title: Strategy for apexification of wide-open apex associated with extensive periapical lesion in a weakened root.
abstract: This case report describes successful apexification for a challenging case involving a 30-year-old man, who suffered from dental trauma involving tooth No. 7 (which had occurred several years earlier) and recently experienced acute periapical abscess in this region. Radiographic analysis revealed incomplete root formation, a wide-open apex, thin root canal walls, and an extensive periapical lesion. Chemomechanical debridement was performed gently using K-files and irrigation with a 1% sodium hypochlorite solution. The root canal was filled with a calcium hydroxide paste, which was replaced periodically. At 18 months post-treatment, an apical barrier tissue and significant reduction of periapical radiolucency were observed; at that time, the entire root canal was filled with gray mineral trioxide aggregate (MTA). At a follow-up 16 months later, the tooth had normal function and periapical repair was complete.
authors: Department of Endodontics, Diamantina Dental School, Federal University of Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.
authors: George Moreira
authors: GM
authors: Costa
authors: Suelleng Maria Cunha Santos
authors: SM
authors: Soares
authors: Leandro Silva
authors: LS
authors: Marques
authors: Jose Christiano Ramos
authors: JC
authors: Gloria
authors: Janir Alves
authors: JA
authors: Soares
mesh_terms: D000328:Adult; D017607:Aluminum Compounds / Q000627:therapeutic use; D056624:Apexification / Q000379:methods*; D017610:Calcium Compounds / Q000627:therapeutic use; D002126:Calcium Hydroxide / Q000627:therapeutic use; D003786:Dental Pulp Cavity / Q000473:pathology; D003809:Dentin, Secondary / Q000473:pathology; D004338:Drug Combinations; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010087:Oxides / Q000627:therapeutic use; D010482:Periapical Abscess / Q000628:therapy*; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D012388:Root Canal Irrigants / Q000627:therapeutic use; D018915:Root Canal Preparation / Q000295:instrumentation; D017640:Silicates / Q000627:therapeutic use; D012973:Sodium Hypochlorite / Q000627:therapeutic use; D019227:Tooth Apex / Q000187:drug effects / Q000473:pathology*; D014092:Tooth Root / Q000293:injuries*; D014945:Wound Healing / Q000502:physiology
chemical_list: D017607:Aluminum Compounds; D017610:Calcium Compounds; D004338:Drug Combinations; D010087:Oxides; D012387:Root Canal Filling Materials; D012388:Root Canal Irrigants; D017640:Silicates; C086631:mineral trioxide aggregate; D012973:Sodium Hypochlorite; D002126:Calcium Hydroxide