Endodontic Intervention for the Control of Periapical Injury Associated with Traumatized Teeth: A Case Report

Document Type : Case Reports

Authors

Department of Dentistry, Nilton Lins University, Manaus, Brazil

Abstract

The incidence of patients affected by dental trauma is quite frequent. The treatment of choice should be selected according to the severity level of dental trauma in odontology. Periapical injuries caused by trauma can lead to a rupture of the pulpal blood supply. The objective of the present paper is to present a clinical case of endodontic therapy on two necrotic teeth with a periapical lesion resulting from dental trauma. A 36-year-old patient, male, melanoderma, normosystemic, attended the Nilton Lins University Dental Clinic reporting anterior region discomfort on chewing. He also complained about his smile due to tooth darkening. Sensibility tests were performed, confirming a state of necrosis in teeth 11 and 12. In the periapical radiographs, the teeth presented a radiolucent, circumscribed image delimited in the root apex region, suggesting periapical injury. Based on clinical and radiographic findings, the proposed treatment was pulpectomy with subsequent endogenous bleaching. The endodontic intervention was performed in two sessions after exposure to intracanal medication and endogenous bleaching in four sessions, using the association of 37% Whiteness carbamide peroxide and 20% Whiteness sodium perborate. The success or failure of endodontic treatment with a periapical lesion is related to the control of the infection associated with the healing response, whether partial or total. The treatment proved effective after one year of follow-up, supported by the clinical characteristics combined with the radiographic findings, promoting the return of the teeth to their aesthetic and functional capacities, meeting the expected expectations. The patient is under follow-up.

Keywords

Main Subjects

References

[1]  Karamifar K, Tondari A, Saghiri MA. Endodontic periapical lesion: An overview on the etiology, diagnosis and current treatment modalities. European Endodontic Journal. 2020;5(2):54-67. https://doi.org/10.14744/eej.2020.42714.
[2]  Paikkatt JV, Aslam S, Sreedharan S, Philomina B, Kannan VP, Madhu S. Efficacy of various intracanal medicaments against aerobic and facultative anaerobic microorganism found in human primary teeth with necrotic pulp: a randomized clinical trial. Journal of Indian Society of Pedodontics and Preventive Dentistry. 2018;36(3):268-72. https://doi.org/10.4103/JISPPD.JISPPD_152_17.
[3]  Bergenholtz G. Assessment of treatment failure in endodontic therapy. Journal of oral rehabilitation. 2016;43(10):753-8. https://doi.org/10.1111/joor.12423.
[4]  Cassol DV, Duarte ML, Pintor AV, Barcelos R, Primo LG. Iodoform vs calcium hydroxide/zinc oxide based pastes: 12-month findings of a randomized controlled trial. Brazilian Oral Research. 2019;33. https://doi.org/10.1590/1807-3107bor-2019.vol33.0002.
[5]  Prada I, Micó-Muñoz P, Giner-Lluesma T, Micó-Martínez P, Muwaquet-Rodríguez S, Albero-Monteagudo A. Update of the therapeutic planning of irrigation and intracanal medication in root canal treatment. A literature review. Journal of clinical and experimental dentistry. 2019;11(2):e185-193. https://doi.org/10.4317/jced.55560.
[6] Swanljung O, Vehkalahti MM. Root canal irrigants and medicaments in endodontic malpractice cases: a nationwide longitudinal observation. Journal of endodontics. 2018;44(4):559-64. https://doi.org/10.1016/j.joen.2018.01.003.
[7]  Zancan RF, Vivan RR, Lopes MR, Weckwerth PH, de Andrade FB, Ponce JB, et al. Antimicrobial activity and physicochemical properties of calcium hydroxide pastes used as intracanal medication. Journal of endodontics. 2016;42(12):1822-8. https://doi.org/10.1016/j.joen.2016.08.017.
[8]  França GM, Carmo AF, Costa H, Andrade AL, Lima KC, Galvão HC. Macrophages subpopulations in chronic periapical lesions according to clinical and morphological aspects. Brazilian Oral Research. 2019;33. https://doi.org/10.1590/1807-3107bor-2019.vol33.0047.
[9]  Caldeira CL, Barletta FB, Ilha MC, Abrão CV, Gavini G. Pulse oximetry: a useful test for evaluating pulp vitality in traumatized teeth. Dental Traumatology. 2016;32(5):385-9. https://doi.org/10.1111/edt.12279.
[10] Moccelini BS, De Alencar NA, Bolan M, Magno MB, Maia LC, Cardoso M. Pulp necrosis and crown discoloration: a systematic review and meta‐analysis. International Journal of Paediatric Dentistry. 2018;28(5):432-42. https://doi.org/10.1111/ipd.12372.
[11] Kimura S, Ebihara A, Maki K, Nishijo M, Tokita D, Okiji T. Effect of optimum torque reverse motion on torque and force generation during root canal instrumentation with crown-down and single-length techniques. Journal of Endodontics. 2020;46(2):232-7. https://doi.org/10.1016/j.joen.2019.11.007.
[12] Peralta-Mamani M, Rios D, Duarte MA, Santiago Junior JF, Honorio HM. Manual vs. rotary instrumentation in endodontic treatment of permanent teeth: A systematic review and meta-analysis. American journal of dentistry. 2019;32(6):311-24.
[13] Manchanda S, Sardana D, Yiu CK. A systematic review and meta‐analysis of randomized clinical trials comparing rotary canal instrumentation techniques with manual instrumentation techniques in primary teeth. International Endodontic Journal. 2020;53(3):333-53. https://doi.org/10.1111/iej.13233.
[14] Schwendicke F, Göstemeyer G. Single-visit or multiple-visit root canal treatment: systematic review, meta-analysis and trial sequential analysis. BMJ open. 2017;7(2):e013115. http://dx.doi.org/10.1136/bmjopen-2016-013115.
[15] Riaz A, Maxood A, Abdullah S, Saba K, Din SU, Zahid S. Comparison of frequency of post-obturation pain of single versus multiple visit root canal treatment of necrotic teeth with infected root canals. A Randomized Controlled Trial. J Pak Med Assoc. 2018;68(10):1429-33.
[16] Ibrahim AM, Zakhary SY, Amin SA. Calcium hydroxide intracanal medication effects on pain and flare-up: a systematic review and meta-analysis. Restorative Dentistry & Endodontics. 2020;45(3):e26. https://doi.org/10.5395/rde.2020.45.e26.
[17] Donnermeyer D, Bürklein S, Dammaschke T, Schäfer E. Endodontic sealers based on calcium silicates: a systematic review. Odontology. 2019;107(4):421-36. https://doi.org/10.1007/s10266-018-0400-3.
[18] Palanivelu CR, Ravi V, Sivakumar AA, Sivakumar JS, Prasad AS, Arthanari KK. An in vitro comparative evaluation of distribution of three different sealers by single-cone obturation technique. Journal of pharmacy & bioallied sciences. 2019;11(Suppl 2):S438-441. https://doi.org/10.4103/JPBS.JPBS_64_19.
[19] Komabayashi T, Colmenar D, Cvach N, Bhat A, Primus C, Imai Y. Comprehensive review of current endodontic sealers. Dental materials journal. 2020;39(5):703-20. https://doi.org/10.4012/dmj.2019-288.
[20] Çalışkan MK, Kaval ME, Tekin UĞ, Ünal T. Radiographic and histological evaluation of persistent periapical lesions associated with endodontic failures after apical microsurgery. International Endodontic Journal. 2016;49(11):1011-9. https://doi.org/10.1111/iej.12554.
[21] Akbulut MB, Terlemez A, Akman M, Buyukerkmen B, Guneser MB, Eldeniz AU. Tooth discoloration effects of calcium silicate based barrier materials used in revascularization and treatment with internal bleaching. Journal of Dental Sciences. 2017;12(4):347-53. https://doi.org/10.1016/j.jds.2017.03.009.
[22] Abbott PV. Prevention and management of external inflammatory resorption following trauma to teeth. Australian dental journal. 2016:82-94. https://doi.org/10.1111/adj.12400.
[23] Heboyan A, Avetisyan A, Karobari MI, Marya A, Khurshid Z, Rokaya D, et al. Tooth root resorption: A review. Science Progress. 2022;105(3):00368504221109217. https://doi.org/10.1177/00368504221109217.
[24] Frank AC, Kanzow P, Rödig T, Wiegand A. Comparison of the bleaching efficacy of different agents used for internal bleaching: a systematic review and meta-analysis. Journal of Endodontics. 2022;48(2):171-8. https://doi.org/10.1016/j.joen.2021.10.011.
 
International Journal of Scientific Research in Dental and Medical Sciences
Volume 5, Issue 2
June 2023
Pages 102-106

Files

History

  • Receive Date: 13 April 2023
  • Revise Date: 18 May 2023
  • Accept Date: 21 May 2023

Share

How to cite

Statistics