[Calcium hydroxide and treatment of inflammatory inter-radicular bone resorption of non-vital deciduous molars].
On non-vital deciduous molars, inter-radicular bone resorption is often an indication of extraction. The endodontic treatment of these teeth by means of zinc oxide-eugenol (ZOE) paste also showed its limits. To mitigate the deficiencies of this material, we suggested a preliminary treatment by means of calcium hydroxide (Ca(OH)2) for its anti-inflammatory and antiseptic properties as well as its ability to stimulate calcified tissues apposition or remineralisation. This study concerns 21 non-vital deciduous molars. X-rays excluded any lesion of the underlying permanent bony crypt (bone tissue) as well as any inflammation of the dental follicle. After preparation, root canals were filled by means of Pulpdent. An initial X-ray check was made 15 days and then every 3 months. After disappearance of the inflammatory resorption, root canal fillings were performed with ZOE paste. The remineralisation of the inter-radicular alveolar bone was observed for 14 deciduous molars, which were then filled using ZOE. The remineralisation period varies from 3 to 18 months depending on the scale of the lesion. Of the 7 failed treatments, 3 failed following downfall of the crown filling material, and 2 due to failure to keep appointments and late replacement of resorbed Ca(OH)2. On 2 teeth, the treatment did not stop the lesion forming. Calcium hydroxide (Ca(OH)2) give encouraging results in the treatment of inter-radicular alveolar bone resorption of non-vital deciduous tooth. Its fast resorption requires rigorous controls, frequent refills, and thus strong motivation on the part of the child and parents. It cannot, on any account, be considered as permanent filling material.
Charles
Pilipili
P
Université Catholique de Louvain, Ecole de Médecine Dentaire et de Stomatologie, Service de Pédodontie et de Soins Dentaires aux Personnes Handicapées, Bruxelles, Belgique.
Nathalie
Senger
S
Carine
Defat
D
Alexandru
George
G
D016301:Alveolar Bone Loss / Q000517:prevention & control / Q000628:therapy*; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001861:Bone Regeneration / Q000187:drug effects; D002126:Calcium Hydroxide / Q000627:therapeutic use*; D002648:Child; D003785:Dental Pulp Capping; D003790:Dental Pulp Necrosis / Q000628:therapy; D003794:Dental Restoration, Temporary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008963:Molar / Q000473:pathology*; D012387:Root Canal Filling Materials / Q000627:therapeutic use*; D018915:Root Canal Preparation; D014094:Tooth, Deciduous / Q000473:pathology*; D019553:Tooth, Nonvital / Q000628:therapy*; D016896:Treatment Outcome; D015035:Zinc Oxide-Eugenol Cement / Q000627:therapeutic use
D000891:Anti-Infective Agents, Local; D000893:Anti-Inflammatory Agents; D012387:Root Canal Filling Materials; D015035:Zinc Oxide-Eugenol Cement; C029777:Pulpdent; D002126:Calcium Hydroxide