2005 Volume 26 Issue 1 Pages 23-28
Abstract : Infected root canal treatment was performed for an upper left second premolar with incomplete dental root and buccal periapical abscess, and the prognosis was observed for 10 years.
The patient was a Japanese boy of 10 years old. Fracture of the central tubercle seemed to be the cause of the problem and periapical abscess had sometimes occurred during the 3 months before treatment. The dental root was incomplete, and the root canal was very large with a widely opened apex. The pulp of this tooth was vital in spite of the occurrence of periapical abscess.
Mechanical cleaning was impossible because of the incomplete root canal, so chemical surgery for 15 minutes using 2.5% NaClO and application of iodoglycerin were repeated two times, and the root canal was filled using Vitapex® paste which is a calcium hydroxide-iodoform preparation. The X-ray after filling showed that Vitapex® reached almost 2/3 of the root canal.
The periapical abscess disappeared after the second treatment, and the abscess did not return during the 10 years. The dental root was formed almost normally and the root apex was completed after 3 years of treatment. Furthermore, no periapical lesion was observed for 10 years.
The one of the main reasons for the favorable formation of dental root in this case would be the existence of dental pulp in spite of the occurrence of periapical abscess.
