NUR KAMALIAH BINTI JAMEL

DIA160039

SEMINAR: IMMARURE ANTERIOR PERMANENT TOOTH

A 9-year-old boy presented with localized abscess on 21. He alleged fall 2 months
ago and sustained tooth fracture. He did not seek for any treatment.

1. Describe the clinical picture and intraoral radiograph (5 marks)

Clinical picture:
An abscess with approximately 1cm x 1cm in diameter on the
attached gingiva of tooth 21.

Periapical radiograph:
Tooth of concern is tooth 21.
There is radiopacity in the pulp of tooth 21.
The canal is not tapered and it shows a wide open apex.
Radiolucency present on the apical of tooth 21 extending to the
mesial of 21.

2. Discuss the clinical examination and investigations that need to be done

before you could come up with the diagnosis (5 marks)

Clinical examinations: I will examine the abscess and check for sinus
tract. Then, I will percuss and probe around tooth 21.
Investigation: I will do a cold test to assess the vitality of tooth.

3. List 3 options of pulp therapy techniques for this case (3 marks)

Multivisit apexification
Single visit apexification
Regenerative endodontic

4. Describe the dentinal wall outcome/features of each pulp therapy

technique (3 marks)
 Multivisit apexification: the root will continue to grow and form
apical barrier and the dentinal walls become thicker.

Single visit apexification: no thickening of dentinal walls

Regenerative endodontic: dentinal walls become thicker

5. Discuss the challenges for pulp treatment of 21 (4 marks)

The challenge for pulp treatment of 21 is the dentinal walls are very
thin, so minimal instrumentation should be done. Next is the wide
apex, which requires clinician to be careful and make sure not to
injure the periapical tissue.