RESUMO
Management of open apex cases in endodontics poses a significant challenge, especially in immature teeth with necrotic pulps. Traditional apexification techniques have been the mainstay of treatment, aiming to induce the formation of a calcific barrier at the root apex. However, newer approaches incorporating biological materials such as platelet-rich fibrin (PRF) and demineralized bone matrix (DMBM) have emerged as promising alternatives. This article presents a case report of an 18-year-old male patient who presented with fractured upper central incisors, with the upper right central incisor displaying an open apex due to trauma sustained eight years prior. The treatment plan involved apexification using a combination of DMBM and PRF, with mineral trioxide aggregate (MTA) utilized as an apical barrier. The procedure was performed under rubber dam isolation, meticulously removing necrotic pulp tissue, irrigating with sodium hypochlorite solution, and placing a calcium hydroxide medicament. Subsequent visits included the placement of DMBM and PRF mixture into the canal space to create an apical barrier, followed by MTA placement and final restoration. Follow-up examinations at 3 and 12 months revealed the tooth to be asymptomatic and functionally normal, with radiographic evidence of osseous repair and complete apical closure. This case underscores the efficacy of a multimodal approach utilizing DMBM, PRF, and MTA in successfully managing open apex cases. Further research and long-term follow-up studies are warranted to validate this treatment modality's predictability and long-term success.
RESUMO
Aim: The present in vitro experimental study was undertaken to evaluate and compare the antimicrobial activity of triple antibiotic paste (TAP), diclofenac, and proton-pump inhibitor (PPI) against the microorganism Enterococcus faecalis. Materials and Methods: Three medicaments were selected for the study, TAP, diclofenac, and PPI. The experimental groups for the test were as follows: Part 1 - Group 1: TAP, Group 2: diclofenac, and Group 3: PPI; Part 2 - Group 1: TAP + PPI and Group 2: diclofenac + PPI. An agar well diffusion test was used to determine the efficacy of the experimental medicaments against E. faecalis (ATCC 29212). The diameter of inhibition zones was measured in millimeters using an inhibition zone measuring scale and the results were recorded. Statistical Analysis: The statistical analysis was done using an analysis of variance and an unpaired t-test. P value was set at < 0.05. Results: There was a significant difference in the diameter of growth inhibition zones, with the greatest diameter noted for TAP + PPI followed by diclofenac sodium (DS) + PPI, TAP, DS, and PPI. Conclusions: The antimicrobial effectiveness of TAP + PPI was found to be superior to all other medicaments (DS + PPI, TAP, DS, and PPI).
