A Case Report: Management of Blunderbuss Canal Using Tailor Made Gutta percha Obturating Technique.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 2
Abstract
This clinical report aims to report management of Blunderbuss canal applied to 11 of a healthy 11-year-old female after a trauma. Clinical inspection of the tooth showed fractures involving incisal edge and mesial angle. Radiographic analysis of the root revealed incomplete apex formation. The possibility of fracture into the root or luxation injury was rejected, and the diagnosis of pulp necrosis was verified. Apexification by calcium hydroxide and subsequent obturation with tailor made gutta-percha were planned. Clinical, radiographic, examinations verified the success of the treatment, although the choice of calcium hydroxide for apexification treatment is discussed. Introduction Trauma to the anterior teeth is a relatively common occurrence during childhood .Depending on its magnitude, it may produce concussion, luxation, fracture, or avulsion of the teeth, leading, in more severe cases, to necrosis of the pulp tissue1. When pulp regeneration or repair is not possible, the endodontic treatment of immature permanent necrotic teeth is more time consuming and technically more difficult than conventional procedures because these teeth present widened root canals and open apices.2 the tooth roots may also suffer external infection-related (inflammatory) root resorption or alterations of their formation during treatment. In cases of infected pulps, it’s necessary to use a specific dressing material to neutralize the bacteria and their products and to stimulate the apexification process by forming a mineralized apical barrier so that the subsequent condensation of gutta-percha can be properly achieved3. Traditionally, apexification had been performed by using calcium hydroxide paste, due to its biological and healing performances4. Regardless of the proprietary brand, calcium hydroxide has been successfully used for apical barrier formation in 74–100% of cases 5. Additionally, 86% of the treated teeth survived after a follow-up of 5years. However, the suitability of calcium hydroxide paste use for apexification has been questioned because it involves a long treatment time and the prognosis is always uncertain. The average length of time for apical barrier formation ranges from 3 to17 months, necessitating multiple visits for material replacement and delays in the construction of the definitive5.Long-term exposure of the tissue to calcium hydroxide may weaken the root structure, resulting in cervical fractures, as well as inducing periapical bone necrosis when there is over filling of the material6. Nevertheless, the authors believe that calcium hydroxide paste, if properly used, may still be a suitable material for apexification. Currently, the use of other alternative materials, such as mineral trioxide aggregate (MTA) or calcium hydroxide microspheres, may still be restricted due to socio economical regional conditions.
Authors and Affiliations
Dr. Divya Putalikar
Keywords
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