Recurrence of dental trauma and management of pulp revascularized tooth: a case report

Abstract

Pulp revascularization treatment has the potential benefit to increase thickness of root walls and root length of immature necrotic teeth. Dental trauma is the most frequent etiology of pulp necrosis in immature teeth, and its recurrence is frequent in children. To date, no study presented a case report of recurrence of dental trauma in a pulp revascularized tooth. Therefore, the objective of this case report is to describe a clinical management of a traumatized immature necrotic tooth that was first treated with pulp revascularization and suffered a second dental trauma, being then treated with a an alternative filling therapy. A 9-year-old girl suffered fall from a chair one year previously. Considering the late occurrence of the trauma, diagnosis of pulp necrosis and the presence of open apex, the treatment of choice to the right maxillary central incisor was pulp revascularization using the combination of calcium hydroxide and 2% chlorhexidine gel as intra canal medication. Patient returned after 1 year of pulp revascularization, due to the recurrence of dental trauma 1 month previously. A second endodontic intervention of the right maxillary central incisor was accomplished with an alternative filling therapy (filling paste composed by calcium hydroxide, 2% chlorhexidine gel and zinc oxide). In conclusion, pulp revascularization is an effective therapy for permanent immature necrotic teeth that suffered dental trauma. However, there is a high risk of recurrence of dental trauma, which may interfere in the treatment success. Therefore, professionals should be prepared for the necessity of alternative measures and techniques according to the evolution of each case.