Apexification with mineral trioxide aggregate plug in the upper anterior teeth: Presentation of three clinical cases

Alejandro Iglesias-Linares,Asunción Mendoza-Mendoza,Beatriz Solano-Mendoza,Carolina Caleza-Jiménez,M Cruz Moreno-Hidalgo,Rosa Yañez-Vico

doi:10.5348/d01-2014-1-cs-1

Alejandro Iglesias-Linares, Asunción Mendoza-Mendoza + Show 4 more

Open Access

https://doi.org/10.5348/d01-2014-1-cs-1

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Abstract

Introduction: The aim is to describe the treatment of three immature permanent incisors associated to apical periodontitis, based on the placement of an apical mineral trioxide aggregate (MTA) plug for apexification. Case Series: Apexification was carried out by opening the pulp chamber, with debridement of the canal following anesthesia and isolation of the tooth. The canal was filled with pure calcium hydroxide in powder form, dissolved in saline solution for one week, and the aperture was sealed with IRM (Dentsply, Germany). One week later, the calcium hydroxide was removed and an MTA apical plug was positioned, sealing with a humid cotton pellet and IRM (Dentsply, Germany). After setting of the MTA, conventional endodontic treatment was carried out using gutta-percha, with definitive restoration of the tooth. Conclusion: All three cases, treated with MTA showed complete apical repair with rounding of the apex at radiographic control one year later, and the patients remained free of symptoms.

Highlights

The aim is to describe the treatment of three immature permanent incisors associated to apical periodontitis, based on the placement of an apical mineral trioxide aggregate (MTA) plug for apexification
In patients presenting a permanent tooth with an open apex and extensive pulp degeneration or necrosis, and with clinical and radiographic signs of periapical reaction, the dental pulp tissue must be eliminated, with disinfection of the root canal system and stimulation of the formation of an apical barrier to allow posterior filling with gutta-percha [1]
This study aims to describe a reliable and predictable alternative to conventional apexification with calcium hydroxide in permanent teeth with an open apex associated to apical periodontitis and arrested root development, based on the presentation of three clinical cases in which MTA was used as a novel material for apical plugging

Summary

Introduction

The aim is to describe the treatment of three immature permanent incisors associated to apical periodontitis, based on the placement of an apical mineral trioxide aggregate (MTA) plug for apexification. In patients presenting a permanent tooth with an open apex and extensive pulp degeneration or necrosis, and with clinical and radiographic signs of periapical reaction, the dental pulp tissue must be eliminated, with disinfection of the root canal system and stimulation of the formation of an apical barrier to allow posterior filling with gutta-percha [1]. Such treatment requires special care, since we will be dealing with a large root canal with thin and fragile walls, and a divergent apical architecture. This process is known as apexification [2]

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