Endodontic Management of a Mature Mandibular First Permanent Molar That Survived for 20 Years after Complete Pulpotomy: A Case Report
10.21315/aos2019.14.2.372
- Author:
Lin Galvin Sim Siang
1
Author Information
1. Unit of Conservative Dentistry, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
- Collective Name:Nik Rozainah Nik Abdul Ghani; Kasmawati Mokhtar; Mohamad Syahrizal Bin Halim
- Publication Type:Journal Article
- Keywords:
Calcified canals;
endodontic treatment;
HyFlex CM;
mature permanent teeth;
pulpotomy.
- From:Archives of Orofacial Sciences
2019;14(2):169-175
- CountryMalaysia
- Language:English
-
Abstract:
Complete pulpotomy as a treatment option for caries exposure in mature permanent teeth with
complete root formation still remains controversial due to lack of evidence on the long-term success.
This article highlights a rare complete pulpotomy case done on a mature permanent tooth that survived
for 20 years. A 34-year-old female presented with dull spontaneous pain on her right mandibular first
molar and showed positive response to both cold test and electrical pulp test. The tooth was previously
restored with tooth coloured restoration at the disto-occlusal surface and pre-operative periapical
radiograph revealed large radiopacity covering the entire pulp chamber with calcified canals. The
tooth was diagnosed as previously initiated therapy with symptomatic apical periodontitis. Endodontic
treatment was initiated. All canals were located and corrected working length achieved followed by
cleaning and shaping using HyFlex CM rotary files with copious irrigation of 2.5% sodium hypochlorite
solution. Intracanal medication (non-setting calcium hydroxide) was placed and the tooth was restored
with temporary restoration. After two weeks, obturation was done using single cone technique with
EndoRez sealer. Universal composite resin was placed as permanent restoration and follow-up was
done after one month and three months respectively without symptoms and evidence of periapical
lesion. This minimally invasive pulpotomy procedure may be an alternative treatment option for mature
permanent teeth whenever carious exposure to the pulp occurs.
- Full text:2.2019my0182.pdf
