Melis Bahar Akyıldız MD, MERVE ERKMEN ALMAZ, Işıl Şaroğlu SÖNMEZ

Revaskülarizasyon Sonrası Tamamlanmamış Kök Gelişimi ile İyileşme: Kırk Aylık Takipli Olgu Raporu

Son yıllarda gelişen revaskülarizasyon tedavisi, antibakteriyel ilaçların karışım halinde uygulanması ile enfekte kök kanallarında dezenfeksiyonun sağlanmasını amaçlayan bir yaklaşımdır. Klinik ve radyolojik değerlendirme sonucunda, 13 yaşında kız hastada açık apeksli alt ikinci premolar dişinde (#35) derin çürük ve periapikal radyolusensi tespit edilmiştir. Muayene bulgularına göre revaskülarizasyon tedavisi önerilmiştir. Revaskülarizasyon tedavisi için üçlü antibiyotik patı 2 hafta süre ile uygulanmıştır. Sonrasında kanal içinde kan pıhtısı oluşturulmuş ve üzerine mineral trioksit agregatı yerleştirilmiştir. Koronal restorasyon için kompozit rezin kullanılmıştır. Kırk aylık takip sonucunda diş asemptomatik, pulpa testine pozitif yanıt alınmıştır ve periapikal lezyonda iyileşme gözlenmiştir. Ancak, kök gelişiminde devamlılık gözlenmemiştir. Revaskülarizasyon tedavisi ile ilgili literatürdeki birçok çalışma olmasına rağmen, uzun dönem takipte kök gelişimi devam etmeyen çalışma daha önce rapor edilmemiştir. Kök gelişiminin devamlılığının sağlanamamasına rağmen pulpa teslerine pozitif pulpal yanıt alınması dikkat çekici bir bulgudur.

Healing with Incomplete Root Development After Forty Months Following: A Case Report

In recent years, the concept of revascularization has been developed that employs the use of a mixture of antibacterial drugs for disinfection of infected root canals. The clinical and radiographic examinations showed deep coronal caries, immature root, and periapical radiolucency in mandibular second premolar (#35) of a 13-yearold girl. The exam findings suggested revascularization treatment. Revascularization with triantibiotic mix was administered for 2 weeks. Then, a blood clot was created in the canal, over which mineral trioxide aggregate was placed. Coronal sealing was performed with composite resin. After 40 months follow-up, the tooth was asymptomatic with a positive response to the pulp test and periapical radiolucency was healed. However, no evidence of root development was observed. In spite of numerous reports of revascularization treatment, no incomplete root development was reported after long-term follow-up. Despite incomplete root development, positive response to the pulp test is controversial.

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