Apeksyfikacja i stała odbudowa protetyczna jako sposób leczenia głębokiego złamania koronowo-korzeniowego u pacjenta w wieku rozwojowym – opis przypadku

Renata Pazera¹, *Joanna Szczepańska²

Summary
Injuries of permanent teeth with unfinished apical development, resulting in the need to remove pulp from the canal, require specialist treatment. Upon eruption, permanent teeth need time to form roots. The process takes up to 3 years from the moment when the dental crown appears in the child’s mouth and is referred to as apexogenesis. At that time, a harmful factor, such as an injury, may lead to irreversible pulpitis or necrosis of the pulp, thus resulting in arrested apical growth. The treatment plan includes enabling the completion of apical development (among others using calcium hydroxide or MTA) – performing apexification and restoration of lost dental tissues. Difficulty in restoring missing dental tissues increases along with the extent of tooth damage, e.g. when it is necessary to do prosthetic work in the paedodontic patient.
The aim of the study was to present the model of treatment of undeveloped permanent teeth through apexification using MTA and prosthetic work including a post-and-core and full ceramic crown. The study presents the treatment of post-traumatic conditions of permanent central incisors of the maxilla and incisors of the mandible. The right maxillary incisor with a complicated crown-root fracture was subjected to apexification using MTA and prosthetically restored, i.e. a post-and-core and crown. The left maxillary incisor was restored with composite material. Mandibular teeth were left to be observed. The carried out treatment and follow-up visits prove the proposed treatment to be justified. It allowed to spare the patient discomfort connected with extraction, a removable prosthetic restoration or cantilever bridge. During follow-up visits the patient did not report pain and diagnostic tests did not indicate alarming signs.
The post-traumatic treatment of undeveloped teeth is problematic. Research reports confirm the superiority of apexification using MTA over calcium hydroxide. It is necessary to perform prosthetic work in the case of major dental tissue loss. An individual prosthetic restoration does not affect the child’s stomatognathic system – further observation is required.

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