Obturation of root canals in deciduous teeth and in permanen teeth in children

Endodontic technique in immature permanent teeth (apexification).

The permanent tooth with a vital but degen­erating, or a non-vital, pulp and with incom­pletely formed apices presents a severe problem. The open apex defy attempts at conventional root-canal therapy because the apical dimensions of the canal exceed those at the coronal access area.

The principles of treatment are to debride and sterilize the canal before filling it with a calcium hydroxide paste; saturating the periapical tissues with calcium ions, together with the elimination of bacteria, stimulates physiological calcific repair at the apex. When repair is complete, conventional root therapy can be performed using lateral and apical condensation against the repaired, calci­fied apical tissue. This technique is called apexification.

Barbed broaches are used to remove debris and necrotic tissue from the canal. A diagnostic radiograph must be taken with an instrument in the canal to assess the correct root length. Care should be exercised to avoid penetration of the apex, since the induction of periapical haemor­rhage and the formation of a blood clot do not expedite periapical repair. The maxillary central incisor's normal root length is between 22 and 24 mm from incisal edge to apex. Since the root is incompletely formed, the clinician should place the diagnostic instrument appropriately short. After the diagnostic radio­graph has been obtained the canal should be debrided to within 2 mm of the radiographic apex. The wide and diverging canal encourages the use of large instruments from the outset. Because of this divergent shape, the file should be worked around the canal at the coronal access to ensure proper mechanical cleansing at the apex. Hedstrom files are used intermittently with copious irrigation by saline to remove infected dentine from the canal walls. The appearance of clean dentine filings should encourage the operator to terminate instrumen­tation. The canal is irrigated with saline and dried with paper points. The canal should be filled with calcium hydroxide while the apical barrier have formed.

Correct endodontic treatment of deciduousand immature permanent teeth permits to keep them during a long time.

Actuality: obturation of the radicular space is the final procedure in the root canal during the endodontic treatment of temporary or permanent tooth. So this stage must be perform perfectly to provide being the tooth healthy for a long time. Correctly endodontic treatment and canal obturation of deciduous tooth prevents damaging of permanent successor.

Object of the lecture – to present the knowledges about methods of obturation of root canals in deciduous teeth and permanent teeth in children.

Plan of lecture:

1. Requirements for root canal filling materials.

2. Materials for root canal filling in deciduous teeth.

3. Technique of root canal filling in deciduous teeth.

4. Materials for root canal filling in permanent teeth.

5. Technique of root canal filling in decidui teeth.

The preliminary objectives of operative endodontics are total debridement of the pulpal space, development of a fluid-tight seal at the apical foramen, and total obliteration of the root canal.

Дата добавления: 2014-01-05