Uso do hidróxido de cálcio para apicificação de molar permanente com periodontite apical assintomática: relato de caso

Abstract

INTRODUCTION: Endodontic treatment is essential for disinfecting root canals, aiming to eliminate infections, relieve pain, and preserve natural tooth structure. Treatment effectiveness depends on accurate diagnosis, knowledge of canal anatomy, and proper execution of preparation, obturation, and coronal sealing steps. Sodium hypochlorite irrigation, combined with mechanical agitation, enhances debris and residue removal and is widely used in modern endodontics. OBJECTIVE: To describe the effectiveness of calcium hydroxide apexification in a clinical case of asymptomatic apical periodontitis in a tooth with an open apex, evaluating infection control and preservation of dental structure. METHODOLOGY: After ethical committee approval, a patient with asymptomatic apical periodontitis was selected. Diagnosis was confirmed through radiographic exams showing periapical lesions. The treatment plan included calcium hydroxide apexification in paste form, followed by obturation. The protocol involved anesthesia, access surgery, absolute isolation, chemomechanical preparation, and sodium hypochlorite irrigation, complemented with photodynamic therapy sessions. Intracanal medication was replaced periodically, and radiographic monitoring was performed to assess apical barrier formation and lesion reduction. RESULTS: Calcium hydroxide treatment resulted in the formation of a dense and continuous apical barrier, effectively isolating periapical tissue from infection. A significant reduction in the periapical lesion was observed, indicating successful infection control and tissue regeneration. The patient reported improvement in initial symptoms, such as pain and discomfort, and the treated tooth’s structure was preserved. CONCLUSION: Apexification with calcium hydroxide proved to be an effective method for treating immature teeth with apical periodontitis, promoting apical barrier formation and preservation of dental structure. This protocol provides a viable alternative for treating periapical lesions in teeth with open apices, supporting the success of endodontic treatment in similar cases.