Clinical Update quiz
The Clinical Update online is a free member service providing up to 11 FREE CPD hours per year.
Each month, the Clinical Update is published online. There are 11 Clinical Updates per year. This service is available to ADAVB and ADATas members only. Members can log in to view and answer the Clinical Update questions. If you answer at least eight out of 10 questions correctly, you will receive one hour of scientific CPD.
Please note: Each new Clinical Update will be available below from the first business day of each month.
September Clinical Update
Outcomes of apexification in immature traumatised necrotic teeth and risk factors for premature tooth loss: A 20‐year longitudinal study.
Dental Traumalogy. Wikström, A., Brundin, M., Mohmud, A., Anderson, M., & Tsilingaridis, G. (2024).
This article was originally published by the Wiley Online Library and has been edited for brevity and clarity.
Compiled by Dr Francis Chan
Introduction
The treatment of traumatised infected immature permanent incisors can pose a challenge due to the thin dentine walls, open apices with short roots, and wide root canals which make endodontic treatment more complex and increases the risk of material extrusion in the periapical tissues.
Historically, apexification techniques involving calcium hydroxide have been the treatment of choice for these teeth. The purpose is to prevent overfilling by induction of hard tissue deposition at the apical foramen, and to achieve periapical healing. However, prolonged use of calcium hydroxide may alter the organic matrix of dentine and reduce the dentine fracture strength by 50% after one year, therefore increasing the risk of cervical root fractures.
An alternative to calcium hydroxide is to use mineral trioxide aggregate (MTA) or other bioactive cements. These can induce a hard tissue apical barrier in a significantly shorter time and enable treatment to be completed in fewer sessions.
Regenerative endodontic procedures are another option but are not seen as the gold standard because there is little evidence of efficacy for the treatment of traumatised immature teeth with pulp necrosis and infection.
The objectives of the present study were to evaluate the long-term survival of immature traumatised incisors with pulp necrosis and apical periodontitis after endodontic treatment with two apexification techniques (calcium hydroxide apexification and MTA apical plug) compared with a control group of mature teeth treated with conventional endodontic techniques and to identify major factors affecting the survival of these teeth.
Members click here to continue reading and complete this month's Clinical Update questions online or download the current quiz below.
July 2024 Clinical Update | pdf
August 2024 Clinical Update | pdf
September 2024 Clinical Update | pdf
