DEVİTAL GENÇ DAİMÎ DİŞLERDE APEKSİFİKASYON TEDAVİLERİ: GÜNCEL LİTERATÜR EŞLİĞİNDE OLGU SERİSİ

Abstract

Amaç: Kök gelişimini tamamlamamış genç daimî dişlerde travma veya çürüğe bağlı pulpa nekrozu gelişmesi durumunda endodontik tedavi süreci zorlaşmaktadır. Bu olgu serisinin amacı, açık apeksli devital genç daimî dişlerde Mineral Trioksit Agregat (MTA) kullanılarak gerçekleştirilen apeksifikasyon tedavisinin klinik başarısını değerlendirmektir. Olgu Sunumları: İlk olgu, travma sonrası 11 numaralı dişinde apikal lezyon ve fistül yolu gelişen 10 yaşındaki erkek hastadır. İkinci olgu, düşme sonrası 11 numaralı dişinde sublüksasyon ve 21 numaralı dişinde lateral lüksasyon gelişen 10 yaşındaki kız hastadır. Her iki dişin de devital hale geldiği belirlenmiş ve apikal tıkama materyali olarak MTA kullanılmıştır. Üçüncü olgu ise ağrı şikayetiyle kliniğimize başvuran 14 yaşındaki erkek hastada 37 numaralı dişte C kanal formasyonu bulunan bir vakadır. Tüm olgularda iki seanslık tedavi protokolü uygulanmış, MTA apikal bariyer olarak yerleştirilmiş, kalan kanal kısmı rezin esaslı pat ve gutta perka ile doldurulmuştur. Sonuçlar: Olguların tümünde klinik semptomlar kaybolmuş, radyografik olarak periapikal iyileşme gözlenmiştir. Literatürde MTA’nın kısa tedavi süresi, yüksek biyouyumluluk ve sızdırmazlık özellikleri nedeniyle kalsiyum hidroksite göre üstünlük sağladığı bildirilmektedir. Önceki çalışmalarla uyumlu olarak, mevcut olgularda da başarılı klinik ve radyografik sonuçlar elde edilmiştir. Bununla birlikte, daha güçlü kanıtlar ortaya koyabilmek için uzun dönem takip çalışmalarına ve biyoseramik materyallerle yapılacak karşılaştırmalı araştırmalara ihtiyaç vardır.

Keywords

• Apeksifikasyon
• Endodontik Tedavi
• Genç Daimî Diş
• Kalsiyum Hidroksit
• Mineral Trioksit Agregat

APEXIFICATION TREATMENTS IN NONVITAL IMMATURE PERMANENT TEETH: A CASE SERIES WITH CURRENT LITERATURE REVIEW

Abstract

Objective: Endodontic treatment of immature permanent teeth becomes challenging when pulp necrosis develops due to trauma or caries. The aim of this case series was to evaluate the clinical success of apexification using Mineral Trioxide Aggregate (MTA) in nonvital immature permanent teeth with open apices. Case Reports: The first case involved a 10-year-old male patient presenting with an apical lesion and sinus tract in tooth #11 following trauma. The second case was a 10-year-old female patient who presented with subluxation in tooth #11 and lateral luxation in tooth #21 after a fall; both teeth were found to be nonvital. In both cases, MTA was used as an apical barrier material. The third case involved a 14-year-old male patient presenting with pain in tooth #37, which exhibited a C-shaped canal configuration. In all cases, a two-visit treatment protocol was performed; MTA was placed as an apical barrier, and the remaining canal space was obturated with a resin-based sealer and gutta-percha. Results and Discussion: All patients were asymptomatic at follow-up, and radiographic examinations revealed periapical healing. The literature indicates that MTA has advantages over calcium hydroxide due to its shorter treatment duration, superior biocompatibility, and excellent sealing ability. Consistent with previous studies, successful clinical and radiographic outcomes were achieved in the present cases. However, long-term follow-up studies and comparative research with bioceramic materials are needed to provide stronger evidence.

Keywords

• Apexification
• Calcium Hydroxide
• Endodontic Treatment
• Immature Permanent Teeth
• Mineral Trioxide Aggregate

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