Management of Non-Vital Teeth with Open Apices using MTA as an Apical Plug: Two Case Reports

ABSTRACT Management of non-vital teeth with open apices is a challenge to dental practitioners. In this clinical scenario, it is difficult to maintain the obturation material within the confines of root canal without encroaching into periapical area. Also, thin dentinal walls of canal is a matter of concern. These cases cannot be managed by conventional endodontic treatment and need customized treatment plan. Treatment of such teeth with calcium hydroxide may demand long time and patient compliance. But with MTA same treatment can be done in reasonably less time with predictable results. Hence, these two case reports present the use of MTA to form an apical plug in open apex followed by complete root canal obturation using thermoplasticized gutta-percha under operating microscope.

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APEXIFICATION WITH BIODENTINE - A CASE REPORT

CODS Journal of Dentistry ◽

10.5005/cods-5-2-3 ◽

2013 ◽

Vol 5 (2) ◽

pp. 3-5

Author(s):

R.S. Bassvanna ◽

Chitra Gohil

Keyword(s):

Case Report ◽

Calcium Hydroxide ◽

Root Canal ◽

Endodontic Treatment ◽

Clinical Scenario ◽

Root Canal Obturation ◽

Single Visit ◽

Dental Practitioners ◽

New Material ◽

Open Apices

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.

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Healing of a tooth with an overinstrumented apex, extensive transportation and periapical lesion using a 5 mm calcium hydroxide apical plug: an 8-year follow-up report

Brazilian Dental Journal ◽

10.1590/s0103-64402012000500024 ◽

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 ◽

...

Keyword(s):

Calcium Hydroxide ◽

Root Canal ◽

Apical Periodontitis ◽

Filling Material ◽

Root Canal Filling ◽

Apical Constriction ◽

Gutta Percha ◽

Open Apices ◽

Canal Transportation

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.

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Mineral trioxide aggregate for apexification in non-vital teeth with open apices: A case report

Journal of Dental Specialities ◽

10.18231/j.jds.2021.021 ◽

2021 ◽

Vol 9 (2) ◽

pp. 84-87

Author(s):

Priya Mendiratta ◽

Pooja Srivastava ◽

Bhavna Gupta

Keyword(s):

Case Report ◽

Calcium Hydroxide ◽

Root Canal ◽

Mineral Trioxide Aggregate ◽

Permanent Teeth ◽

Filling Material ◽

Cast Metal ◽

Full Coverage ◽

Gutta Percha ◽

Open Apices

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.

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Management of a non-vital immature tooth using MTA as an apical plug: Two case reports

Journal of Chitwan Medical College ◽

10.3126/jcmc.v5i1.12574 ◽

2015 ◽

Vol 5 (1) ◽

pp. 41-46

Author(s):

S Wagle ◽

N Joshi ◽

K Prajapati

Keyword(s):

Root Canal ◽

Case Reports ◽

Mineral Trioxide Aggregate ◽

Canal System ◽

Immature Teeth ◽

Open Apices ◽

Root Canal System

MTA appears to be a valid option for apexification with its main advantage being, the speed at which the treatment can be completed. A major problem in performing endodontics in immature teeth with necrotic pulp and wide open apices is obtaining an optimal seal of the root-canal system. Mineral Trioxide Aggregate (MTA), has been proposed as a potential material to create an apical plug at the end of the root-canal system, thus preventing the extrusion of filling materials.DOI: http://dx.doi.org/10.3126/jcmc.v5i1.12574

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Root Development of Permanent Incisors and Mandibular Molars in Correlation with Treatment Plan

Folia Medica ◽

10.1515/folmed-2017-0093 ◽

2018 ◽

Vol 60 (2) ◽

pp. 283-290

Author(s):

Yordan Tarpomanov ◽

Sevda Rimalovska ◽

Ani Belcheva ◽

Miroslava Yordanova ◽

Svetla Yordanova ◽

...

Keyword(s):

Root Development ◽

Treatment Plan ◽

X Rays ◽

Proper Treatment ◽

Treatment Protocols ◽

Mandibular Molars ◽

Dental Practitioners ◽

Open Apices ◽

And Function ◽

Demirjian’S Method

Abstract Background: The incisors and molars play a major role in the formation and function of permanent dentition. Much research has been devoted to investigating the eruption of teeth and their root development. Aim: To study the root development of permanent incisors and mandibular molars in correlation with treatment plan and proper treatment protocols. Materials and methods: The Demirjian’s method was used to assess the root development of incisors and mandibular molars in children between 7 and 12 years old. Results: In 7-year-old children most of the lower first mandibular molars (76%) had complete root length, but open apices. Eighty-two percent of the roots of the first mandibular molars of the 8-year-old children and 54% of these molars of the 9-year-old children were with open apices. The first mandibular molars had incomplete roots in the 10-year-olds (6%) and even in the 11-year-old children (4%). We detected Stage E in 32% of the 10-year-olds and in 24% of the 11-year-old children. Even in 12-year-old children we found Stage E in 4% of them from their panoramic X-rays. We detected complete root development in all of the children at the age of 12. Conclusions: Dental practitioners have to wait until the age of 10, 11 and even 12 to extract the first molars, when the furcation is formed. Proper clinical examination and diagnostic radiographs should be done before the beginning of the treatment of molars and incisors at the age between 7 and 12.

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Staining Potential of Calcium Hydroxide and Monochlorophenol Following Removal of AH26 Root Canal Sealer

The Journal of Contemporary Dental Practice ◽

10.5005/jcdp-9-3-56 ◽

2008 ◽

Vol 9 (3) ◽

pp. 56-63 ◽

Cited By ~ 3

Author(s):

Ali Cemal Tinaz ◽

Baǧdagül Helvaciölu Kivanç ◽

Güliz Gürgül

Keyword(s):

Calcium Hydroxide ◽

Root Canal ◽

Filling Material ◽

Root Canal Sealer ◽

Tooth Structure ◽

Root Canals ◽

Gutta Percha ◽

Anterior Teeth ◽

Tooth Surfaces ◽

Tooth Preparation

Abstract Aim The focus of this study was to examine the staining potential of calcium hydroxide (Ca(OH)2) on tooth structure following the removal of AH26 root canal sealer. Methods and Materials Fifty maxillary anterior teeth were prepared and obturated with AH26 and gutta percha. The sealers were then removed 24 hours later and the teeth were randomly divided into two groups. Ca(OH)2 was then placed in the root canals of the first group of teeth as a medicament and camphorated monochlorophenol (CMCP) was placed in the second group of teeth after the filling material was removed. The color of the external tooth surfaces was determined before tooth preparation and two weeks after the placement of the medicaments. The Z test was used for statistical analysis. Results All experimental teeth showed varying degrees of coronal discoloration with the Ca(OH)2 group showing more discoloration than the CMCP group (p<0.05). Conclusion Using Ca(OH)2 as a medicament after removing AH26 caused progressive discoloration of the teeth, whereas using CMCP caused only slight discoloration. Clinical Significance To avoid staining of the treated tooth, AH26 root canal sealer must be completely removed from the dentin walls before using a medicament. Citation Tinaz AC, Kivanç BH, Görgül G. Staining Potential of Calcium Hydroxide and Monochlorophenol Following Removal of AH26 Root Canal Sealer. J Contemp Dent Pract 2008 March; (9)3:056-063.

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PENGARUH KHLORHEKSIDIN DIGLUKONAT 2% DAN GLISERIN SEBAGAI BAHAN PENCAMPUR KALSIUM HIDROKSIDA TERHADAP SISA KALSIUM HIDROKSIDA PADA SEPERTIGA APIKAL DINDING SALURAN AKAR GIGI

Jurnal Teknosains ◽

10.22146/teknosains.6127 ◽

2013 ◽

Vol 3 (1) ◽

Author(s):

Emmawati Prawitasari, Diatri Nari Ratih, dan Widowati Siswomihardjo

Keyword(s):

Calcium Hydroxide ◽

Root Canal ◽

Apical Part ◽

T Test ◽

Working Time ◽

Chlorhexidine Digluconate ◽

Gutta Percha ◽

Stereo Microscope ◽

Apical Leakage

The most widely used intracanal medicament is calcium hydroxide (Ca(OH2). However, the residue ofCa(OH)2 in the root canal must be removed prior to obturation. The residue of Ca(OH)2 in the root canalwalls would result in apical leakage. This is due to the unstable dimension of Ca(OH)2, reduced flowand working time of the sealers, and decreased adhesion of sealers and gutta percha to root canal walls.This study aimed to determine the effect of Ca(OH)2 vehicles and agitation irrigation techniques on theresidue of Ca(OH)2 in the apical third of the root canal walls.Twelve extracted mandibular first premolars were used in this study. The crowns of the teethwere removed at the apical part of cemento enamel junction with a length of 14 mm from the apical.The canals were prepared with a Step Back technique to obtain Master Apical File ( MAF ) # 40. Thespecimens were randomly devided into groups I, the pastes of Ca(OH)2+chlorhexidine digluconate 2%.In groups II, the pastes of Ca (OH)2+ glycerin were applied. Each specimen of the study was sectionedin the sagittal direction, then was photographed under a stereo microscope at 120x magnification. Thepercentages of Ca(OH)2 residue were calculated using UTHSCSA image tool 3 software. Data wereanalyzed using T-test at 95% level of significance.The results revealed that the group of Ca(OH)2+ chlorhexidine digluconate 2% paste showed thelowest number of residual Ca(OH)2.The conclusion of this study was that the vehicles affected the totalresidue of Ca(OH)2.

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SELECTION OF OBTURATIONS MATERIALS IN PULPECTOMY TREATMENT OF DECIDUOUS TEETH

Interdental Jurnal Kedokteran Gigi (IJKG) ◽

10.46862/interdental.v17i2.1426 ◽

2021 ◽

Vol 17 (2) ◽

pp. 63-68

Author(s):

Bambang Tri Hartomo ◽

Laksmita Tanjung ◽

Mahindra Awwaludin Romdlon ◽

Fitri Diah Oktadewi

Keyword(s):

Zinc Oxide ◽

Calcium Hydroxide ◽

Root Canal ◽

Treatment Plan ◽

Deciduous Teeth ◽

Radiographic Examination ◽

Pulp Tissue ◽

Root Canals ◽

Left Posterior ◽

Selection Of

Introduction: Pulpectomy is the procedure of taking the entire pulp tissue from all the roots and corona of a tooth. There are several materials for obturation / root canal fillers in deciduous teeth, namely zinc oxide eugenol (ZOE), calcium hydroxide and iodoform paste a mixture of calcium hydroxide. A 6 year old boy patient came to RSGM with his parents seeking for treatment a tooth with a large cavity in the upper left posterior region and had been pain before. Intraoral examination revealed deep caries in the occlusal tooth 65 which reaching the pulp, percussion (-), palpation (-), mobility (-), vitality (-). Radiographic examination of tooth 65 showed a radiolucent image that had reached the pulp and the root canals had not yet undergone resorption. The diagnosis of this case was pulp necrosis at tooth 65. Case management: The treatment plan to be carried out was non-vital pulpectomy on tooth 65 and used technique non-vital pulpectomy because the tooth had already necrosis. Discussion: The filler used is ZOE. The reason for choosing this material was because it was indications for the use of ZOE material for teeth with necrosis. Conclussion: ZOE has anti-inflammatory and analgesic properties that can reduce pain

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