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RO0111

14 I I case report _ revascularisation _Two years ago, I was struggling to learn how to performagoodapicalMTAplug.Iusedalltheexisting MTA carriers and absorbable barriers that I could find on the Greek dental market. It took me a while, but I finally ended up performing some proper apical MTA plugsandwithpractice,Iamnowabletoperformapi- calMTAplugsevenwithoutusingabsorbablebarriers (Figs. 1a–c). Itwasbackthen,thatIstartedgatheringinforma- tion on revascularisation procedures of the necrotic open apex. A case report by Iwaya et al. published in a 2001 issue of Dental Traumatology was repro- duced by Banchs and Trope in 2004, giving the work of Nygaard-Ostby et al. and Skoglund et al. from the seventies a whole new meaning. According to DrMartinTrope,“Ifthecanaliseffectivelydisinfected, ascaffoldintowhichnewtissuecangrowisprovided, and the coronal access is effectively sealed, revascu- larisation should occur as in an avulsed immature tooth.” I believe this is an excellent description of the philosophy behind the revascularisation procedure. Dr Trope’s words gave me all the information that I needed for making the attempt myself. _Case report On a rainy morning, the phone in my private practice rang. The referring doctor was very anxious to obtain an early appointment, as it concerned a trauma case of an eight-year-old child. I saw the little girl the same afternoon. Two days earlier, little Marlene had been hit by a car. Her right maxillary centralincisorhadsufferedanenamel-dentinefrac- Fig. 1a_Pre-op radiograph of tooth #11 with Ca(OH)2 dressing from the referring doctor. Fig. 1b_Radiographic appearance of properly placed apical MTA plug. Fig. 1c_Post-treatment radiograph with gutta-percha backfilling. roots1_2011 Revascularisation of the necrotic open apex Author_ Dr Antonis Chaniotis, Greece Figs. 2a & b_Initial situation. Fig. 1a Fig. 2a Fig. 2b Fig. 1b Fig. 1c