Abstract
Traditionally, immature teeth diagnosed with necrotic pulp and periapical periodontitis were treated by apexification with long-term calcium hydroxide or in one session with mineral trioxide aggregate (MTA) or Biodentine apical plug. However, these teeth become fragile and susceptible to root fracture. Regenerative endodontic procedure is a new therapeutic approach that promotes continuation of root growth in immature necrotic teeth potentially preventing root fracture. Only few case reports have shown the success of this procedure on molar cases. The current case report demonstrates a regeneration of a lower first molar with necrotic pulp and chronic apical abscess treated with Micro Mega-MTA (MM-MTA), a new endodontic biomaterial that has not been described previously. Calcium hydroxide was used as an intracanal medicament for two weeks. Next, calcium hydroxide was removed and after blood clot creation, MM-MTA® was placed over it. Apical healing and continuation of root growth were evident at nine months follow-up. CBCT at two years follow-up confirmed apical closure and complete healing. This case shows that a regenerative endodontic procedure for management of an immature necrotic permanent molar is feasible and can be successfully done using Ca(OH)2 and MM-MTA.
Highlights
Treatment of immature necrotic teeth is clinically challenging
Treatment options include apexification procedures using of calcium hydroxide (Ca(OH)2 ) to induce formation of a calcific barrier at the apex or placement of mineral trioxide aggregate plug (MTA) [1,2,3,4]
ethylene diamine tetra-acidic acid (EDTA) allows the release of the growth factors from dentin
Summary
Treatment options include apexification procedures using of calcium hydroxide (Ca(OH)2 ) to induce formation of a calcific barrier at the apex or placement of mineral trioxide aggregate plug (MTA) [1,2,3,4] Both techniques achieve clinical success but do not allow further root development, leaving the tooth susceptible to fracture [4,5,6]. The use of MM-MTAreports a new endodontic biomaterial instead of MTA in molar teeth has not procedures with Ca(OH). The use of MM-MTA a new endodontic biomaterial instead of MTA in molar teeth has not This case report describes a successful regenerative endodontic therapy performed on an been previously reported. As an intracanal medication and MM-MTA® (Micro Mega, Besançon, CEDEX, France) for coronal sealing [20]
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