PULP REVASCULARIZATION IN THE UPPER CENTRAL INCISOR OF AN ADULT PATIENT WITH INCOMPLETE RHIZOGENESIS: A CASE REPORT
DOI:
https://doi.org/10.25110/arqsaude.v30i2.2026-12443Keywords:
Chlorhexidine, Endodontics, Periapical periodontitis, Regenerative endodonticsAbstract
Introduction: Pulp revascularization (PR) consists of reestablishing intrapulpal blood flow, after disinfection of the pulp cavity, by inducing apical bleeding, through which stem cells from the periapical region reach the root canal space and differentiate into a new pulp-like connective tissue. Objective: To describe the technique PR using bioceramic cement in a maxillary central incisor with incomplete root formation in an adult patient. Case report: A 37-year-old female patient sought endodontic treatment for a tooth with open apex. Radiographic examination revealed an extensive radiolucent periapical lesion. The PR treatment was carried out in two sessions, using 2% chlorhexidine (CLX) as the only antimicrobial solution, 17% EDTA as a chelating solution, passive ultrasonic agitation of the irrigants, and Ultracall XS® calcium hydroxide paste as intracanal medication between sessions for 7 days. At the second visit, after confirming the absence of signs and symptoms of secondary or persistent infection, intracanal bleeding was induced by excessive instrumentation with a #25 K hand file positioned 2 mm beyond the apical foramen. A resorbable collagen hemostatic sponge (Hemospon®), an MTA Angelus® cervical plug and a glass ionomer cement base were sequentially placed on the blood clot. The access cavity was restored with Master Fill® composite resin. Conclusion: Twelve months after completion of the PR, the tooth was asymptomatic and showed signs of repair of the periapical lesion and closure of the root apex, demonstrating successful treatment.
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