Endodontic Treatment Of Carious And Traumatic Upper Anterior Teeth

Dental caries and trauma are the main causes of pulp exposure.The thickness of enamel and dentin of anterior teeth is thin.In the process of dental caries,it is easy to invade the dental pulp and cause the infection of dental pulp tissue.The upper anterior teeth,located in the front of the mouth,are the most common teeth involved in trauma.When the dental pulp is involved,the bacteria in the oral cavity directly invade the dental pulp,causing infection and even necrosis of the dental pulp.The apex of mature permanent teeth has been fully developed,and root canal therapy is often chosen when the dental pulp is exposed or infected and necrotic.In recent years,with the development of biomaterials,more and more vital pulp therapy is used in mature permanent teeth.Compared with root canal therapy,vital pulp therapy is more minimally invasive and based on biological principles.Pulp revascularization is usually used to treat immature permanent teeth with pulp necrosis or periapical inflammation.Successful pulp revascularization can make clinical symptoms disappear,periapical bone healing,root canal wall thickening,and root development continue.Recently,the pulp revascularization technique has been successfully used to treat mature permanent teeth with pulp necrosis or periapical inflammation,with good outcomes.The thesis mainly describes the endodontic treatment of carious and traumatic upper anterior teeth,and discusses the treatment of vital pulp therapy and pulp revascularization in mature permanent teeth.Case 1 and case 2 were deep adjacent caries of upper anterior teeth.Partial or total coronal pulpotomy was performed after cariogenic pulp piercing,and resin laminated filling was performed after operation.Case 3 and case 4were complex crown fracture and complex crown-root fracture of upper anterior teeth,respectively,vital pulp therapy and resin layered filling technique were used to restore the appearance.Case 5 was chronic periapical periodontitis of upper anterior teeth.The apical root length was fully developed,but the apical foramen was not completely closed and the root canal wall was thin.Dental pulp revascularization was used to promote apical foramen closure and root canal wall thickening.From case 1 to case 4,four patients had good pulp vitality after operation,and there was no pulp necrosis and periapical inflammation.Composite resin was used to repair the defect,and a good aesthetic effect was obtained.In case 5,the clinical symptoms disappeared after operation,the lesion of periapical inflammation was reduced at 6-month follow-up,but not completely healed,which still needed a long follow-up observation.