Management of Teeth with Necrotic Pulps and Open Apices

Shabahang, Shahrokh; Witherspoon, David E.

doi:10.1002/9781118892435.ch5

Cited by 5 publications

(5 citation statements)

References 130 publications

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“…MTA is a bioactive material developed in the early 1990s, initially a retrograde filling material, that first appeared in the dental scientific literature in 1993 [ 3 ]. Recently, MTA has been used to seal exposed pulp tissue and the root canal system from surrounding tissues for various applications, such as root-end filling, perforation repair, and apexification [ 4 , 5 ]. MTA comprises a modified preparation of 70 wt % of Portland cement, the basic ingredient of concrete and mortar; 20 wt % of bismuth oxides for radiopacity; and 5 wt % of gypsum [ 6 , 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Mineral Trioxide Aggregate (MTA) Upregulates the Expression of DMP1 in Direct Pulp Capping in the Rat Molar

et al. 2021

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Mineral trioxide aggregate (MTA) is an alternative endodontic material that predicts conductive or inductive calcified tissue formation from immature pulp mesenchymal stem cells (IPMSCs). The purpose of this study was to investigate whether MTA could promote reparative odontoblast differentiation via IPMSCs in the early phase of regeneration and compare with calcium hydroxide (CH). Direct pulp capping using calcium hydroxide (CH), MTA, and MTA with platelet-rich plasma (MTA + PRP) was performed on maxillary first molars of 8-week-old male Wistar rats (n = 36). After 3, 7, or 14 days, the teeth were analyzed for mineral density (MD) and volume of MD (VMD) via micro-focusing computed tomography (µCT), nestin, dentin matrix acidic phosphoprotein 1 (DMP1) immunohistochemistry, and real-time PCR for DMP1 mRNA expression. MTA stimulated the early phase differentiation of the IPMSCs into odontoblasts, with positive results for nestin and DMP1 compared with CH. Moreover, MTA + PRP stimulated calcified granule and dentin bridge formation through calcium mineral deposition, following the induction of DMP1 mRNA expression in IPMSCs. Our results suggested that the combination of MTA and PRP is an effective and clinically applicable method for activating endogenous dental pulp stem cells into odontoblasts in the early stages of pulp regeneration.

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Section: Introductionmentioning

confidence: 99%

Mineral Trioxide Aggregate (MTA) Upregulates the Expression of DMP1 in Direct Pulp Capping in the Rat Molar

et al. 2021

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“…Because of its outstanding biocompatibility, ability to set in the presence of blood, and possibility to restore teeth in one to two visits without changing the mechanical properties of dentine, as seen with calcium hydroxide, the first choice of material suitable for single-visit apexification is MTA. 10 In a study done by Simon S et al, apexification treatment with MTA showed a high prevalence of healing and apical closure. 11 Reviewing the above factors, single-step apexification was carried out using MTA in this case and the tooth was then restored with a fiber post and crown to re-establish the function and esthetic demands.…”

Section: Discussionmentioning

confidence: 97%

Management of an Ellis Class IV fracture with open apex using MTA -A case report

Narainia

2023

IJCE

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Management of immature necrotic permanent teeth imposes a challenge to the clinician as they cannot be managed with routine endodontic treatment. To treat such a tooth; thorough disinfection of the root canal system followed by an apical barrier to obturate the canal is required. This case report demonstrates management of an anterior necrotic tooth with an open apex using Mineral Trioxide Aggregate (MTA) for apexification. The tooth was thoroughly disinfected using antimicrobial irrigants. Calcium hydroxide dressing was given for a period of 1 week followed by an apical plug of 4-5 mm of MTA. A fiber post and composite core were given to finally restore the tooth with a full coverage crown. The positive clinical outcome of the case supports the use of MTA apexification for the management of open apex.

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“…While some studies suggest that longer setting times might result in increased material strength and reduced solubility, prolonging the setting time for pulp capping materials may have negative consequences, such as increased chair time, patient discomfort, and higher risks of material displacement or contamination before the material has fully set [5,[39][40][41][42][43]. Notably, the chair time is an important factor for children undergoing dental treatment owing to their specific characteristics, such as shorter attention spans and a tendency to become anxious or restless.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Setting Time, Solubility, and Compressive Strength of Four Calcium Silicate-Based Cements

Jang¹,

Kim²,

Lee³

et al. 2023

J Korean Acad Pediatr Dent

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This study aimed to compare the physical properties of 4 kinds of calcium silicatebased cements (CSCs): 2 kinds of powder-liquid mix type (RetroMTA® [RTMX] and Endocem® MTA Zr [EZMX]) and 2 kinds of premixed type (Well-Root™PT [WRPR] and Endocem® MTA premixed [ECPR]) CSCs, respectively. Further, we assessed the setting times, solubility values, and compressive strengths of the cements. The shortest setting time was observed for EZMX (123.33 ± 5.77 seconds), followed by RTMX (146.67 ± 5.77 seconds), ECPR (260.00 ± 17.32 seconds), and WRPR (460.00 ± 17.32 seconds), respectively. The highest solubility was observed for WRPR (9.01 ± 0.55%), followed by RTMX (2.17 ± 0.07%), EZMX (0.55 ± 0.03%), and ECPR (0.17 ± 0.03%). Furthermore, the highest compressive strength was observed for ECPR (76.67 ± 25.67 Mpa), followed by WRPR (38.39 ± 7.25 Mpa), RTMX (35.07 ± 5.34 Mpa), and EZMX (4.07 ± 0.60 Mpa). In conclusion, the premixed type CSCs (WRPR and ECPR) exhibited longer setting times compared to the powder-liquid mix type CSCs (EZMX and RTMX). The solubility test showed that ECPR had the lowest solubility while WRPR had the highest solubility, with a statistically significant difference between them (p < 0.0083). Additionally, the compressive strength test showed that ECPR had the highest compressive strength, while EZMX had the lowest compressive strength, also with a statistically significant difference between them (p < 0.0083). ECPR is a promising material as it is premixed, eliminating the need for mixing time, and it has also demonstrated improved solubility and compressive strength, making it a potentially favorable option for clinical use.

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Management of Teeth with Necrotic Pulps and Open Apices

Cited by 5 publications

References 130 publications

Mineral Trioxide Aggregate (MTA) Upregulates the Expression of DMP1 in Direct Pulp Capping in the Rat Molar

Mineral Trioxide Aggregate (MTA) Upregulates the Expression of DMP1 in Direct Pulp Capping in the Rat Molar

Management of an Ellis Class IV fracture with open apex using MTA -A case report

Evaluation of Setting Time, Solubility, and Compressive Strength of Four Calcium Silicate-Based Cements

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