PMC4955044_01
Preoperative radiograph of right central incisor
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F1A
Radiograph revealed incomplete root formation (Fig. 1A). On the same day access opening, working length and biomechanical preparation was done and canal was dried with paper point and filled with calcium hydroxide for disinfection for 1 week (Fig. 1B). MTA was placed into apical region (Fig. 1C). Material was then condensed into apical area and access opening was sealed with temporary filling material (Fig. 1D). Placement of the material was confirmed with a radiograph and after a week, tooth was obturated with gutta-percha (Fig. 1E). After 6 months follow-up radiograph revealed well sealed and healthy apical region (Fig. 1F).
PMC4955044_02
IOPA of calcium hydroxide placement in canal for disinfection
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F1B
A 9-year-old girl reported to the Department of Pedodontics and Preventive Dentistry with the chief complaint of pain in upper right front tooth region (Fig. 2A). Access opening was done followed by amputation of the coronal pulp with sharp excavator, carefully to prevent further damage to the pulp and perforation of the pulpal floor (Figs 2B and C). Damp cotton pellet was placed over the material, followed by temporary restoration with Zinc Oxide Eugenol Cement (Fig. 2D). After a week intermediate restorative material was removed and final restoration over set mineral trioxide aggregate was done followed by composite build up (Fig. 2E).
PMC4955044_03
IOPA showing calcium hydroxide removed from canal after a week
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F1C
On examination, his all 4 mandibular primary molars were carious (Fig. 3A). Radiograph revealed deep caries approaching pulp with remaining dentin thickness of about 0.5 mm (Fig. 3B). Then the roof of the pulp chamber was removed by joining the pulp horns with bur cuts followed by amputation of the coronal pulp with a sharp excavator (Fig. 3C). Then 1 to 1.5 mm thick layer of freshly mixed mineral trioxide aggregate was placed directly on the pulp stump surface and then patted with a moist cotton pellet (Fig. 3D). With a damp cotton pellet over the material, temporary restoration was done with zinc oxide eugenol cement (Fig. 3E). After a week intermediate restorative material was removed and mineral trioxide aggregate was placed, tooth was then restored with Glass Ionomer Cement (GIC) followed by stainless steel crown (Fig. 3F).
PMC4955044_04
IOPA showing placement of mineral trioxide aggre gate at the apex and closure with temporary material
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F1D
Radiograph revealed incomplete root formation (Figs 4A and B). Excess moisture was removed from the pellet and placed in the canal (Fig. 4C). Then temporary filling was removed at least after 3 to 4 hours and later a permanent filling material in the root and/or in the access cavity preparation was placed (Figs 4D and E).