[Remote results of the treatment of pulpitis by a single-stage extirpation method under local anesthesia useing diathermocoagulation].
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The treatment and follow-up evaluation of two orally luxated maxillary primary central incisors in a three-year-old girl is described. The injured teeth were displaced into a cross-bite with their mandibular opposing teeth. They were repositioned shortly after the injury and splinted with composite resin for two weeks. Oral hygiene instructions and antibiotic therapy were prescribed. Two weeks after the injury a necrotic pulp was removed and the root canals filled with a resorbable paste. Thirty months after the injury, the teeth and the surrounding tissues were clinically and radiographically asymptomatic and physiologic root resorption could be noted. The permanent successors erupted soon after natural exfoliation of the injured primary teeth. Only mild hypocalcified defects were observed on the permanent incisors.
A pilot study was carried out in five mandibular primary molars using calcium hydroxide (Ca(OH)2) Paste as root canal filling material to find out an alternative to the routinely used zinc oxide eugenol (ZnOE), which is non-resorbable and causes deflection of succedaneous teeth. The six month clinical and radiographic follow-up carried out at 2 months interval, revealed that the treated teeth with Ca(OH)2 as root canal filling material were successful, showing no pain and tenderness to percussion. A tendency for decrease in size of radiolucency was seen. Two teeth showed complete healing of the periradicular radiolucency. Depletion of Ca(OH)2 paste was seen from the root canals even prior to physiological resorption of roots in 2 out of 5 treated teeth.
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Although radicular cysts are relatively rare, they do occur. In addition, it appears that these lesions present in association with endodontically treated primary teeth. As shown in this paper and previous reports, cysts can be associated with a variety of pulp therapies. These lesions can lead to bony expansion and resorption. Radicular cysts may also cause displacement and damage to the developing permanent dentition. Given the severity of these sequelae it is prudent to recommend regular radiographic examination of primary teeth that have undergone pulp therapy.
This article describes the pulp reactions to caries and operative procedures and emphasizes the importance of a clinical diagnosis to evaluate the most appropriate pulp treatment. Conservative and radical treatments are described, stressing the differences between primary and young permanent dentitions.