Pulpotomy in Young Permanent Teeth with Signs of Apical Periodontitis: Case Series Volume 8 - Issue 4

Zivile Grabliauskiene and Greta Lodiene*

• Department of Dental and Oral Pathology, Lithuanian University of Health Science, Lithuania

Received: July 19, 2022;   Published: August 03, 2023

*Corresponding author: Greta Lodiene, Department of Dental and Oral Pathology, Lithuanian University of Health Science, Eiveniu 2, Kaunas, Lithuania

DOI: 10.32474/IPDOAJ.2023.08.000294

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Abstract

Background: Despite the long-standing concept of pulp tissue necrosis as the main etiologic factor for periapical lesions, there has been new evidence that inflamed vital dental pulps can cause apical periodontitis (AP). Infected pulp could heal when the etiological factor is eliminated. The present cases aimed to assess the outcome of vital pulp therapy (VPT) in permanent teeth with vital pulps and signs of an AP.

Cases presentation: In the first case report a 15-year-old boy presented with a chief complaint of constant pain in #15 tooth, lasting for five days. After the clinical and radiographic examination, a diagnosis of pulp necrosis and symptomatic apical periodontitis was conducted, and the root canal treatment (RCT) was initiated. The pulp chamber roof was removed. No intense bleeding and coherent vital pulp tissue were observed; however, the pulp was in dark red color. VPT (pulpotomy) was decided to be performed. In the second case a 16-year-old girl presented for an annual observation. After clinical and radiographic examination, #45 tooth was diagnosed with caries. The excavation revealed caries lesion reaching the pulp. The exposed pulp was bright red color, no intense bleeding overflowing from the exposure site was observed. VPT (pulpotomy) was a treatment of choice. In both cases a layer of hydraulic calcium silicate cement was applied over the vital pulp tissue. In the second case a periapical radiograph performed after the treatment revealed the large apical radiolucency. The teeth crowns were restored with the glass ionomer cement initially or composite resin permanently, in the first and second case, respectively. At the follow-up visits, the patients reported no symptoms. The dental periapical radiographs showed radiolucency considerably reduced in size and completely healed after one year and two years.

Conclusion: Clinical and radiographic evidence of cases showed the successful use of mineral trioxide aggregate for pulpotomy of mature teeth with vital pulps and signs of apical periodontitis.

Keywords: Vital pulp therapy; pulpotomy; apical periodontitis; mineral trioxide aggregate

Abbreviations: VPT: Vital Pulp Therapy; AP: Apical Periodontitis; RCT: Root Canal Treatment; IP: Irreversible Pulpitis; MTA: Mineral Trioxide Aggregate

Abstract| Background| Case 2 Presentation Discussion and Conclusion Acknowledgments Authors’ Contributions Funding Availability of Data and Materials Ethics Approval and Consent to Participate Competing interests Authors Note |