Treatment of open apex teeth using two types of white mineral trioxide aggregate after initial dressing with calcium hydroxide in children

Abstract

The clinical and radiographic success of two types of white mineral trioxide aggregate (MTA) as apical barriers in non-vital immature permanent incisors in children was investigated. Following an initial dressing with calcium hydroxide, MTA apical barriers were placed in 22 non-vital traumatized, permanent incisors with open apices in 21 children (mean age 10years). Teeth were alternately assigned to either white MTA ProRoot(®) or white MTA Angelus groups and treated by two operators. Clinical and radiographic reviews took place at baseline, 3 months and every 6months thereafter. Two other calibrated, blinded examiners evaluated all radiographs. Examiner agreement was assessed using Kappa-Cohen tests. Results were analysed using Fisher's exact tests and repeated measures anova. The mean follow-up time was 23.4months. There were no statistically significant differences in clinical or radiographic outcomes between the two groups. The overall clinical success and relative radiographic success rate was 95.5%. Statistically significant reduction in periapical pathosis was shown over time in both groups (P<0.05). A significant relationship was identified between non-divergent apical anatomy and ideal positioning of the MTA plug in all teeth (P=0.04). Interestingly, coronal discolouration was observed in 22.7% of teeth following white MTA placement. Apical barrier placement using both white MTA ProRoot(®) and white MTA Angelus after an initial calcium hydroxide dressing showed similar favourable clinical and radiographic outcomes.