MTA : Boon to Apexification

2013 ◽  
Vol 7 (2) ◽  
pp. 114-118
Author(s):  
H Kaur ◽  
S Chaudhary ◽  
P Tangde

ABSTRACT A significant problem associated with the endodontic treatment of necrotic teeth with open apices is achieving an acceptable seal in the apical area to allow compaction of root filling material. The procedure to create an apical barrier with a hard tissue at the root end is termed as Apexification. Calcium hydroxide is currently the most accepted material for the same. Because of the certain inadequacies associated with Calcium hydroxide Apexification, employing of an apical plug using MTA (Mineral Trioxide aggregate) has gained popularity in recent years. This article is thus an insight to the evolution and recent trends in Apexification.

2021 ◽  
Vol 9 (2) ◽  
pp. 84-87
Author(s):  
Priya Mendiratta ◽  
Pooja Srivastava ◽  
Bhavna Gupta

Management of immature non-vital teeth poses challenge for the clinician owing to the thin root canal walls and open apices which may show apical divergence. Apexification is the technique of inducing the apical closure with a root end filling material for non-vital immature young permanent teeth. Traditionally, Calcium hydroxide was the material of choice for apexification of immature permanent teeth but introduction of MTA has shown remarkable promise as an alternative to calcium hydroxide. This report presents a case of apexification of anterior two young permanent teeth with open apices using MTA and Gutta percha followed by esthetic build up using cast metal posts and full coverage restorations.


2013 ◽  
Vol 5 (2) ◽  
pp. 3-5
Author(s):  
R.S. Bassvanna ◽  
Chitra Gohil

ABSTRACT Management of non vital teeth with open apices isa challenge to the dental practitioners. In this clinical scenario, it is difficult to maintain the obturating material confine within the root canal without encroaching into periapical area. These kinds of cases cannot be managed by conventional endodontic treatment, and treatment of such cases with calcium hydroxide may take longer time for apical closure. But with this new material called BIODENTINE (Septodont) same treatment can be done in single visit with predictable result. Hence this case report present the use ofbiodentine to form an apical plug in open apex followed by complete root canal obturation using thermoplasticized guttapercha.


2020 ◽  
Vol 10 (2) ◽  
pp. 10-13
Author(s):  
Md Abdul Hannan Sheikh ◽  
Eyad Al Khalifa ◽  
Mozammal Hossain ◽  
Md Faruk Hossain ◽  
Nazneen Karim ◽  
...  

In this study, 120 teeth having periradicular pathosis were treated with single visit root canal treatment and then obturated with either calcium hydroxide containing sealer or mineral trioxide aggregate based sealer. The healing of periradicular pathosis was examined at 3, 6, and 12 months by clinical and radiological evaluation. Collected data were analyzed with standard statistical methods by using SPSS version- 20. The results showed that at 3 and 6 months, the differences between calcium hydroxide containing sealer or mineral trioxide aggregate based sealer were not statistically significant. However, the healing capability of periapical radiolucency at 12 months between two groups was statistically significant (P=0.03). The final outcome of the clinical and radiological investigation showed successful results of 96.6% and 98.1% in calcium hydroxide and mineral trioxide aggregate group, respectively. In conclusion, both calcium hydroxide and mineral trioxide aggregate based sealers are almost equally effective in single visit root canal therapy for the management of periradicular pathosis. Update Dent. Coll. j: 2020; 10 (2): 10-13


2012 ◽  
Vol 23 (5) ◽  
pp. 608-611
Author(s):  
Ronaldo Araújo Souza ◽  
Yara T. Corrêa Silva-Sousa ◽  
Suely Colombo ◽  
Maurício Lago ◽  
Marco Antonio Hungaro Duarte ◽  
...  

Besides the risk of filling material extrusion throughout the apex, a satisfactory apical seal can be difficult to achieve in canals with open apices or iatrogenic enlargements of the apical constriction. These situations pose a challenge to root canal filling. This paper describes the root canal filling of a maxillary right canine with an overinstrumented apex, complete loss of the apical stop, extensive canal transportation and apical periodontitis. A 5 mm calcium hydroxide apical plug was placed before root canal filling. The plug was made by soaking paper points with saline, dipping the points in calcium hydroxide powder and then applying it to the apex several times, until a consistent apical plug was obtained. The canal was then irrigated with saline in order to remove any residual calcium hydroxide from the root canal walls, dried with paper points and obturated with an inverted #80 gutta-percha cone and zinc oxide-eugenol based sealer by the lateral condensation technique. An 8-year radiographic follow-up showed formation of mineralized tissue sealing the apical foramen, apical remodeling and no signs of apical periodontitis.


2014 ◽  
Vol 3 (2) ◽  
pp. 13-19
Author(s):  
Tasnim Wakia ◽  
Mohammad Aminul Islam ◽  
Mohammad Naser ◽  
Md Shamsul Alam ◽  
Md Ismail Hossain

Objective: To evaluate the clinical and radiological outcome of MTA in nonvital teeth with open apices. Methods: Twenty-five non-vital teeth with open apices were treated with MTA apexification procedure. Standard endodontic procedures were followed and an apical plug of at least 5 mm was created by using MTA after a calcium hydroxide intra-canal dressing for at least 1 week. Final obturation was done after 24 hours by vertical compaction technique using gutta percha. Patients were recalled at 3, 6, 9 and 12 months interval. Clinical outcome was evaluated by assessing pain, tenderness, mobility and sinus tract. Blind to the treatment record, two examiners assessed the pre-treatment and post-treatment radiographs. Each radiograph was scored with the Periapical Index (PAI) and the size of the apical lesion was measured. The presence of an apical bridge over MTA was also noted. Results: Clinically 92% success rate was found whereas radiologically absolute success rate was 84%. Before treatment the mean PAI was 3.6 and mean size of the lesion was 3.24 mm. But, after 12 months follow up, the mean PAI was 1.36 and the mean lesion size was 0.68 mm. An apical barrier over MTA was distinguishable in 5 cases. Conclusion: Apexification using MTA can be considered as a predictable treatment option than calcium hydroxide apexification. DOI: http://dx.doi.org/10.3329/updcj.v3i2.17994 Update Dent. Coll. j: 2013; 3 (2): 13-19


2009 ◽  
Vol 2009 ◽  
pp. 1-12 ◽  
Author(s):  
Takashi Okiji ◽  
Kunihiko Yoshiba

This paper aims to review the biological and physicochemical properties of mineral trioxide aggregate (MTA) with respect to its ability to induce reparative dentinogenesis, which involves complex cellular and molecular events leading to hard-tissue repair by newly differentiated odontoblast-like cells. Compared with that of calcium hydroxide-based materials, MTA is more efficient at inducing reparative dentinogenesis in vivo. The available literature suggests that the action of MTA is attributable to the natural wound healing process of exposed pulps, although MTA can stimulate hard-tissue-forming cells to induce matrix formation and mineralization in vitro. Physicochemical analyses have revealed that MTA not only acts as a “calcium hydroxide-releasing” material, but also interacts with phosphate-containing fluids to form apatite precipitates. MTA also shows better sealing ability and structural stability, but less potent antimicrobial activity compared with that of calcium hydroxide. The clinical outcome of direct pulp capping and pulpotomy with MTA appears quite favorable, although the number of controled prospective studies is still limited. Attempts are being conducted to improve the properties of MTA by the addition of setting accelerators and the development of new calcium silicate-based materials.


Author(s):  
Dr. Aseem Jolly Garg ◽  

Trauma to the dentition during the period of root formation may cause incomplete development of root resulting in open apex. In order to eliminate infection from root canal endodontic treatment is a tooth-saving treatment modality. The absence of a natural apical constriction in a nonvital permanent tooth makes endodontic treatment a challenge. Therefore, it is necessary to induce or create an apical barrier against, which the obturating material can be condensed. Traditionally, calcium hydroxide is considered as the gold standard to induce apexification. Due to certain drawbacks such as very long treatment period, possibility of tooth fracture, and incomplete apical barrier formation, it is being replaced by materials, which have a more predictable outcome like mineral trioxide aggregate (MTA). One-step apexification with MTA reduces the treatment time when compared with traditional calcium hydroxide apexification, which requires an average time of 12–19 months. Also, MTA has various other superior properties compared to calcium hydroxide that are discussed below in detail along with successful treatment of an immature permanent tooth with open apex wherein MTA was used for one-step apexification.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Khoa Van Pham ◽  
Thu Anh Tran

Abstract Background The present study aims to evaluate the effectiveness of mineral trioxide aggregate (MTA) application in treating dens evaginatus affected teeth with apical lesions and open apices using haemostatic collagen membrane to prevent the apical extrusion of MTA. Methods Twelve patients with 14 dens evaginatus affected teeth with apical lesions and open apices were treated with MTA apical plug and haemostatic collagen membrane. Clinical symptoms of subjective pain, pain of palpation, percussion, sinus tract, and the apical lesions' radiographic parameter were recorded at every 3-month interval up to 9 months after treatment. Paired t-test or Wilcoxon signed-rank test was used for statistical analysis with P < 0.05 as the threshold for considering results to be statistically significant. Results No patient experienced clinical symptoms 3 months after endodontic treatment. In addition, there was a significant difference in the dimensions of the apical lesions' before compared to 3 months after endodontic treatment. Conclusions The combination of MTA apical plug and haemostatic collagen membrane effectively treated dens evaginatus affected teeth with apical lesions, and open apices.


2021 ◽  
pp. 68-71
Author(s):  
Jaziya Z ◽  
Suchithra M S ◽  
Rita Zarina A ◽  
Fathima. S

Pulpal necrosis in permanent teeth with immature roots leads to development of roots which are very short, thin walled and an inadequate crown-root ratio, which overshadows their survival prognosis. Traditionally, the apexication procedure has consisted of multiple and long-term applications of calcium hydroxide to create an apical barrier to aid the obturation. Recently, articial apical barriers such as those made with mineral trioxide aggregate (MTA) have been used in teeth with necrotic pulps and open apices. More recently, procedures referred to as regenerative endodontics have received much attention as an option for these teeth. This paper reviews the past, present and recent concepts used for apexication.


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