Interesting case

[Shiko]

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Dear dentists,
A 28 years old male came to the office with an abcess related to a dicolored malformed lower lateral incisor, the radiograph showed a periapical radiolucency related to that tooth which showed an open apex as well, there was a history of trauma to that tooth several years ago.
The challenge is , how to perform root canal treatment to that case ( I know i can use Caoh for apexification ) but studies show that it takes from 3 till 18 months for a hard tissue to form close to the apex, and the patient needs an esthetic restoration as soon as possible .
The second challenge after apexification is obtaining a hermetic seal to that tooth, i have thought of using the soft gutta percha technique or injecting soft gutta percha into the canal but still there's a chance of missing the apex ..
Any suggestions?

 

[DrJeff]

This might be an instance to try the new obturator/fiber post system that Jeneric Pentron has introduced. The apical 5 or so mm of the post is made of gutta percha and utilizes the warm gutta percha technique, the remaining coronal portion of the post is a fiber reinforced post. The sealer they apparently include is a dual cure resin based cement. With this, you could probably use to large diameter post that would account for the widened "immature" apex. Traditional canal preparation should allow of the apical few mm to remain dry for the dual cure sealer. The fiber reinforced post would then provided an excellent esthetic supporting post for a final restoration.
We've just order this system in my office, and after talking with the Jeneric reps at the Greater New York Dental Meeting this week, my partner and I were impressed with the system and can't wait for the UPS truck to show up with the delivery. Hope that may help shed some light on this situation.


Jeneric Pentrons web site: <a href="http://www..jeneric.com" target="_blank">www..jeneric.com</a>