Mineral trioxide aggregate apical plug and biodynamic intraradicular restoration for rehabilitation of fractured anterior central incisor with open apex: A case report with 1-year follow-up

Abstract

Restoration of teeth with the extensive loss of coronal structure requires post and core for its rehabilitation. In this context, Biological post prepared from natural tooth offers a feasible and promising treatment option to restore the tooth with a “biologic restoration”. Properties of biologic post similar to dentin make it a good alternative in comparison to conventional post systems. Along with post and core if teeth have open apices, it needs a more rationalized approach. It becomes necessary to create an apical barrier for root canal filling. For this purpose, MTA has gained enough popularity thanks to its biomimetic properties and good sealing ability. This case report discusses the successful management of fractured anterior teeth having an open apex. Treatment was done under three phases- Formation of apical barrier with MTA apical plug causing root formation, followed by thermoplasticised obturation and final rehabilitation with the placement of biological dentin post. Freshly extracted maxillary canine was trimmed and shaped to form biological post. This customized biological post was sterilized and cemented. One year of follow up showed successful structural functioning, performance and esthetics of the tooth along with apical root formation.