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Traitement de la résorption osseuse inter-radiculaire des molaires temporaires
nécrosées à l'aide de l'hydroxyde de calcium (Ca(OH)2)
1PILIPILI
Charles
2SENGER
Nathalie
2DEFAT
Carine
2GEORGE
Alexandru
1Chargé
de cours, Chef de Clinique
2 Anciens
Assistants
Université Catholique de Louvain
Ecole de Médecine Dentaire et de Stomatologie
Service de Pédodontie et de Soins Dentaires aux Personnes
Handicapées (C. Demars)
Mots clés :
dent temporaire,
hydroxyde de calcium, nécrose pulpaire, résorption, traitement canalaire.
Key words:
primary tooth, calcium hydroxide, pulp necrosis, resorption, root canal
treatment.
Abstract
“Calcium hydroxide and
treatment of inflammatory inter-radicular bone resorption of non-vital
deciduous molars”
On non-vital deciduous
molars, inter-radicular bone resorption is often an indication of extraction.
The endodontic treatment of these teeth by means of zinc oxide-eugenol (ZOE)
paste also showed its limits. To mitigate the deficiencies of this material, we
suggested a preliminary treatment by means of calcium hydroxide (Ca(OH)2) for
its anti-inflammatory and antiseptic properties as well as its ability to
stimulate calcified tissues apposition or remineralisation.
This study concerns 21
non-vital deciduous molars. X-rays excluded any lesion of the underlying
permanent bony crypt (bone tissue) as well as any inflammation of the dental
follicle. After preparation, root canals were filled by means of Pulpdent®. An
initial X-ray check was made 15 days, 1 month and then every 3 months. After
disappearance of the inflammatory resorption, root canal fillings were performed
with ZOE paste.
The remineralisation of
the inter-radicular alveolar bone was observed for 14 deciduous molars, which
were then filled using ZOE. The remineralisation period varies from 3 to 18
months depending on the scale of the lesion. Of the 7 failed treatments, 3
failed following downfall of the crown filling material, and 2 due to failure to
keep appointments and late replacement of resorbed Ca(OH)2. On 2 teeth, the
treatment did not stop the lesion forming.
Calcium hydroxide (Ca(OH)2)
give encouraging results in the treatment of inter-radicular alveolar bone
resorption of non-vital deciduous tooth. Its fast resorption requires rigorous
controls, frequent refills, and thus strong motivation on the part of the child
and parents. It cannot, on any account, be considered as permanent filling
material.
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