Endodontic Management of Tooth with Open Apex Using MTA as a
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Endodontic therapy of a tooth with open apex and necrotic pulp presents multiple challenges during treatment. Microbial elimination from chronic lesions makes treatment all the more difficult. Apexification and pulp revascularization are the treatment options available. Apexification with calcium hydroxide has certain disadvantages and mineral trioxide aggregate (MTA) may be considered as a promising alternative.

This case describes the management of a symptomatic maxillary left central incisor with immature apex and a chronic periapical lesion. Sodium hypochlorite of 3% and EDTA were used as irrigants for microbial elimination. Repeated intracanal dressings with calcium hydroxide were given for better periapical healing. MTA was used for apical barrier formation. After confirming the hard set of MTA, obturation was done with thermoplasticized gutta-percha and access cavity sealed with composite resin restoration.

Conclusively, In this case, MTA helped to form an apical barrier in the immature necrotic maxillary central incisor and showed a good clinical and radiographic success. The use of irrigants and calcium hydroxide as an intracanal medicament promoted the periapical healing of the chronic apical periodontitis.

Clinical Significance : Adequate infection control with mechanical debridement and irrigants in combination with intracanal medicaments helps in nonsurgical treatment of chronic lesions and favors regression and healing. Apical barrier with MTA helps to contain the obturating material without impinging on the periodontal tissues and obtaining a fluid-tight seal in immature teeth with an open apex.

Source: https://www.cdejournal.com/doi/CDEJ/pdf/10.5005/jp-journals-10048-0042
Dr. D●●●●●i V●●●●●h and 1 others like this2 shares
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Dr. D●●●●●i V●●●●●h
Dr. D●●●●●i V●●●●●h Dentistry
It is a very good explanation found for specification immature permanent tooth with open apex.
Mar 22, 2020Like