Evaluation of Healing of Periapical Tissue in Permanent Incisors with Open Apices after Unintentional Extrusion of Mineral Trioxide Aggregate – a Retrospective Study

Roy, Sonali; Kumari, Archana; Chandra, Praveen; Agarwal, Radhika; Bankoti, Pinki; Ahmed, Farah

doi:10.4103/jpbs.jpbs_570_20

Cited by 4 publications

(9 citation statements)

References 11 publications

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“…In addition to being wet and dark, substances are easily removed from the apex foramen because of the open space, especially for slurries and substances with extensive setting times, such as calcium silicate-based cement and endodontic sealers. Although the apical extrusion of MTA has an unconsiderable effect on the healing process of periapical lesions, healing progress takes longer, and this outcome was not recommended by the authors of a previous study [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Platelet rich fibrin and MTA in the treatment of teeth with open apices

Pham,

Pham

et al. 2024

BMC Oral Health

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Background The present study aimed to evaluate the effectiveness of using platelet-rich fibrin (PRF) as the apical matrix for the placement of MTA in nonsurgical endodontic therapy for teeth with periapical lesions and open apices. Methods Twelve teeth from eleven patients with periapical periodontitis and open apices were enrolled in the study. Nonsurgical endodontic therapy was performed with the PRF used as an apical barrier and the MTA manipulated as an apical plug for further thermoplasticized gutta percha in the remaining part of the root canal. Clinical signs and periapical digital radiographs were recorded and analyzed to evaluate the curing progress after periodical follow-ups of 1, 3, and 6 months. The horizontal dimension of the periapical lesion was determined, and the changes in the dimensions were recorded each time. The Friedman test was used for statistical analysis, with P < .05 serving as the threshold for determining statistical significance. Results All patients had no clinical symptoms after the first month of treatment, with a significant reduction in the periapical lesion after periodical appointments. Conclusions PRF is an effective barrier when combined with MTA for the treatment of teeth with periapical periodontitis and open apices.

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Section: Introductionmentioning

confidence: 99%

Platelet rich fibrin and MTA in the treatment of teeth with open apices

Pham,

Pham

et al. 2024

BMC Oral Health

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“…In several reports, healing of the periapical lesion was observed in the presence of MTA extruded beyond the apex, and it was without significant problems for the patient, probably due to this material's biocompatibility. [20][21][22][23] Also, in several reports during follow-up, the absorption of extruded MTA has been seen simultaneously with the healing of the lesion. However, it is not a prerequisite for periapical lesion healing.…”

Section: Discussionmentioning

confidence: 94%

“…In this case, during the placement of the apical plug, some of the MTA was extruded from the apex, but in the follow‐ups, despite the presence of a large part of the extruded material, the patient was asymptomatic, and the periapical lesion was resolved. In several reports, healing of the periapical lesion was observed in the presence of MTA extruded beyond the apex, and it was without significant problems for the patient, probably due to this material's biocompatibility 20–23 . Also, in several reports during follow‐up, the absorption of extruded MTA has been seen simultaneously with the healing of the lesion.…”

Section: Discussionmentioning

confidence: 98%

Management and saving a traumatized poor prognosis maxillary central incisor for 18 years: A patient‐centered treatment

Aminsobhani,

HafeziMotlagh,

MahjourianQomi

2023

Clinical Case Reports

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Key clinical messageWith today's increasing desire to preserve natural teeth, managing teeth with a poor prognosis is a new challenge for clinicians. A dentist's attention to patient‐centered care is essential, which improves dental outcomes.AbstractNowadays, patients' interest in preserving their natural teeth has increased. In the patient‐centered care model, the clinician should consider the patient's preferences and values in the treatment plan. This strengthens the patient's responsibility toward his own body, resulting in more patient satisfaction and effective cooperation. Therefore, the skill of saving teeth with a poor prognosis, in which there was no other choice but to extract them, becomes essential in patients who want to preserve their natural teeth. This case report presents the successful 18‐year treatment and management of a maxillary central incisor of a 17‐year‐old male with a horizontal root fracture, who was incompletely treated in another medical center when the trauma occurred. The patient presented to us after 6 months. Due to the short length of the root, the patient underwent regenerative endodontic treatment first, but he did not attend follow‐ups. Finally, after 8 years, the patient returned with symptoms of infection and periapical radiolucency. The apical part of the root was resorbed during this time. Finally, it was decided to place an apical plug with MTA. MTA was extruded from the apical part of the root canal during the placement of the apical plug. In the 1‐, 2‐, 4‐, and 10‐year follow‐ups, the patient was completely asymptomatic, and the radiolucent periradicular lesion had healed. However, the extruded MTA was still present in the radiographic images without interfering with the healing process. Finally, the tooth has remained functional for 18 years.

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“…The environment is wet and invisible, and the material is easily extruded beyond the apex because of the large foramina, especially because of the instability and long setting time of the material, such as calcium silicate-based cement and root canal sealer. Although the extrusion of MTA had a nonsignificant effect on the healing of periapical lesions, healing may take a longer time, and this consequence is not supported by clinicians [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Platelet-rich fibrin as an apical barrier for MTA placement in the treatment of teeth with open apices: a pilot study

Pham,

Pham

et al. 2024

J Transl Med

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Objective The aim of the present pilot study was to assess the effectiveness of the platelet-rich fibrin (PRF) apical barrier for the placement of MTA for the treatment of teeth with periapical lesions and open apices. Methods A total of thirty teeth on twenty-eight patients with open apices and periapical periodontitis were enrolled and divided into two groups in the present pilot study. In the PRF group (fourteen teeth in thirteen patients), nonsurgical endodontic treatment was performed using PRF as an apical matrix, after which the apical plug of the MTA was created. For the non-PRF group (fourteen teeth in fourteen patients), nonsurgical endodontic therapy was performed using only the MTA for an apical plug with no further periapical intervention. Clinical findings and periapical digital radiographs were used for evaluating the healing progress after periodic follow-ups of 1, 3, 6, and 9 months. The horizontal dimension of the periapical lesion was gauged, and the changes in the dimensions were recorded each time. The Friedman test, Dunn-Bonferroni post hoc correction, and Mann-Whitney U test were used for statistical analysis, with P < 0.05 serving as the threshold for determining statistical significance. Results All patients in both groups in the present pilot study had no clinical symptoms after 1 month, with a significant reduction in the periapical lesion after periodic appointments. The lesion width of the PRF group was significantly smaller than that of the non-PRF group in the sixth and ninth month after treatment. Conclusions PRF is a promising apical barrier matrix when combined with MTA for the treatment of teeth with open apices and periapical periodontitis. Small number of study subjects and the short time of follow-up period limit the generalizability of these results. Trial registration TCTR, TCTR20221109006. Registered 09 November 2022 - Retrospectively registered, https://www.thaiclinicaltrials.org/show/TCTR20221109006.

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Evaluation of Healing of Periapical Tissue in Permanent Incisors with Open Apices after Unintentional Extrusion of Mineral Trioxide Aggregate – a Retrospective Study

Cited by 4 publications

References 11 publications

Platelet rich fibrin and MTA in the treatment of teeth with open apices

Platelet rich fibrin and MTA in the treatment of teeth with open apices

Management and saving a traumatized poor prognosis maxillary central incisor for 18 years: A patient‐centered treatment

Platelet-rich fibrin as an apical barrier for MTA placement in the treatment of teeth with open apices: a pilot study

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