Non-Surgical Management of Blunderbuss Root Apices by Chemical Debridement and High-Viscosity Silicate Based Apical Plug

Abstract

Endodontic ttreatment of Blunderbuss open apices requires meticulous handling by a dentist in a clinic. These canals pose challenges due to fragile canal walls and complete absence of a tangible hard tissue resistance for termination of their obturation.

Calcium Hydroxide has been efficaciously used for apexifying open apices. It, however, is no more a material of choice for clinicians as it takes quite a long time for closing an apex. Calcium silicate-based materials have shown better performance to accomplish apical closure in shorter time but owing to its low viscosity, its compaction in an open apex is difficult. A putty-like silicate cement has now been developed to be easily placed and form an impervious to fluid apical plug.

Disinfection in such canals is another encounter a dentist comes across as mechanical debridement of existing thin canal walls may prove fatal. Intracanal instrumentation with cutting capability may further weaken them. In this case, therefore, maximum disinfection was achieved with irrigating solution of 2.5% Sodium Hypochlorite.