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Dental Tribune United Kingdom Edition

15Endo TribuneFebruary 2014United Kingdom Edition that set the benchmark for everyone to follow. This is the one with a long legacy of innovation. This is the one which became synonymous with quality – This is Instrumentarium Dental's ORTHOPANTOMOGRAPH® . The OP1. With a legacy of innovation and experience spanning over 50 years, we’ve mastered the clinical excellence valued by true dental professionals. We’re ready for the next 50 years. As a true professional yourself, are you ready to join us for this journey? The OneThe OneThe One 2011 | ORTHOPANTOMOGRAPH® OP3001961 | ORTHOPANTOMOGRAPH® OP1 2013 | The journey continues 2D 3D “THE TRUE IMAGING EXPERTS” GO FOR INSTRUMENTARIUM DENTAL ORTHOPANTOMOGRAPH® isaregisteredtrademarkofInstrumentariumDental,PaloDExGroupOy. www.instrumentariumdental.com This is the one that started it all. This is the one, The patient recently attended for a six month review, which reported no symptoms associ- ated with the UR1. With regards to the UL1, there was a query whether there was some perio- dontal ligament widening, how- ever the sensibility tests were inconclusive and the tooth was asymptomatic. It was therefore decided to continue to monitor the UL1 for now, and review the patient again in a further six months. Discussion The patient’s traumatic incident had resulted in pulpal necrosis of the UR1 and consequently an incomplete formation of the root. Effective cleaning of the canal walls was achieved with large K-flex handfiles, inter- dental brushes and sodium hy- pochlorite irrigation. The MTA technique allowed for success- ful obturation of the maxillary central incisor with an open apex. I successfully completed this treatment in an anxious 10- year old girl, who had not had any previous extensive dental treatment. I overcame this by using different behaviour man- agement techniques including tell-show-do, and ensuring that all appointments were not of too long a duration. This meant compliance was not lost. In fact, the patient initially began treat- ment under RA sedation due to her anxiety, but at subsequent visits, decided she no longer wanted it, and appeared to cope well without it. Finally, I decided to submit this case, because I feel that I obtained an excellent final out- come, both clinically and ra- diographically. The tooth was symptom free at the six-month review appointment at Birming- ham Dental Hospital. The 4mm MTA apical plug was to the cor- rect length, and radiographi- cally, there were no voids in the thermoplastic GP. The access cavity was sealed with a vitre- bond lining, followed by adhe- sive composite restoration, en- suring a good coronal seal. The endodontic prognosis for this tooth is good, however the patient is fully aware of the long term consequences of trau- ma, and the subsequent need for regular dental monitoring and sensibility testing of the trauma- tised upper incisor teeth. DT References 1. Bystrom A, Sundqvist G (1981) Bac- teriologic evaluation of the efficiency of mechanical root canal instrumentation in endodontic therapy. Scandinavian Jour- nal of Dental Research 89: 321-328 2. Kawashima N et al. (2009) Root canal medicaments, International Dental Jour- nal 59 (1): 5-11 3. Masoud P, Mahmoud T (2010) Mineral Trioxide Aggregate: A Comprehensive Literature Review—Part III: Clinical Ap- plications, Drawbacks, and Mechanism of Action, Journal of Endodontics 36: 400-413 4. Ng et al. (2010) Tooth survival follow- ing non-surgical root canal treatment: a systematic review of the literature, Inter- national Endodontic Journal 43: 171–189 5. Pitt Ford TR (2004) Harty’s Endo- dontics in Clinical Practice, 5th Edition, published by Elsevier Limited 6. Williams J, Williams L (2010) Is coro- nal restoration more important than root filling for ultimate endodontic success? Dental Update 37: 187-193 7. Witherspoon et al. (2008) Retrospective Analysis of Open Apex Teeth Obturated with Mineral Trioxide Aggregate, Journal of Endodontics 34 (10): 1171-1176 8. Zehnder M (2006) Root canal irrigants, Journal of Endodontics 32 (5): 389-398 Fig. 1.5 Master cone peri- apical radiograph Fig. 1.6 4mm MTA apical plug Fig. 1.7 Post-operative radiograph About the author Rupal Shah was on duty at Birming- ham Dental Hospital’s paediatric de- partment in April 2013. A foundation dentist (in her second year of training) she had to treat a 10-year-old patient who was returning to the hospital for endodontic treatment on her UR1.