Apical barrier formation after incomplete orthograde MTA apical plug placement in teeth with open apex--report of two cases

• Published in: Brazilian dental journal Vol. 24; no. 2; p. 163
• Main Authors: Floratos, Spyros G, Tsatsoulis, Ioannis N, Kontakiotis, Evangelos G
• Format: Journal Article
• Language: English
• Published: Brazil 2013
• Subjects: Aluminum Compounds - administration & dosage; Aluminum Compounds - therapeutic use; Apexification - methods; Calcium Compounds - administration & dosage; Calcium Compounds - therapeutic use; Calcium Hydroxide - therapeutic use; Child; Dental Pulp Necrosis - therapy; Dentin - pathology; Dentin, Secondary - pathology; Drug Combinations; Epoxy Resins - therapeutic use; Female; Follow-Up Studies; Gutta-Percha - therapeutic use; Humans; Incisor - injuries; Male; Oxides - administration & dosage; Oxides - therapeutic use; Periapical Periodontitis - therapy; Root Canal Filling Materials - therapeutic use; Root Canal Irrigants - therapeutic use; Root Canal Obturation - methods; Root Canal Preparation - methods; Silicates - administration & dosage; Silicates - therapeutic use; Tooth Apex - pathology; Tooth Avulsion - therapy; Tooth Fractures - therapy
• ISSN: 1806-4760

Two cases are reported in which incomplete placement of 4 mm mineral trioxide aggregate (MTA) plug was performed unintentionally at the apical third of permanent immature teeth with open apex and apical periodontitis. As confirmed radiographically, there were gaps between MTA and dentinal walls along the MTA-dentin interface. After setting of MTA was confirmed, endodontic treatment was completed and access was sealed with composite resin. At 6 to 16 months follow-up examinations, formation of dentin in contact with the MTA surface, as well as apical closure and periapical healing were ideied radiographically for both cases. The results of these cases showed that apical barrier formation and complete periapical healing is possible despite the incomplete apical placement of the MTA plug. This might be due to the biological properties of the MTA. Even so, an incomplete three-dimensional placement of the filling material is not advocated.