TREATMENT OF IMMATURE TEETH WITH A 3-MIX PASTE: CASE REPORT

An immature tooth with infected pulp has numerous potential complications. Conventional apexification with calcium hydroxide has several disadvantages, including susceptibility to tooth fracture. This method does not promote continual root development. Pulp revascularization of a necrotic, immature permanent tooth will allow further development of the root and dentinal structure. Disinfection of the root canal system is a prerequisite for pulp revascularization and tissue regeneration. A combination of antibiotic drugs (ciprofloxacin, metronidazole, and minocycline) is effective for disinfection of necrotic pulp, and has been used successfully in regenerative endodontic treatment. These case reports involve the treatment of 3 immature permanent teeth with necrotic pulp using a 3-Mix paste and mineral trioxide aggregate. All cases showed the notable apical maturation with closure of the apex and increased thickness of dentinal walls. This approach suggests a paradigm shift in treating endodontically involved immature permanent teeth from the traditional apexification with calcium hydroxide to the conservative approach by providing a favorable environment for tissue regeneration.

[1]  K. Er,et al.  Retreatment of a resected tooth associated with a large periradicular lesion by using a triple antibiotic paste and mineral trioxide aggregate: a case report with a thirty-month follow-up. , 2009, Journal of endodontics.

[2]  M. Cullinan,et al.  Dental stem cells and their potential role in apexogenesis and apexification. , 2009, International endodontic journal.

[3]  G. Guven,et al.  Use of triple antibiotic paste as a disinfectant for a traumatized immature tooth with a periapical lesion: a case report. , 2009, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[4]  Blayne Thibodeau.  Case report: pulp revascularization of a necrotic, infected, immature, permanent tooth. , 2009, Pediatric Dentistry.

[5]  N. Cohenca,et al.  Pulp revascularization of necrotic bilateral bicuspids using a modified novel technique to eliminate potential coronal discolouration: a case report. , 2009, International endodontic journal.

[6]  G. T. Huang.  A paradigm shift in endodontic management of immature teeth: conservation of stem cells for regeneration. , 2008, Journal of dentistry.

[7]  Brett Rosenberg,et al.  The effect of calcium hydroxide root filling on dentin fracture strength. , 2007, Dental traumatology : official publication of International Association for Dental Traumatology.

[8]  G. T. Huang,et al.  Immature teeth with periradicular periodontitis or abscess undergoing apexogenesis: a paradigm shift. , 2006, Journal of endodontics.

[9]  M. Trope.  Treatment of immature teeth with non‐vital pulps and apical periodontitis , 2006 .

[10]  B. Karabucak,et al.  Vital pulp therapy with mineral trioxide aggregate. , 2005, Dental traumatology : official publication of International Association for Dental Traumatology.

[11]  A. Sigurdsson,et al.  Disinfection of immature teeth with a triple antibiotic paste. , 2005, Journal of endodontics.

[12]  R. Rogers,et al.  Tetracycline and other tetracycline‐derivative staining of the teeth and oral cavity , 2004, International journal of dermatology.

[13]  A. Sigurdsson,et al.  Pulp revascularization of replanted immature dog teeth after treatment with minocycline and doxycycline assessed by laser Doppler flowmetry, radiography, and histology. , 2004, Dental traumatology : official publication of International Association for Dental Traumatology.

[14]  M. Trope,et al.  Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? , 2004, Journal of endodontics.

[15]  E. Hoshino,et al.  Endodontic treatment of primary teeth using a combination of antibacterial drugs. , 2004, International endodontic journal.

[16]  J. Andreasen,et al.  Long-term calcium hydroxide as a root canal dressing may increase risk of root fracture. , 2002, Dental traumatology : official publication of International Association for Dental Traumatology.

[17]  S. Iwaya,et al.  Revascularization of an immature permanent tooth with apical periodontitis and sinus tract. , 2001, Dental traumatology : official publication of International Association for Dental Traumatology.

[18]  M. Trope,et al.  Pulp revascularization of replanted immature dog teeth after different treatment methods. , 2000, Endodontics & dental traumatology.

[19]  P. Abbott,et al.  The effects of Ledermix paste on discolouration of immature teeth. , 2000, International endodontic journal.

[20]  M. Iwaku,et al.  In-vitro antibacterial susceptibility of bacteria taken from infected root dentine to a mixture of ciprofloxacin, metronidazole and minocycline. , 1996, International endodontic journal.

[21]  M. Iwaku,et al.  Sterilization of infected root-canal dentine by topical application of a mixture of ciprofloxacin, metronidazole and minocycline in situ. , 1996, International endodontic journal.

[22]  E. Hoshino,et al.  In vitro antimicrobial susceptibility to combinations of drugs on bacteria from carious and endodontic lesions of human deciduous teeth. , 1993, Oral microbiology and immunology.

[23]  P. Cleaton-jones,et al.  Effect of topical application of doxycycline on pulp revascularization and periodontal healing in reimplanted monkey incisors. , 1990, Endodontics & dental traumatology.

[24]  I. Mejàre,et al.  Rate and predictability of pulp revascularization in therapeutically reimplanted permanent incisors. , 1986, Endodontics & dental traumatology.

[25]  L. Fabricius,et al.  Predominant indigenous oral bacteria isolated from infected root canals after varied times of closure. , 1982, Scandinavian journal of dental research.

[26]  G. Sundqvist,et al.  Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy. , 1981, Scandinavian journal of dental research.