Restor Dent Endod.  2020 Aug;45(3):e29. 10.5395/rde.2020.45.e29.

Endodontic approach in a replanted tooth with an immature root apex and chronic apical periodontitis: a case report

• Mori GG
• Andrade BS
• Araujo MB

• KMID: 2512020
• DOI: http://doi.org/10.5395/rde.2020.45.e29

Abstract

This study describes the clinical steps taken in the treatment of a patient who had an avulsed right upper central incisor that presented with incomplete root development and chronic apical periodontitis. A 7-year-old boy was referred from a private dentist to a dental office specializing in endodontics. The tooth had remained in a dry environment for 20 minutes, and tooth replantation was performed at an emergency appointment. After clinical and radiographic examinations, root canal decontamination was performed, followed by several changes in intracanal calcium hydroxide medication. Blood clot formation was attempted, but bleeding within the root canal was insufficient; therefore, we opted for an intracanal medication change to stimulate mineralized tissue formation in the apical region. Root obturation was performed 45 days after the last change of intracanal medication, and clinical, radiographic, and tomographic follow-up examinations were performed at 3, 6, 18, and 40 months after the endodontic intervention. The increase in thickness and length of the root structure and the absence of root resorption were verified through follow-up examinations. Therefore, it was concluded that the procedures used were successful for tooth replantation.

Keyword

Tooth avulsion; Tooth replanted; Root canal treatment; Odontogenesis

Figure

• 

  Figure 1 Radiographic images of endodontic treatment. (A) Initial radiograph of the case; (B) sinus tract tracking; (C) odontometry; (D) radiographic check-up examination to evaluate apical barrier formation; (E) formation of mineralized tissue between the cervical and middle thirds of the root canal; (F) increased deposition of mineralized tissue between the cervical and middle thirds of the root canal; (G) radiograph supporting root obturation; (H) final radiograph of root obturation; (I) radiographic follow-up examination 3 months after the endodontic intervention.

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  Figure 2 Tomographic examinations to determine the absence of root resorption and occurrence of root development performed 6 (A), 18 (B) and 40 (C) months after the endodontic intervention was completed.

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