Management of non-vital immature root canal of right maxillary central incisor with Metapex-MTA Coating: A Case Report
Brief background: A tooth with Blunderbuss canal and periapical lesion is difficult to treat by traditional root canal procedures. The dentinal wall surrounding the Blunderbuss canal is very thin, fragile and prone to fracture with a slight blow/ trauma. Therefore, a new strategy is required to treat such a case. Materials and Methods: Canal was cleaned and irrigated with 5.25% NaOCl and 0.2% Chlorhexidine. It was temporized with Ca (OH) 2 for one week to obtain canal disinfection. After one week, Ca(OH) 2 was removed from the canal with a sterilized file and rinsed out with the help of saline. A 2-3mm thick Metapex layer was placed at the apical region of 11, followed by an MTA layer, once the apical MTA layer obtained sufficient strength; the rest of the canal was filled with MTA. Discussion: This new treatment procedure not only closes the open root apices but also provides strength to the dentinal wall. Metapex –MTA combination provides advantages of both the materials; like calcium hydroxide of Metapex stimulates odontoblast of residual apical pulp and MTA stimulates cementoblast cells to bring about root apex closure. Summery & Conclusion: Two year follow-up & a positive clinical outcome of this case were encouraging for the use of Metapex-MTA coating as an apical plug. The rest of the canal was filled with MTA to strengthen and supports the thin dentinal wall for better compliance with the occlusal forces. Key Words: Blunderbuss canal, MTA, Metapex