Dental Tribune Asia Pacific Edition No.4, 2017

Dental Tribune Asia Paciﬁ c Edition | 4/2017 TRENDS & APPLICATIONS 15 line 1:100,000) was administered, the restorative material was re- moved, and endodontic access corrected. After rubber dam isola- tion, the material inside the canal was removed under thorough irri- gation using a 2.5 % sodium hy- pochlorite solution (Fórmula & Ação) and a CPR-7 ultrasonic tip (Obtura Spartan Endodontics). After the removal of the material from the canal, #2 and #3 Largo burs were used to prepare the ﬁ rst two-thirds of the canal. Then, the apical foramen was located with the aid of an apex locator (RAYPEX, VDW), and the working length was established at 0.0 and con- ﬁ rmed with a radiograph. Instru- mentation proceeded using stain- less-steel K-type hand ﬁ les in a crown-down technique until a #80 hand ﬁ le achieved the work- ing length. Between each ﬁ le change, copious irrigation with 2.5 % sodium hypochlorite solu- tion was performed (approxi- mately 100 ml throughout the entire treatment). During the procedure, passive ultrasonic irrigation was per- formed for 1 minute several times to ensure complete removal of the old material and to maximise the irrigation technique. After the completion of instrumentation, the canal was irrigated with 5 ml of 17 % EDTA (Fórmula & Ação) for 3 minutes and a ﬁ nal rinse with 5 ml of saline solution. A calcium hydroxide-based paste was placed in the canal as an inter-appoint- ment dressing, and the tooth was temporarily restored (Fig. 2). After ten days, the patient came to the clinic for conclusion of treatment. The tooth was asymptomatic, and the area was no longer swollen. The temporary ﬁ lling was re- moved, and the calcium hydrox- ide paste was removed from the canal using a 2.5 % sodium hy- pochlorite solution and passive ultrasonic irrigation as previously described. The #80 hand ﬁ le was used again to working length. The canal was then irrigated with 5 ml of 17 % EDTA for 3 minutes to re- move the smear layer, and 5 ml of saline solution was used for the ﬁ nal rinse. The canal was dried with paper points, and MTA REPAIR HP was manipulated according to the manufacturer’s instructions and placed with the aid of pluggers (B&L Biotech) in the last 3 mm of the root canal, forming an apical plug. After 10 minutes, the mate- rial had set, and the tooth was ob- turated using BC Sealer (Brasseler USA) and gutta-percha cones with the lateral condensation technique (Figs. 3a & b). The pulp chamber was cleaned with a sponge soaked in 70 % alco- hol, and the access cavity was re- stored using composite (Figs. 4a & b). A high-resolution CBCT scan of the patient was requested imme- diately after treatment so that it could be used for comparison later in the follow-up. The patient presented for re- call one month later without any symptoms. Postoperative radio- graphic and clinical evaluations were performed at three, six and nine months. The tooth was asymptomatic, and the area did not have any signs of inﬂ amma- tion. After nine months, another CBCT examination was con- ducted. Comparison of the CBCT images was performed, and bone healing and apical closure of the open apex could be observed (Figs. 4a & 4b, 5a & 5b). 5a 5b Figs. 5a & b: CBCT images. (a) Sagittal view just after MTA REPAIR HP placement. (b) Sagittal view at the nine-month follow-up. Reformulation of the cortical plate is visible, as well as partial apical closure. AD The Dental Tribune International Magazines www.dental-tribune.com I would like to subscribe to CAD/CAM Clinical Masters* cosmetic dentistry* implants laser ortho** prevention* roots Journal of Oral Science & Rehabilitation*** EUR 44 per year (4 issues per year; incl. shipping and VAT for customers in Germany) and EUR 46 per year (4 issues per year; incl. shipping for customers outside Germany). * EUR 12 per year (1 issue per year; incl. shipping and VAT for customers in Germany) and EUR 14 per year (1 issue per year; incl. shipping for customers outside Germany). ** EUR 22 per year (2 issues per year; incl. shipping and VAT for customers in Germany) and EUR 23 per year (2 issues per year; incl. shipping for customers outside Germany). *** EUR 200 per year (4 issues per year; incl. shipping and VAT). Your subscription will be renewed automatically every year until a written cancellation is sent to Dental Tribune International GmbH, Holbeinstr. 29, 04229 Leipzig, Germany, six weeks prior to the renewal date. Shipping Address Name Address Zip Code, City E-mail Date, Signature Country PayPal Credit Card Credit Card Number Expiration Date Security Code SUBSCRIBE NOW! F +49 341 48474 173 subscriptions@dental-tribune.com

Dental Tribune Asia Pacific Edition No.4, 2017

Pages Overview