Mineral Trioxide Aggregate Apical Plug Method for the Treatment of Nonvital Immature Permanent Maxillary Incisors: Three Case Reports

Overview

Journal J Conserv Dent

Specialty Dentistry

Date 2012 Feb 28

PMID 22368340

Citations 10

Authors

Betul Gunes

Hale Ari Aydinbelge

Affiliations

Soon will be listed here.

Abstract

Treatment of nonvital immature permanent teeth with calcium-hydroxide is associated with some difficulties such as weakened tooth fracture, root canal reinfection and long treatment time. Mineral trioxide aggregate (MTA) apical plug method is an alternative treatment option for open apices, and has gained popularity in the recent times. In this case report, we have attempted to present successful treatment of three maxillary incisors with open apices and periapical lesions with MTA. After preparing the access cavity, the working length was determined. The root canals were irrigated with 2.5% Sodium hypochlorite (NaOCl) and disinfected with calcium-hydroxide for two weeks. MTA was then placed in the apical 3 millimeters of the root canal. The remaining part of the root canal was filled with gutta-percha and the coronal restoration was finished with composite resin. After six months the radiographic examination showed a decrease of periapical lesions. At a 1-year and 18-months follow up, radiological and clinical successful healing of the incisor teeth was seen. MTA seems as an effective material for the apical plug method for the treatment of nonvital immature permanent teeth with open apices.

Citing Articles

Management of an Open Apex Using a Platelet-Rich Fibrin Membrane as an Internal Matrix and Mineral Trioxide Aggregate as an Apical Barrier: A Case Report.

Bhandare R, Mattigatti S Cureus. 2025; 16(12):e75316.

PMID: 39776744 PMC: 11706102. DOI: 10.7759/cureus.75316.

The osteoinductive potential of different root-end filling materials in a rat femur model.

Aksu S, Delikan E, Kucuk A, Demiray Asoglu Z, Yilmaz S Sci Rep. 2024; 14(1):2078.

PMID: 38267563 PMC: 10808533. DOI: 10.1038/s41598-024-52584-5.

Evaluation of a Novel Tool for Apical Plug Formation during Apexification of Immature Teeth.

Alsayed Tolibah Y, Droubi L, Alkurdi S, Abbara M, Bshara N, Lazkani T Int J Environ Res Public Health. 2022; 19(9).

PMID: 35564699 PMC: 9102688. DOI: 10.3390/ijerph19095304.

Comparison of Obturation Quality after MTA Orthograde Filling with Various Obturation Techniques.

An H, Yoon H, Jung H, Shin D, Song M J Clin Med. 2021; 10(8).

PMID: 33923426 PMC: 8074131. DOI: 10.3390/jcm10081719.

Use of mineral trioxide aggregate for retreatment of a tooth with large periapical lesion, wide-open apices and vertical root fracture.

Pandey P, Nandkeoliar T, Bains R, Singh D BMJ Case Rep. 2018; 2018.

PMID: 30396891 PMC: 6229175. DOI: 10.1136/bcr-2018-227627.

References

Rotstein I, Friedman S, Katz J . Apical closure of mature molar roots with the use of calcium hydroxide. Oral Surg Oral Med Oral Pathol. 1990; 70(5):656-60. DOI: 10.1016/0030-4220(90)90418-r. View

Torabinejad M, Pitt Ford T . Root end filling materials: a review. Endod Dent Traumatol. 1996; 12(4):161-78. DOI: 10.1111/j.1600-9657.1996.tb00510.x. View

Schwartz R, Mauger M, Clement D, Walker 3rd W . Mineral trioxide aggregate: a new material for endodontics. J Am Dent Assoc. 1999; 130(7):967-75. DOI: 10.14219/jada.archive.1999.0337. View

Tait C, Ricketts D, Higgins A . Weakened anterior roots--intraradicular rehabilitation. Br Dent J. 2005; 198(10):609-17. DOI: 10.1038/sj.bdj.4812351. View

Erdem A, Sepet E . Mineral trioxide aggregate for obturation of maxillary central incisors with necrotic pulp and open apices. Dent Traumatol. 2008; 24(5):e38-41. DOI: 10.1111/j.1600-9657.2008.00636.x. View

Khatavkar R, Hegde V . Use of a matrix for apexification procedure with mineral trioxide aggregate. J Conserv Dent. 2010; 13(1):54-7. PMC: 2883809. DOI: 10.4103/0972-0707.62629. View

Ghaziani P, Aghasizadeh N, Sheikh-Nezami M . Endodontic treatment with MTA apical plugs: a case report. J Oral Sci. 2008; 49(4):325-9. DOI: 10.2334/josnusd.49.325. View

Torabinejad M, Chivian N . Clinical applications of mineral trioxide aggregate. J Endod. 1999; 25(3):197-205. DOI: 10.1016/S0099-2399(99)80142-3. View

Rafter M . Apexification: a review. Dent Traumatol. 2005; 21(1):1-8. DOI: 10.1111/j.1600-9657.2004.00284.x. View

10.

Simon S, Rilliard F, Berdal A, Machtou P . The use of mineral trioxide aggregate in one-visit apexification treatment: a prospective study. Int Endod J. 2007; 40(3):186-97. DOI: 10.1111/j.1365-2591.2007.01214.x. View

11.

Lee S, Monsef M, Torabinejad M . Sealing ability of a mineral trioxide aggregate for repair of lateral root perforations. J Endod. 1993; 19(11):541-4. DOI: 10.1016/S0099-2399(06)81282-3. View

12.

DArcangelo C, DAmario M . Use of MTA for orthograde obturation of nonvital teeth with open apices: report of two cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 104(4):e98-101. DOI: 10.1016/j.tripleo.2007.05.021. View

13.

Holden D, Schwartz S, Kirkpatrick T, Schindler W . Clinical outcomes of artificial root-end barriers with mineral trioxide aggregate in teeth with immature apices. J Endod. 2008; 34(7):812-7. DOI: 10.1016/j.joen.2008.04.003. View

14.

Oliveira T, Sakai V, Cruvinel Silva T, Santos C, Abdo R, Machado M . Mineral trioxide aggregate as an alternative treatment for intruded permanent teeth with root resorption and incomplete apex formation. Dent Traumatol. 2008; 24(5):565-8. DOI: 10.1111/j.1600-9657.2008.00577.x. View

15.

Giuliani V, Baccetti T, Pace R, Pagavino G . The use of MTA in teeth with necrotic pulps and open apices. Dent Traumatol. 2002; 18(4):217-21. DOI: 10.1034/j.1600-9657.2002.02107.x. View