Endodontic treatment of traumatized teeth with chronic periapical lesions using antibiotic paste and mineral trioxide aggregate obturation - a preliminary study

Introduction/Objective. The purpose of this study was to assess effectiveness of endodontic root canal procedures in traumatized permanent teeth with necrotic pulps and chronic periapical lesions after definitive obturation with mineral trioxide aggregate (MTA) products. Adobe Photoshop CS (San Jose, CA, USA) image-analysis software was used for healing assessment. Methods. Twenty-seven traumatized single-rooted permanent teeth diagnosed with necrotic pulps and chronic periapical lesions were treated with non-surgical procedure using a tri-antibiotic paste and calcium hydroxide as intra-canal medication. Definitive obturation was performed with ProRoot MTA (Dentsply Tulsa Dental Specialties, Tulsa, OK, USA) or MTA+ Cerkamed (Cerkamed, Stalowa Wola, Poland). Control follow-ups were done three, six, 12, and 24 months following the completion of treatment. Results. The positive clinical outcome was recorded in 24 (88.9%) cases, while radiographic success was present in 26 (96.3%) cases. A statistically significant decrease in the sizes of periapical lesions was consistently observed at follow-up periods (p < 0.001). There was no statistically significant difference between the two tested MTA materials (p > 0.05). Conclusion. The MTA products were effective for the root canal obturation and appeared to contribute to the significant reduction or complete regression of periapical lesions in teeth treated. The presented procedure may be proposed for everyday clinical practice.

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Clinical and Radiographic Evaluation of Mineral Trioxide Aggregate Pulpotomy in Permanent Teeth

Dental Journal of Advance Studies ◽

10.1055/s-0038-1672067 ◽

2016 ◽

Vol 04 (03) ◽

pp. 183-188

Author(s):

Neha Verma ◽

Avninder Kaur ◽

Shivesh Acharya ◽

Sunila Sharma

Keyword(s):

Root Canal ◽

Mineral Trioxide Aggregate ◽

Root Canal Treatment ◽

Permanent Teeth ◽

Radiographic Evaluation ◽

Future Research ◽

Standard Protocol ◽

Radiographic Outcome ◽

Irreversible Pulpitis

Abstract Aim and objective: The aim of the present study was to evaluate clinical and radiographic outcome of MTA as a pulpotomy agent in permanent teeth as an alternative to conventional root canal treatment. Materials and Methods: Ten permanent teeth with symptoms of irreversible pulpitis with vital pulp were selected for the study. MTAPulpotomy procedure was done in all the cases using standard protocol. Teeth were evaluated for various clinical and radiographic parameters at 3, 6, 9 and 12 months of follow up. Results: None of the patients reported any kind of clinical discomfort or radiographic abnormality during the follow up period of 3, 6, 9 and 12 months. All the teeth responded positive on electric pulp test at all successive follow ups. Conclusions: MTA Pulpotomy may be used as an alternative treatment modality to root canal treatment in permanent teeth with irreversible pulpitis, if future research continues to show promising results.

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Efficacy of Mineral Trioxide Aggregate as an Apical Plug in Non-Vital Young Permanent Teeth: Preliminary Results

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.35.2.9061h7g718834017 ◽

2010 ◽

Vol 35 (2) ◽

pp. 149-155 ◽

Cited By ~ 7

Author(s):

Sankar Annamalai ◽

Jayanthi Mungara

Keyword(s):

Root Growth ◽

Success Rate ◽

Root Canal ◽

Treatment Protocol ◽

Mineral Trioxide Aggregate ◽

Root Canal Treatment ◽

Permanent Teeth ◽

Preliminary Results ◽

Gutta Percha

Purpose: The purpose of this study was to evaluate the efficacy of Mineral trioxide aggregate (MTA) clinically and radiographically as material used to induce root end closure in nonvital permanent teeth with immature apices (apexification) in children. Methods: The study included 30 non vital young permanent,single rooted teeth of 22 children between 8 and 13 years of age. Treatment followed a standard non-surgical root canal treatment protocol and the root canal was filled with a apical plug of 4-5 mm of MTA (white MTA – Angelus, Brazil), followed by gutta-percha obturation. The children were reviewed for 1 year at 3 month interval and the teeth were assessed clinically and radiographically. Results: MTA showed success rate of 100% both clinically and radiographically at the 12th months follow up and root end closure was seen in 86.6% of cases and root growth in 30% of cases. Conclusions: MTA showed clinical and radiographic success as an apexification material by inducing root end closure and root growth in non-vital young permanent teeth.

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Use of Mineral Trioxide Aggregate in the Treatment of Large Periapical Lesions: Reports of Three Cases

European Journal of Dentistry ◽

10.1055/s-0039-1697867 ◽

2010 ◽

Vol 04 (04) ◽

pp. 468-474 ◽

Cited By ~ 8

Author(s):

Tahsin Yildirim ◽

Nimet Gencoglu

Keyword(s):

Case Report ◽

Root Canal ◽

Mineral Trioxide Aggregate ◽

Filling Material ◽

Periapical Lesion ◽

Canal System ◽

Periapical Lesions ◽

Root Canal System ◽

Root Apices

Pulpal and periradicular pathosis are the result of microbial, mechanical, or chemical invasion. Microorganisms are the main irritants of pulpal and periapical tissues. The goal of the obturation is to obtain a fluid-tight seal of the root canal system from its coronal aspect through its apical extent to preserve from the irritants.. Root apices have morphological irregularities in teeth with periapical lesions. Therefore, it is more difficult to produce hermetically apical stop with conventional guttapercha obturation techniques. This case report describes the treatment and six years follow-up of the teeth with large periapical lesion using MTA as apical filling material. (Eur J Dent 2010;4:468- 474)

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Partial pulpotomy without age restriction: a retrospective assessment of permanent teeth with carious pulp exposure

Clinical Oral Investigations ◽

10.1007/s00784-021-04007-2 ◽

2021 ◽

Author(s):

Florin Eggmann ◽

Thomas J. W. Gasser ◽

Hanjo Hecker ◽

Mauro Amato ◽

Roland Weiger ◽

...

Keyword(s):

Survival Rates ◽

Age Groups ◽

Permanent Teeth ◽

Eligibility Criteria ◽

Presumptive Diagnosis ◽

Tooth Discoloration ◽

Significant Difference ◽

Pulp Exposure ◽

The Mean

Abstract Objectives This study aimed to retrospectively evaluate clinical and radiographic outcomes of partial pulpotomy performed in permanent teeth with carious pulp exposure. Materials and methods Records of patients undergoing treatment at an undergraduate dental clinic between 2010 and 2019 were screened for partial pulpotomies in teeth with a presumptive diagnosis of normal pulp or reversible pulpitis. The follow-up had to be ≥ 1 year. Patient data were retrieved and analyzed using Mantel-Cox chi square tests and Kaplan–Meier statistics. The level of significance was set at α = 0.05. Results Partial pulpotomy was performed in 111 cases, of which 64 (58%) fulfilled the eligibility criteria. At the time of partial pulpotomy, the mean age was 37.3 (± 13.5) years (age range 18–85). The mean observation period was 3.1 (± 2.0) years. Two early failures (3.1%) and five late failures (7.7%) were recorded. The overall success rate of maintaining pulp vitality was 89.1%, with 98.4% tooth survival. The cumulative pulp survival rates of partial pulpotomy in patients aged < 30 years, between 30 and 40 years, and > 40 years were 100%, 75.5%, and 90.5%, respectively, with no significant difference between the age groups (p = 0.225). At follow-up, narrowing of the pulp canal space and tooth discoloration were observed in 10.9% and 3.1% of cases, respectively. Conclusions Across age groups, partial pulpotomy achieved favorable short and medium-term outcomes in teeth with carious pulp exposure. Clinical relevance Adequate case selection provided, partial pulpotomy is a viable operative approach to treat permanent teeth with deep carious lesions irrespective of patients’ age.

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An in Vivo Comparison of Antimicrobial Efficacy of Sodium Hypochlorite and Biopure MTAD™ against Enterococcus Faecalis in Primary Teeth: A qPCR Study

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.39.1.c4q2155r16817219 ◽

2014 ◽

Vol 39 (1) ◽

pp. 30-34 ◽

Cited By ~ 3

Author(s):

SG Tulsani ◽

N Chikkanarasaiah ◽

S Bethur

Keyword(s):

Root Canal ◽

Primary Teeth ◽

Antimicrobial Efficacy ◽

Permanent Teeth ◽

Control Group ◽

Statistical Significant Difference ◽

Anterior Teeth ◽

Significant Difference ◽

Root Canal Irrigant

Objectives: Biopure MTAD™, a new root canal irrigant has shown promising results against the most common resistant microorganism, E. faecalis, in permanent teeth. However, there is lack of studies comparing its antimicrobial effectiveness with NaOCl in primary teeth. The purpose of this study was to compare the in vivo antimicrobial efficacy of NaOCl 2.5% and Biopure MTAD™ against E. faecalis in primary teeth. Study design: Forty non vital single rooted primary maxillary anterior teeth of children aged 4-8 years, were irrigated either with NaOCl 2.5% (n=15), Biopure MTAD™ (n=15) and 0.9% Saline (n=10, control group). Paper point samples were collected at baseline (S1) and after chemomechanical preparation (S2) during the pulpectomy procedure. The presence of E. faecalis in S1 & S2 was evaluated using Real time Polymerase Chain Reaction. Results: Statistical significant difference was found in the antimicrobial efficacy of NaOCl 2.5 % and BioPure MTAD™ when compared to saline (p>0.05). However, no statistical significant difference was found between the efficacies of both the irrigants. Conclusions: NaOCl 2.5% and BioPure MTAD™, both irrigants are equally efficient against E. faecalis in necrotic primary anterior teeth. MTAD is a promising irrigant, however clinical studies are required to establish it as ideal root canal irrigant in clinical practice.

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Prospective cohort study of regenerative potential of non vital immature permanent maxillary central incisors using platelet rich fibrin scaffold

Scientific Reports ◽

10.1038/s41598-021-93236-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Selvakumar Kritika ◽

V. Sujatha ◽

N. Srinivasan ◽

Senthil Kumar Renganathan ◽

Sekar Mahalaxmi

Keyword(s):

Gradual Increase ◽

Mineral Trioxide Aggregate ◽

Permanent Teeth ◽

Bonferroni Correction ◽

Platelet Rich Fibrin ◽

Triple Antibiotic Paste ◽

Fibrin Scaffold ◽

The Mean ◽

Post Hoc

AbstractRegenerative endodontic procedures have gained momentum as a treatment modality of young immature permanent teeth. Literature reports reveal that platelet-rich fibrin (PRF) stimulates growth factors and induces regeneration. This study was undertaken to assess the regenerative potential of non-vital immature permanent maxillary central incisors using PRF with a follow-up for 2 yrs. 19 patients in the age group of 9–25 yrs with immature, non-vital permanent maxillary central incisors (n = 23) with/without signs and/or symptoms of periapical pathosis and open apex were included in this study. In the first appointment, access opening, canal disinfection and triple antibiotic paste placement were done. In the subsequent visit, PRF was prepared and placed inside the canal. Access was sealed with Mineral trioxide aggregate plug and composite. The patient was reviewed up to 24 mths. The mean difference was statistically analyzed using Friedman test followed by Dunn post hoc test and adjusted by Bonferroni correction (p < 0.05). As per AAE guidelines, the primary and secondary goals were achieved. A significant (p < 0.001) gradual increase in the root length, thickness of dentinal walls and decrease in apical diameter were observed. Within the limitations of this study, PRF placement was clinically and radiographically effective in inducing regeneration of non-vital immature permanent teeth.

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Radicular Perforation Repair with Mineral Trioxide Aggregate: A Case Report with 10-Year Follow-up

The Open Dentistry Journal ◽

10.2174/1874210601610010733 ◽

2016 ◽

Vol 10 (1) ◽

pp. 733-738 ◽

Cited By ~ 3

Author(s):

Leopoldo Cosme-Silva ◽

Breno Carnevalli ◽

Vivien Thiemy Sakai ◽

Naiana Viana Viola ◽

Leon Franco de Carvalho ◽

...

Keyword(s):

Case Report ◽

Root Canal ◽

Mineral Trioxide Aggregate ◽

Radiographic Examination ◽

Root Canal Filling ◽

Second Molar ◽

Iatrogenic Perforation ◽

Iatrogenic Complications ◽

Root Canal Retreatment

Background: Iatrogenic complications such as accidental perforation of the root or the floor of the pulp chamber may occur. Case Report: Patient was referred for root canal retreatment of the mandibular left second molar with periapical lesion evidenced through radiographic examination. During post removal, iatrogenic perforation occurred at the mesial face of the distal root. After clinical localization of the perforation and bleeding control, MTA was applied. In a second appointment, the root canal filling was removed and the chemical-surgical retreatment of the canals was performed, followed by the obturation with gutta-percha and sealer. Patient returned after three days reporting no pain. After 6 months, 3, 7 and 10 years of follow-up. Conclusion: Absence of pain, normal periodontal probing and lack of radiolucent area at the region of perforation and the periapices were detected, which evidenced the successful repair of the tooth.

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Revascularization versus apical barrier technique with mineral trioxide aggregate plug: A systematic review

Giornale Italiano di Endodonzia ◽

10.4081/j.gien.2018.10 ◽

2018 ◽

Vol 32 (1) ◽

pp. 9-16 ◽

Cited By ~ 3

Author(s):

Luiz Alexandre Chisini ◽

Guillermo Grazioli ◽

Alejandro Francia ◽

Alissa Schmidt San Martin ◽

Flavio Fernando Demarco ◽

...

Keyword(s):

Clinical Success ◽

Mineral Trioxide Aggregate ◽

Clinical Success Rate ◽

Permanent Teeth ◽

Radiographic Outcomes ◽

Bias Risk ◽

Radiographic Measurements ◽

High Bias ◽

The Mean

Aim: To compare the clinical and radiographic outcomes observed in Necrotic Immature Permanent Teeth (NIPT) after revascularization or apexification with MTA-apical plug. Methodology: PubMed/MEDLINE, Web of science and Scopus were the databases used, up to July 30th, 2017, for article research. Independent reviewers read the titles and abstracts of all reports that met inclusion/exclusion criteria: prospective or retrospective clinical studies comparing the revascularization of root canal and apexification. Clinical success of therapies, deposition and thickening of lateral dentinal walls (root width) and the continuation of root development (root length) were investigated. Bias risk of included studies was assessed using the Cochrane risk of bias. Results: From 1642 records, five papers fulfilled all inclusion criteria. Overall, 91 teeth were submitted to revascularization and 64 teeth to apexification with MTA. The mean follow-up was 23.2 months in revascularization and 21.8 in apexification. Clinical success rate was of 87.9% in the revascularization group and 90.6% in the apexification group. An increase on lateral dentinal walls thickening was observed in most revascularization cases (13%) while MTA as apical plug suggest a mild resorption of the root (1.3%). High bias risk was observed on included studies. Conclusions: Apexification with MTA-apical plug provides similar clinical success to revascularization. However, radiographic measurements showed an improvement in thickening of lateral dentinal walls in most of the revascularization cases in addition to a higher dental development. However, these results should be interpreted with caution.

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Comparison of Medicaments Used in Regenerative Endodontics in Terms of Dentin Microhardness and Adhesion of Mineral in Terms of Dentin Microhardness and Adhesion of Mineral Trioxide Aggregate Trioxide Aggregat

Journal of Dentistry Indonesia ◽

10.14693/jdi.v27i3.1127 ◽

2020 ◽

Vol 27 (3) ◽

Author(s):

Esma Saricam ◽

◽

Neslihan Bulak ◽

Esra Özyurt ◽

Suat Özcan ◽

...

Keyword(s):

Bond Strength ◽

Clavulanic Acid ◽

Root Canal ◽

Mineral Trioxide Aggregate ◽

Significance Level ◽

Regenerative Endodontics ◽

Significant Difference ◽

Amoxicillin Clavulanic Acid ◽

Root Canal Dentin ◽

Push Out

Eliminating microorganisms in the root canal system is important for the success of regenerative endodontics. Objective: This study evaluated the effects of different antibiotic pastes used for regenerative endodontic procedures on dentin microhardness and the push-out bond strength of mineral trioxide aggregate (MTA) to root canal dentin. Methods: Sixty-four maxillary central incisors were instrumented and randomly divided into the following four groups (n = 16) for medicament treatment: triple antibiotic paste, amoxicillin+clavulanic acid, cefaclor, and control (no dressing). After 21 days, two root segments were obtained by sectioning the roots horizontally for push-out and microhardness evaluations. MTA was placed into the root canal of the sectioned segment for the push-out test. In the microhardness evaluation, three indentations were made at 500 and 1,000 μm from the canal lumen. The arithmetic mean was then calculated for each distance. ANOVA with post hoc Scheffe test and t test were used for the statistical analyses. The significance level was set at p < 0.05. Results: No significant difference was found between the groups in terms of push-out bond strength (p > 0.05). Cefaclor and amoxicillin+clavulanic acid reduced the microhardness values of the dentin at 500 μm (p < 0.05) while cefaclor had the lowest value at 1,000 μm (p < 0.05). Conclusion: Cefaclor reduced the microhardness value more than the other medicaments did at a depth of 1,000 μm. The pastes provided similar adhesion of MTA.

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