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Endodontic treatment of deciduous anterior teeth
ENDODONTIC TREATMENT OF DECIDUOUS AZQTERIOB Report of Two Cases David iIf. Nosowwitz, D.D.S., Pleasant Valley, N. Y.
0
CCASIONALLY
the general practitioner is called upon to treat devitalized deciduous anterior teeth which will exfoliate some years later. The principles of approach, instrumentation, and medicaments used for the A.
B.
c.
D.
Root-canal treatment of upper right central Fig. l.-Cass 1. A At age 4% years. Incisor completed. A solfd continuous c&mm of paste is important for success. Note uPPer left central incisor which -ted to trauma by complete calcification. B, April 6, 1461. One half of root is resorbed. The zinc oxyphosphate part of the rootcanal Ailing does not resorb. C, Sept. 6 1961. Tooth almost ready to exfoliate. D, NOV. 16, 1961. Tooth exfoliated. No trace of the zinc oxyphosphate cement remahw 1128
~;‘dum~
ENDODONTIC
TREATMENT
OF DECIDUOUS
ANTERIOR
1129
TEETH
permanent dentition are applicable to deciduous teeth, Following is a technique for the filling of deciduous anterior teeth. A Cellu-Tube* is filled with a thick, creamy mix of zinc oxide and eugenol, and this paste is forced into the canal as the tip of the tube is withdrawn from it. A stiff mix of zinc oxyphosphate cement is fashioned into a short blunt-end cone, the shape of which is slightly larger than the root canal. This cone is attached to a suitable root-canal plugger and delivered into the canal. The purpose of the cement cone is to drive the paste ahead of it to fill the canal sufficiently. I have used this technique very successfully, even for deciduous mo1ars.l CASE
REPORTS
CASE l.-In March, 1959, a 4$&year-old boy presented sn upper right central incisor that was acutely abscessed as a result of a previous traumatic injury. After standard endodontic preparatory treatment, the root canal was filled on April 17, 1960 (Fig. 1, a), by the aforementioned technique. A.
fllled
B.
Fig. 2.---Cast 2. A, At age 6 years, December, 1959. Root canal of lower about 3 mm. short of apex. 8, April 20, 1960. U, April 6. 1961. D, Jan. 13, 1962. Endodontlcally treated tooth Is progressing as expected. lL
D. Caulk
Manufacturing
Comnany.
right
canine
NOSONOWTZ
1130
O.S..O.M.&O.P.
September, 1962
On Nov. 16, I961 (Fig. 1. D), 1 was present when the boy extracted the tooth with his fingers. The apical part. of the zinc oxyphosphate cone had fractured and was spat out by the patient. The periodontal tissue did not adhere to the zinc oxyphosphate cement. This phenomenon is in marked contrast to the adherence of amalgam to periodontal tissue. CASE 2.-In November, 1959, a B-year-old girl presented an acutely abscessed mandibular cuspid. The same procedure was followed as in Case 1. The canal was filled about 3 mm. short of the apex (Fig. 2, A). As of Jan. 13, 1962, the tooth was clinically and roentgenographically sound. In such cases the lingual part of the unfilled root portion resorbs quickly. From that time on, the root resorption pattern will follow the same course as iu Case 1. REFERENCE
1. Nosonowitz, David M.: Endodontic Techniques for Deciduous Molars, New York State Dent. J. 26: 235, 1960. MAIN ST.
Erratum In the article entitled “Inverted Papilloma” by Moskow and Moekow, which appeared on pages 918 to 922 of the August issue of the JOVBNAL, the illustrations were numbered incorrectly. The clinical photograph published as Fig. 4 should have been Fig. 1, and the photomicrographs published as Figs. I, 2, and 3 should have been Figs. 2, 3, and 4, respectively.
0
CCASIONALLY
the general practitioner is called upon to treat devitalized deciduous anterior teeth which will exfoliate some years later. The principles of approach, instrumentation, and medicaments used for the A.
B.
c.
D.
Root-canal treatment of upper right central Fig. l.-Cass 1. A At age 4% years. Incisor completed. A solfd continuous c&mm of paste is important for success. Note uPPer left central incisor which -ted to trauma by complete calcification. B, April 6, 1461. One half of root is resorbed. The zinc oxyphosphate part of the rootcanal Ailing does not resorb. C, Sept. 6 1961. Tooth almost ready to exfoliate. D, NOV. 16, 1961. Tooth exfoliated. No trace of the zinc oxyphosphate cement remahw 1128
~;‘dum~
ENDODONTIC
TREATMENT
OF DECIDUOUS
ANTERIOR
1129
TEETH
permanent dentition are applicable to deciduous teeth, Following is a technique for the filling of deciduous anterior teeth. A Cellu-Tube* is filled with a thick, creamy mix of zinc oxide and eugenol, and this paste is forced into the canal as the tip of the tube is withdrawn from it. A stiff mix of zinc oxyphosphate cement is fashioned into a short blunt-end cone, the shape of which is slightly larger than the root canal. This cone is attached to a suitable root-canal plugger and delivered into the canal. The purpose of the cement cone is to drive the paste ahead of it to fill the canal sufficiently. I have used this technique very successfully, even for deciduous mo1ars.l CASE
REPORTS
CASE l.-In March, 1959, a 4$&year-old boy presented sn upper right central incisor that was acutely abscessed as a result of a previous traumatic injury. After standard endodontic preparatory treatment, the root canal was filled on April 17, 1960 (Fig. 1, a), by the aforementioned technique. A.
fllled
B.
Fig. 2.---Cast 2. A, At age 6 years, December, 1959. Root canal of lower about 3 mm. short of apex. 8, April 20, 1960. U, April 6. 1961. D, Jan. 13, 1962. Endodontlcally treated tooth Is progressing as expected. lL
D. Caulk
Manufacturing
Comnany.
right
canine
NOSONOWTZ
1130
O.S..O.M.&O.P.
September, 1962
On Nov. 16, I961 (Fig. 1. D), 1 was present when the boy extracted the tooth with his fingers. The apical part. of the zinc oxyphosphate cone had fractured and was spat out by the patient. The periodontal tissue did not adhere to the zinc oxyphosphate cement. This phenomenon is in marked contrast to the adherence of amalgam to periodontal tissue. CASE 2.-In November, 1959, a B-year-old girl presented an acutely abscessed mandibular cuspid. The same procedure was followed as in Case 1. The canal was filled about 3 mm. short of the apex (Fig. 2, A). As of Jan. 13, 1962, the tooth was clinically and roentgenographically sound. In such cases the lingual part of the unfilled root portion resorbs quickly. From that time on, the root resorption pattern will follow the same course as iu Case 1. REFERENCE
1. Nosonowitz, David M.: Endodontic Techniques for Deciduous Molars, New York State Dent. J. 26: 235, 1960. MAIN ST.
Erratum In the article entitled “Inverted Papilloma” by Moskow and Moekow, which appeared on pages 918 to 922 of the August issue of the JOVBNAL, the illustrations were numbered incorrectly. The clinical photograph published as Fig. 4 should have been Fig. 1, and the photomicrographs published as Figs. I, 2, and 3 should have been Figs. 2, 3, and 4, respectively.