Management of immature teeth with apical infections using mineral trioxide aggregate

Abstract

Traumatic injuries to the young permanent teeth lead to devitalization of the pulp with concomitant arrest in further development of the immature root of the involved tooth. Hermetic seal of the root canal system during obturation is not possible in such cases, due to the lack of an apical constriction. The traditional management technique in such cases has been apexification involving induction of a calcific barrier at the apex using calcium hydroxide, which in turn facilitates obturation of the root canal. However this becomes complicated when there is persistent infection leading to periapical changes. This case report describes the use of mineral trioxide aggregate (MTA) for management of a periapically compromised immature tooth.

Multidisciplinary Treatment Options of Tooth Avulsion Considering Different Therapy Concepts

“…To prevent resorption it is important to facilitate diffusion through the dentine by removing the smear layer in the root canal with EDTA irrigation and to put in Ledermix as an intermediate dressing twice for 7 days each time [ 19 , 20 ]. The root filling should be performed with a dental microscope to insert the MTA apically [ 21 - 23 ]. The backfill of the remaining root canal can be done with gutta-percha.…”

In Vitro Evaluation of the Effects of MTA, CEM and Biodentine on Apical Leakage in Open Apex Teeth

“…32,33 Literatürde açık apeksli immatür dişlerde apikal tıkaç olarak MTA'nın kullanılması-nın başarılı sonuçlar verdiğini gösteren birçok ça-lışma vardır. 1,7,34,35 Ancak son zamanlarda araş-tırmacılar, MTA'nın yüksek maliyeti, çalışma zamanının uzunluğu ve dişte renklenmeye neden olması gibi dezavantajlarından dolayı CEM ve trikalsiyum silikat içerikli "Biodentine" materyallerini tek seans apeksifikasyon çalışmalarında kullanmışlardır. 11,14,36 İn vitro koşullarda materyallerin apikal örtü-cülük özelliklerinin değerlendirmesinde elekrokimyasal analiz, radyoizotop yöntemi, kimyasal ajanların kullanımı, basınçlı hava kullanımı, bakteri sızıntı yöntemi ve boyama yöntemi gibi pek çok sızıntı testi kullanılmaktadır.…”

The Management of Crown Fracture of Immature Teeth by MTA and Calcium Hydroxide: Case Reports

“…The traditional, long-term radicular closure procedure applies calcium hydroxide, Ca(OH) 2 [15]. This technique was the mainstay for the management of immature apices for over half a decade [16]. Ca(OH) 2 is the most widely accepted material, due to its biological and antimicrobial properties, such as reparative dentin to bridge a pulp exposure, induction of hard tissue formation and ability to stimulate the formation of new bone, healing of large periradicular lesions and inhibition of root resorption [17][18][19].…”