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Fig 3: IOPA HD digital radiograph: 84 – Fig 4: IOPA HD digital radiograph: 84 – Fig 5: IOPA HD digital radiograph: 84 – reviewed after 26
2 Months Review. 3 Months post treatment review. months (>2 years) Post Treatment.
- Distal Root – Good Peri-apical Healing. - Increased radiopaqueness in the - The Partial Pulpectomy seal is intact
- Sealer Puff has resorbed considerably. peri-apical area with the apical puff still - Mesial and Distal roots have resorbed slightly
- Mesial Roots – also reveals Peri-apical present. - Furcal area also appears to have slightly resorbed
puff with good bone healing. - The Zinc-oxide sealer puff has not - Indication of Exfoliation has initiated – the Cuspal tip of
resorbed. 44 also appears to be more Occlusal than before.

The mother was offered a third attempt at Re-Treatment Pulp Therapy, On examination:
which she accepted. Re-treatment Partial Pulpectomy was completed - Decayed teeth: 54, 64, 65, 74.
in two visits, followed by a post-treatment radiograph. A follow-up - Decay with Buccal abscess: 74.
review, conducted more than two years after the Re-treatment Partial - Filled teeth – from elsewhere: 75, 84, 85.
Pulpectomy, confirmed the success of such attempts⁷.
The contributing factors to this success include: The restorations for this child were done with Nano-Cluster paste
- Better debridement of the tortuous root canal internal structure by composites and Nano-Cluster Flowable composites in the 2nd quadrant
using rotary endodontic instruments. and later on in the 4th quadrant, to allow us to compare the outcome
- Good Occlusal and apical seal. of flowable against paste form composites as an evidence-based
- Adequate application of partial pulpectomy protocols. clinical review. The previously restored teeth from elsewhere were not
- Cooperative child. treated initially but were re-restorated as needed and in one tooth a
Partial Re-treatment Partial Pulpectomy was undertaken, as follow up
CASE B – A FULL MOUTH REHABILITATION IN A CHILD continued. The restorations as well as the Partial Re-treatment have
WITH PREVIOUSLY RESTORED TEETH FROM ELSEWHERE been followed-up for 4 to 5 months, with very encouraging results that
AND MULTIPLE DECAYED DECIDUOUS TEETH would result in a paradigm shift in our applications at the clinical level,
An 8-year-old girl was brought with complaints of multiple decayed which in turn would allow us to modify our Pediatric Restorative and
teeth and a gum boil in the lower left back region since 1 month or so. Pediatric Endodontic procedures.

Fig 6: Pre-treatment labial view Fig 7: Maxillary: Occlusal view – 54, 64, Fig 8: Mandibular: Occlusal View – 74 Proximal
65 - Proximal decay – Pre-treatment. Decay (Distal)
75, 84, 85 – Proximal Restorations from
elsewhere – Pre-Treatment.

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Dental Practice I January-February 2025 I Vol 21 No 1 21