Back ground & Aim: Preservation of tooth vitality is one of the most important tasks for clinicians dealing with exposed teeth. Several different materials have been used for pulp capping in recent years with calcium hydroxide being of the most Due to pathologic complication in the pulp following the are of Ca(OH)2, this investigation was designed to evaluate the effect of MTA on pulp reaction following pulp capping procedure. Method & Material: Calcium Hydroxide (Dycal) was used for direct pulp cap ping of II human maxillary third molar teeth with intentional exposure as control group. The same number of teeth was capped using MTA using the same condition. Results: Results showed that the dentinal bridge was thicker in cases treated with MTA with a clearly milder inflammation in pulp of the teeth treated by MTA. Conclusion: MTA could be used as an acceptable material for pulp capping of exposed permanent teeth.

Objectives The purpose of this study was to present a case of regenerative endodontic procedure. Case The maxillary 1st premolar of a 9-year-old patient was diagnosed as necrotic. Since the tooth was immature, we decided to treat this tooth with regenerative endodontic procedure. After disinfection of the canal, bleeding was induced by lacerating the peri-apical tissues and a blood clot was formed. Orifice was sealed by MTA and the tooth was restored. 6-months and 1-year follow-ups showed increased root thickness and closure of the apical. Conclusion It can be concluded that the regenerative endodontic procedure used in this study was successful since there was an evident development in root width.

Introduction: Revascularization is the newest treatment proposed for an immature permanent tooth with necrotic pulp. Revascularization is defined as a treatment process with a biological base which is aimed at replacing the lost structures and the continued development of roots. Case presentation: Patient was an eight-year-old child with the history of trauma to the maxillary anterior region. After clinical and radiographic evaluations, tooth #9 was diagnosed with the pulp necrosis, and revascularization was carried out according to Banch and Trope principles. Conclusion: The clinical and radiographic evaluation after treatment revealed no signs and symptoms and root development was in progress which was an indication of successful treatment. It seems that, in the case of proper selection of the patient, this method can be an appropriate replacement for apexification in immature teeth with pulp necrosis.

The treatment of necrotic permanent teeth with immature apices is a daunting challenge. Apexification has been traditionally used to treat immature permanent teeth with lost pulp vitality. This technique promotes the formation of an apical barrier to close the open apex so that filling materials can be confined to the root canal. The authors present a case report of the successful treatment of a traumatized tooth with an open apex that was weakened due to a long-standing infection and thin dentin walls. In this case, we first used a triple antibiotic to disinfect the canal and then placed a calcium-enriched mixture (CEM) cement plug. Follow-up evaluations were performed 15 months after treatment. The CEM-cement appears to be a valid material to obtain periradicular healing in teeth with open apices and necrotic pulps.

The treatment of an immature tooth with pulp necrosis and apical periodontitis is a major challenge for clinicians. The endodontic treatment of such teeth entails apexification, apical barriers, or more recently, revascularization. The current study reports an immature replanted tooth treated with calcium hydroxide medicament. A 13-year-old female patient with a history of abscess formation in tooth #45 was referred to the Department of Endodontics, Shiraz Dental School, Shiraz, Iran. The clinical and radiographic examinations revealed a necrotic pulp, a root with an open apex, and periradicular radiolucency. Case Presentation: The treatment was rendered under rubber dam isolation and local anesthesia. The root canal was irrigated with 2. 5% sodium hypochlorite solution and medicated with calcium hydroxide. The patient did not return for the completion of treatment in the next session. Twelve months later, she returned to the Department; she was asymptomatic and the root development was observed. The canal was then dried with paper points and obturated with thermoplastic injection technique.

Endodontic intervention in necrotic immature permanent teeth is usually a clinical challenge. With appropriate case selection, regenerative treatment can be effective, providing a desirable outcome. However, there is still no consensus on the optimal disinfection protocol or the method to achieve predictable clinical outcome. This article presents two cases of regenerative treatment in necrotic immature teeth, using mineral trioxide aggregate (MTA) and Biodentine TM as coronal barriers and different irrigants, which led to different clinical outcomes.

The management of necrotic immature permanent teeth, with blunderbuss root anatomy, is a treatment challenge. Treatment protocols include root canal apexification, creation of an apical plug and recently, regeneration and revascularization protocol (RRP). The latter may have the advantage of continued root development. The main purpose of this case series was to describe the RRP of three necrotic immature permanent mandibular molars with open apices. RRP involved accessing the pulp chamber, disinfecting the root canal system with copious irrigation using 2.5% sodium hypochlorite, applying triple antibiotic paste/calcium hydroxide as an intracanal medicament and sealing the access cavity. After three weeks, the medicament was removed and the apex was irritated with a K-file to induce blood-clot formation inside the pulp canal space; which would provide a suitable matrix for new tissue in-growth. Mineral trioxide aggregate was employed to seal the canal orifices before final restoration. During follow-up sessions, patients were asymptomatic and root development seemed to be in progress. Therefore, it seems that with proper case selection, regeneration and revascularization can be considered as a suitable alternative for the apexification of necrotic immature teeth.

Tooth nonvitality is one of the frequently seen consequences of dental trauma that causes the arrest of root development. Amniotic membrane has received a lot of attention for its use in transplantation and regeneration procedures. This article reports a unique and novel case of successful regenerative endodontic procedure done using amniotic membrane in a traumatized immature right maxillary central incisor of an 8-year-old girl. The clinical and radiographic evaluation done during the recall visits at 1, 3, 6, 9 and 12 months showed a progressive root growth with apical closure.

Introduction: Sinus tracts are routes of purulent drainage, which are supposed to be related to a specific source of infection. To the best of the authors’ knowledge, there have been no documented cases of multiple intra-oral sinus tracts arising from a non-vital maxillary molar. This observation highlights a unique clinical scenario that has not been previously reported in the literature. Case Presentation: A rare case with three intra-oral sinus tracts, all related to a non-vital, previously pulp-capped maxillary second molar is presented. After a two-visit root canal treatment, sinus tracts were closed and patient’s symptoms relieved. In such cases, a proper disinfection of the root canal system combined with an ideal obturation of the prepared canals would be required. Conclusion: Necrotic maxillary molars might be associated with multiple sinus tracts.