Addendum

There’s More to the Story

Author adds variation on endodontic treatment of primary teeth.

Wayne W. Maibaum, M.A., D.M.D.

IN THE APRIL New York State Dental Journal, Dr. Steven R. Spitzer and I presented a case that preserved a non-vital primary tooth with appropriate endodontic treatment (“Successful Treatment of a ‘PedoEndo’ Lesion in a Primary First Molar”). I would like to add a variation on the endodontic treatment of primary teeth by presenting a case of a non-vital anterior tooth with no succedaneous replacement.

Several years ago, a young adult Hispanic female patient presented to the oral diagnosis clinic at Columbia University with a discolored retained #D and a periapical abscess on the facial gingiva near the root apex (Figure 1). The patient did not want to extract the tooth since she exhibited agenesis of tooth #7 and did not want to deal with the resulting space (Figure 2). Conventional root canal therapy, using gutta-percha as a filling material, was performed in the postgraduate endodontic clinic (Figure 3).

Figure 1. Preop photo #D.

Figure 2. Preop PA #D.

Figure 3. Postop PA #D.

This case demonstrates that conventional root canal therapy can be performed to retain primary teeth, with closed apices, for the long term. This differs from the treatment of primary teeth that are retained as space maintainers until exfoliation. Both treatment modalities can be considered by general dentists, pediatric dentists and endodontists.

Dr. Maibaum is a retired life member of the ADA. He is former director of the Oral Diagnostic Clinic at Columbia University College of Dental Medicine, New York, NY, currently living in Danbury, CT.