iwaya et al., 2001; Jung et al., 2008), Calcium hydroxide alone or combination(Chueh and Huang, 2006; Cotti et al., 2008) with antibiotics and formocresol (Shah et al., 2008)
TECHNIQUE:
• The root canal is disinfected using irrigation solutions (like sodium hypochloride) and dressing with triple antibiotic paste
• After disinfection ,bleeding is introduced in the canal space to create the scaffold on which new tissue grows and application of MTA and good coronal seal with Glass ionomer cement is done
• Root maturation is checked during follow ups using radiographs.
CONCLUSION

Deep carious lesions lead to changes in the pulp dentine complex depending on the severity of the disease and the age of the pulp. Early diagnosis and treatment is important to keep the tooth vital and achieve the normal root