Treatment of non-vital permanent incisors with calcium hydroxide. VI. A clinical, microbiological and radiological evaluation of treatment in one sitting of teeth with mature or immature root.
The purpose of the investigation was clinically, microbiologically and radiologically to assess the effect of calcium hydroxide as a temporary root-filling inserted in the same sitting as root canal debridement in non-vital permanent incisors with mature and immature root, infected or uninfected root canal and with or without radiologically demonstrated periapical bone changes. The material consisted of 141 teeth divided in 3 groups in which mechanical cleansing was accompanied by flushing with sterile saline and sodium hypochlorite solutions giving 0.5% or 5.0% active chlorine, respectively. Microbiological samples were taken from root canals after extirpation of necrotic pulp tissue, after completed cleansing of the root canal and 3 and 6 month after treatment. Results of treatment were evaluated from the radiographs taken before treatment and at the 3 and 6 month follow-ups. Complication, pain and an abscess, occurred in 2 cases, 2 and 5 days, respectively, after treatment. No statistical correlation between occurrence of samples that gave growth, taken from the root canals at 3 (8%) or 6-month control (9%) and 1) bacteriological status of the root canal prior to filling with calcium hydroxide, 2) the development of the root or 3) periapical healing at 3 or 6 month follow-up could be ascertained. Periapical bone healing at the end of 6-months observation period was noted in 61 teeth (46%), regression of periapical bone lesions in 64 (49%) and no periapical healing in 6 (5%). The only difference in healing pattern, statistically significant on 0.1% level, was found in the group of teeth flushed with 5.0% sodium hypochlorite. At 3 month control they showed percentually less cases with regression and more cases with no healing of periapical bone lesions than the teeth in the other two groups. It was concluded that treatment in one sitting can be done routinely, irrespective of the initial status, in all those cases where no other treatment is possible. If the periodontium or the periapical bone are injured during cleansing procedures or if necrotic rests are not pressed out through the apical foramen, no complications after treatment need to be feared.
D000293:Adolescent; D002126:Calcium Hydroxide; D002648:Child; D003782:Dental Pulp / Q000382:microbiology; D003786:Dental Pulp Cavity / Q000382:microbiology; D003794:Dental Restoration, Temporary; D004202:Disinfectants; D006801:Humans; D007180:Incisor / Q000254:growth & development / Q000382:microbiology; D010486:Periapical Tissue / Q000000981:diagnostic imaging / Q000502:physiology; D011859:Radiography; D012387:Root Canal Filling Materials; D012390:Root Canal Therapy; D012965:Sodium Chloride; D012973:Sodium Hypochlorite; D014092:Tooth Root / Q000254:growth & development; D014945:Wound Healing
D004202:Disinfectants; D012387:Root Canal Filling Materials; D012965:Sodium Chloride; D012973:Sodium Hypochlorite; D002126:Calcium Hydroxide