Abstract

Owing to the popularity of pulp regenerative procedures, the American Association of Endodontics (AAE) issued guidelines based on clinically proven protocols that govern such procedures. Our aim was to follow the pulp regeneration guidelines recommended by the AAE and evaluate the outcome. A 12-year-old male patient reported with the chief complaint of dull, spontaneous, repetitive pain episodes related to the lower left second premolar accompanied by sinus tract discharge. A diagnosis of pulpal necrosis with symptomatic chronic periapical abscess was made. Following endodontic access, irrigation with sodium hypochlorite was done followed by the application of a triple antibiotic paste as intracanal medication. At the second visit, irrigation, blood clot induction through laceration of the periapical area, and placement of a mineral trioxide aggregate seal were performed. The third visit involved clinical assessment and placement of a permanent coronal seal. Followup was done after 3 and 6 months. Clinical resolution was achieved within 3 weeks of initiation of treatment, and radiographic evidence of continued root development was observed during the 3rd month followup visit. In conclusion, adherence to the AAE guidelines for pulp regeneration resulted in resolution of the clinical symptoms with an outcome that may be considered successful both clinically and radiographically.

Keywords: Anti-bacterial agents, Bicuspids, Mineral trioxide aggregate, Periapical abscess, Sodium hypochlorite