Vital pulp cut impact on the root morphogenesis

Youth permanent anterior teeth in root formation, resulting in crown fracture and pulp exposure and damage due to trauma, root formation of the correct treatment of dental injury, prompting the root to continue development of a very important clinical significance, and crown repair and lay a good foundation.

6 months to 2 years after injury to trace 80 cases of 90 root form of crown fracture exposed pulp constant on the incisor line of vital pulp, pulp, cut off the root morphological development of the observation period.

1. Materials and Methods

1.1. Cases of select 1987 to 1990, hospital outpatient treatment 7 to 10-year-old children, permanent upper central incisor traumatic crown fracture exposed pulp, dental X-ray showed no root fracture, root development in about 2/3 of the root canal thick apical foramen is not formed, the root end of diseased teeth, and newly diagnosed, referral hospital pediatric formal operation treatment, referral, clinical no independent symptoms.

1.2 Treatment

1.2.1. The initial and referral by regular mouth checks and fill the card in the same projection angle shot of the local dental film. Pulpotomy: a total of 80 cases, 90 teeth.

1.2.2. Indications broken crown, pulp exposure, leak oozing bright red, medium, explore pain, pulp, good toughness, percussion pain.

1.2.3. Operating points with the glutaraldehyde line pulpotomy no clinical symptoms, two solid, using GIC filled.

2. Result

90 teeth the QUICKER marrow amputation, root side to have calcification in the formation of 90, accounting for 100%, the root end elongation gradually tapering, form no exception to 71, accounting for 78.9%, root end of the gradual elongation thinning abnormal morphology 18, accounted for 20% of the root end elongation of a visible group flocculent calcification (1.1%). The root end of all development and lesions of the root end has no roots continue to grow formation accounted for 98.9%.

3. Discuss

Recent years, animal experiments and clinical studies have confirmed the development to stop the root tip can continue to be repaired. Root formation of the enamel device after the formation of the inner enamel epithelium, the epithelial sheath formed by the two-tier cell layer between the inner and outer enamel epithelium. The epithelial sheath in the future on the one hand the formation of the contours of the tooth root, on the one hand, to the development of the root apex lateral to the surface of the dental papilla differentiate into odontoclasis cells, when epithelial sheath surrounded by dental papilla growth at right angles to distort the upper and lower dental papilla. Epithelial sheath. And root formation, so when the tooth has not been completed in the treatment of root, it should be noted. Thus, to retain complete the epithelial sheath, is the root key to further development. Mechanism to continue on the root, most scholars believe and agree that the mainly epithelial root sheath generated cementum guide made cementum cells. In a large number of root formation is not the case, some asymptomatic, and dental instruments some repeated symptoms, but eventually made the success of the treatment, which pointed out that the damage of the epithelial root sheath is not impossible to recover, but to minimize the epithelial sheath caused by the human damage, the key is the completion of the apical pulp tissue. Once the cells of the dental papilla and odontoblasts have been destroyed, the root form of development will also be affected, and 1971 found that such a tooth from the root atresia repair to replace the root continue to develop the final apical connective tissue proliferation and calcification, the formation of osteoid dentin. Apical closure is a result of irregular deposition of dental hard tissue and bone, these organizations from the pulp remaining odontogenic cells and connective tissue components, if obvious pulp tissue, after the formation of root morphological and anatomical features and more inclined to the normal type. The pulp absence of residue, the closure of the apical foramen is irregular hard tissue blocks to complete. The dactylon continue to form the epithelial root sheath is still alive. Our results also confirmed this point.

Exposure of the pulp is still vital pulp is generally believed that the pulpotomy has a good effect. Existence of serious infection in the exposed pulp site the purposes of the pulp cut is still a good healing. Observed 175 cases of pulp cut off, and that the traumatic exposed pulp to be treated within 48 hours, the best prognosis. But the pulp cut cases of accidental injury after a few weeks have also been reported.

Root formation of permanent anterior teeth after trauma exposed pulp should try to save the pulp exist. Cut off and the best treatment options for vital pulp. Apical pulp tissue, postoperative formation of root morphological and anatomical characteristics, and more inclined to the normal type.