Of all the amazing things I see in practice, the physical capabilities of the young rank right at the top. From postoperative healing to resolution of sinus tracts, there is no doubt that the young patient is a boon to the endodontic practitioner.
They make us look really good!
This 9 year old patient presented in acute discomfort on the lower left. As is visible in the preoperative bitewing, a cusp appears to have worn down. This very likely was a case of dens evaginatus. The nerve of the tooth was exposed, leading to bacterial influx and an infection. There was a sinus tract, as well as evident expansion and tenderness on the buccal plate and pain on percussion associated with tooth #20.
At the first visit, access was made and serosanguineous drainage was visualized. A mixture of antibiotics were placed into the chamber and a provisional restoration was placed. At the second visit, the sinus tract was gone as were any symptoms. The patient was in no apparent distress. After rinsing out the medication, a collaplug was placed and covered with MTA. A provisional restoration was placed.
At the next visit, the provisional was removed, the set of the MTA was checked and a definitive restoration was placed.
Three month recall revealed an asymptomatic patient with new hard tissue apical to the collaplug and continued root development.
The future of regenerative endodontics is extremely bright.
