Multidisciplinary Treatment of Traumatised Maxillar Central Incisor Associated With Open Apex

Yıl 2018, Sayı: 1, 26 - 30, 01.01.2018

İşıl Karahasanoğlu Aysun Avşar Özlem Ülker

Öz

This case report aims to present the management of a tooth with open apex and periradicular lesion with Mineral Trioxide Aggregate MTA apexification and indirect restoration using CAD-CAM technique. A 9-year-old girl was referred to our clinic with fracture of her tooth #11. Following endodontic access cavity preparation, the root canal was prepared with hand files up to #120 K-file. 2 weeks later the tooth was asymptomatic. MTA apical plug was placed to the apical third of the root canal. One day later, the tooth was restored with fiber post, composite core and reconstructed with CEREC. At 24th month, the tooth showed good periodontal health, marginal adaptation and periapical view at clinical examination and radiographic control. This case report indicates that MTA apexification technique and CAD-CAM restorations are safe and effective treatment options for the management of traumatized teeth with open apex following root canal treatment.

Anahtar Kelimeler

MTA, Dental trauma, Pedodontics, CEREC, CAD-CAM

Açık Apeksli ve Travma Geçirmiş Bir Üst Keser Dişin Multidisipliner Tedavisi

Öz

Bu olgu sunumu, açık apeks ve periradiküler lezyonlu bir dişin Mineral Trioksit Agregat MTA kullanılarak apeksifikasyonu ve CAD-CAM tekniği ile indirekt restorasyonunu sunmayı amaçlamaktadır. 9 yaşındaki kız çocuğu 11 numaralı dişindeki kırık şikayeti ile kliniğimize başvurdu. Endodontik giriş kavitesinin açılmasından sonra, kök kanalı 120 K tipi eğeye kadar genişletildi. 2 hafta sonra diş asemptomatikti ve MTA apikal tıkaç olarak kök kanalının apikal üçte birine yerleştirildi. Bir gün sonra, dişe fiber post ve kompozit kor uygulandı ve CEREC ile restore edildi. 24. ayda, klinik ve radyografik kontrollerde diş iyi bir periodontal sağlık, marjinal adaptasyon ve periapikal görünüme sahiptir. Bu olgu sunumu, travmaya uğramış kök ucu açık dişlerin kök kanal tedavisinde MTA apeksifikasyonunun ve CAD-CAM restorasyonların etkili ve güvenli tedavi seçenekleri olduğunu göstermektedir.

Anahtar Kelimeler

MTA, Dental travma, Pedodonti, CEREC, CAD-CAM.

Kaynakça

• 1. Andreasen JO, Ravn JJ. Epidemiology of traumatic dental injuries to primary and permanent teeth in a Danish population sample. Int J Oral Surg 1972;1:235-239.
• 2. Bogen G, Kuttler S. Mineral trioxide aggregate obturation: a review and case series. J Endod 2009;35:777-790.
• 3. Shabahang S ve ark. A comperative study of root-end induction using osteogenic protein-1, calcium hydroxide and mineral trioxide aggregate in dogs. J Endod 1999;25:1-5.
• 4. Torabinejad M ve ark. Sealing ability of a mineral trioxide aggregate when used as a root end filling material. J Endod 1993;19:51.
• 5. Balkenhol M ve ark. Survival time of cast post and cores: a 10-year retrospective study. J Dent 2007;35:50-58.
• 6. Sadek FT ve ark. Bond strength performance of different resin composites used as core materials around fiber posts. Dent Mater 2007;23:95-99.
• 7. Miyazaki T ve ark. A review of dental CAD/CAM: current status and future perspectives from 20 years of experience. Dent Mater J 2009;28(1):44-56.
• 8. Mörmann WH, Krejci I. Computer-designed inlays after 5 years in situ: clinical performance and scanning electron microscopic evaluation. Quintessence Int 1992;23:109-115.
• 9. Glendor U, Marcenes W, Andreasen JO. Textbook and color atlas of traumatic injuries to the teeth, 4th ed. Oxford, United Kingdom: Blackwell-Munksgaard; 2007.
• 10. Robertson A ve ark. Long term prognosis of crownfractured permanent incisors. The effect of stage of root development and associated luxation injury. International Journal of Paediatric Dentistry, 2000;10:191-199.
• 11. Al Ansary MA ve ark. Interventions for treating traumatized necrotic immature permanent anterior teeth: inducing a calcific barrier & root strengthening. Dent Traumatol 2009;25:367-379.
• 12. Giuluani V ve ark. The use of MTA in teeth with necrotic pulps and open apices. Dent Traumatol 2002;18:217-221.
• 13. Kratchman SI, “Perforation repair and one-step apexification procedures,” Dent Clin N Am 2004;48:291-307.
• 14. Fokkinga WA, Kreulen CM, Vallittu PK, Creugers NH, “A structured analysis of in-vitro failure loads and failure modes of fiber, metal and ceramic posts-and-core systems,” Int J Prosthodont 2004;17:476-82.
• 15. Layton D. A critical appraisal of the survival and complication rates of tooth-supported all-ceramic and metal-ceramic fixed dental prostheses: the application of evidence-based dentistry. Int J Prosthodont 2011;24:417-427.
• 16. Miyazaki T, Hotta Y. CAD/CAM systems available for the fabrication of crown and bridge restorations. Aust Dent J 2011 Jun;56 Suppl 1:97-106.
• 17. Reiss B, Walther W. Clinical long-term results and 10-year Kaplan-Meier analysis of Cerec restorations. Int J Comput Dent 2000;3:9–23.
• 18. Tsitrou EA. Evaluation of the marginal fit of three margin designs of resin composite crowns using CAD ⁄ CAM. J Dent 2007;35:68–73.
• 19. Baroudi K, Ibraheem SN. Assessment of chairside Computer-Aided Design and Computer-Aided Manufacturing restorations: A review of the literature. J Int Oral Health 2015 Apr;7(4):96-104.
• 20. Santos GC Jr ve ark. Overview of CEREC CAD/CAM chairside system. Gen Dent 2013;61(1):36-40.
• 21. Tinscherta J ve ark. Structural reliability of alumina-, feldspar-, leucite-, mica- and zirconia-based ceramics. J Dent 2000;28:529–535.