<![CDATA[Background: Dental caries in children remains a major public health concern due to its high prevalence and propensity to progress to pulp tissue involvement. The thinner enamel and dentin of primary teeth accelerate bacterial penetration to the pulp and periapical tissues. Purpose: This case report describes the endodontic management of pulpal necrosis with a periapical abscess in a mandibular primary second molar. The unique value of this case lies in the integration of emergency trepanation to manage severe acute infection with a specific biocompatible obturation material in a primary molar that served as a space maintainer in a developing dentition. Case Report: An 8-year-old boy presented with food impaction in tooth 85 without accompanying pain. Clinical and radiographic examination confirmed pulpal necrosis with a periapical abscess. Case Management: Treatment was initiated with open access, trepanation, and placement of intracanal dressing. Subsequent visits involved root canal preparation using the conventional step-back technique, irrigation with 2.5% NaOCl, and intracanal medication with calcium hydroxide. Obturation was performed using a combination of Ca (OH)₂ and iodoform paste (Metapex), followed by final restoration with a stainless-steel crown. Conclusion: At the 19-day post-obturation follow-up, clinical evaluation demonstrated complete resolution of symptoms, and radiographic findings indicated early signs of healing and an absence of lesion progression. Within the limits of this single case and a short follow-up of approximately 19 days, structured endodontic management employing initial trepanation, conventional preparation techniques, and a calcium hydroxide–iodoform obturation material was associated with early clinical improvement and early radiographic findings consistent with healing. Longer-term follow-up is required to confirm periapical healing, tooth preservation, and guidance of the permanent successor's eruption until natural exfoliation.Background: Dental caries in children remains a major public health concern due to its high prevalence and propensity to progress to pulp tissue involvement. The thinner enamel and dentin of primary teeth accelerate bacterial penetration to the pulp and periapical tissues. Purpose: This case report describes the endodontic management of pulpal necrosis with a periapical abscess in a mandibular primary second molar. The unique value of this case lies in the integration of emergency trepanation to manage severe acute infection with a specific biocompatible obturation material in a primary molar that served as a space maintainer in a developing dentition. Case Report: An 8-year-old boy presented with food impaction in tooth 85 without accompanying pain. Clinical and radiographic examination confirmed pulpal necrosis with a periapical abscess. Case Management: Treatment was initiated with open access, trepanation, and placement of intracanal dressing. Subsequent visits involved root canal preparation using the conventional step-back technique, irrigation with 2.5% NaOCl, and intracanal medication with calcium hydroxide. Obturation was performed using a combination of Ca (OH)₂ and iodoform paste (Metapex), followed by final restoration with a stainless-steel crown. Conclusion: At the 19-day post-obturation follow-up, clinical evaluation demonstrated complete resolution of symptoms, and radiographic findings indicated early signs of healing and an absence of lesion progression. Within the limits of this single case and a short follow-up of approximately 19 days, structured endodontic management employing initial trepanation, conventional preparation techniques, and a calcium hydroxide–iodoform obturation material was associated with early clinical improvement and early radiographic findings consistent with healing. Longer-term follow-up is required to confirm periapical healing, tooth preservation, and guidance of the permanent successor's eruption until natural exfoliation.]]>
Copyrights © 2026
