DOI: 10.21276/aimdr.2016.2.4.11 Case Report ISSN (O):2395-2822; ISSN (P):2395-2814 Annals of International Medical and Dental Research, Vol (2), Issue (4) Page 32 Babool Thorn in the Root Canal of a Tooth with an Immature Apex: A Case Report and Its Management. Shilpi Gupta 1 , Kanchi Upadhyay 2 , Tapas Kumar Sarkar 3 , Soumik Roy 2 1 Reader, Department of Pedodontics and Preventive Dentistry, Hitkarini Dental College and Hospital, Jabalpur 482005. 2 Pg student 3 rd year, Department of Pedodontics and Preventive Dentistry, Hitkarini Dental College and Hospital, Jabalpur 482005. 3 Assistant Professor, Calcutta National Medical College, Kolkata ,(West Bengal). Received: May 2016 Accepted: May 2016 Copyright: © the author(s), publisher. Annals of International medical and Dental Research (AIMDR) is an Official Publication of “Society for Health Care & Research Development”. It is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non- commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Many children with a habit of placing various objects in the oral cavity eventually end up with foreign body lodgement into the pulp chamber or root canal leading to pain and infection. This case reports babool thorn (Acacia nilotica) as foreign body in the root canals and the successful removal of thorns by nonsurgical technique and its management is presented. A 13 year old boy reported with chief complain of pain and swelling in an upper front tooth region since 1 month. A detail history elicited from the patient that he had suffered dental trauma 4½ years back. Both 11, 21 teeth were discoloured and non vital (Ellis Class IV #). During the biomechanical preparation, Babool thorns were accidentally found from 21, in total 12 babool thorns were recovered and both the teeth were further managed by successful apexification procedure with Biodentine (Septodont) followed by RCT and full crown restoration Keywords: Foreign body, Immature apex, Babool thorn, Biodentine. INTRODUCTION Root canal treatment pose problems in children and sometime clinicians may face intricate situations requiring both skill and patience. Children have a tendency of placing and chewing foreign objects in the oral cavity. Due to the pulpal irritation, these objects are inserted into the tooth to probe and relieve pain and pressure symptoms. Sometimes, these objects are lodged in the teeth. This is the situation in a tooth with an open large carious lesion or open pulp chamber caused by trauma in a tooth left open for drainage during root canal treatment. But presence of foreign objects in the teeth are rare. The foreign objects in teeth may acts as a potential source of infection and pain. [1] Name & Address of Corresponding Author Dr. Shilpi Gupta, Reader, Department of Pedodontics and Preventive Dentistry, Hitkarini Dental College and Hospital, Hitkarini Hills, Dumna road Jabalpur, India E-mail: drshilpi17@gmail.com In most of cases children doesn’t reveal to parents out of fear. The finding of such foreign bodies in the teeth is a special situation, which is diagnosed by chance and may be associated with infection, pain,s welling and recurrent abscess as a sequelae to pulpal exposure. Clinical and radiographic examinations are a must to ascertain the presence, size, location and type of foreign object. This self- inflicting tendency is traumatizing with serious consequences at both individual and social levels. [2] The following case described a foreign object found in the root canal of an immature permanent tooth 21 with their management is presented here. CASE REPORT A 13-year-old male reported to the Department of Pedodontics and Preventive Dentistry, Hitkarini Dental College and Hospital, Jabalpur with chief complaint of pain and swelling in an upper front tooth region since 1 week [Figure-1]. A detail history elicited from the patient was that he had suffered dental trauma 4½ years back. Patient presented with paroxysmal episodes of pain, swelling and pus discharge since 2 years for which he had visited local physician who prescribed him medication. Intra-oral examination revealed Elli’s class-IV fracture with an exposed pulp chamber of tooth 21 [Figure-2]. Both 11, 21 teeth were discoloured and non vital. The tooth exhibited the following clinical features: • Grade I mobility • Tenderness in the buccal sulcus • Pain on percussion • Draining sinus on attached gingiva