Intraradicular rehabilitation of a necrotic, immature tooth using MTA, a fiber post and composite resin - A case report (original) (raw)
Related papers
Management of an Immature Tooth Using MTA and Composite Canal Reinforcement
Global journal of oral science, 2018
Complete debridement, thorough disinfection and optimal sealing of the root canal system are the major challenges associated with endodontic treatment of teeth with open apices. In such teeth, thin radicular dentinal walls are susceptible to fracture. To ensure a better prognosis in such fractured prone thin dentinal walls, internal radicular reinforcement with various adhesive materials like glass ionomer cement, composites is recommended. A 15-year boy reported to the department with tooth #21showing large periapical radiolucency in association with an immature tooth having flared wide root canal. Here presenting a management of this case using MTA as an apical plug and composite as canal reinforcement material. This case report highlights the use of apical stop and canal reinforcement technique for management of immature teeth with thin radicular walls.
Open apex is a common occurrence and conservative approach should be applied because the affected teeth are immature in nature. This article describes the management of open apices with periapical radiolucencies in maxillary incisors. Mineral trioxide aggregate (MTA) was used to form an apical barrier and rest of the canal was obturated with different technique. The case series intends to testify the efficacy of MTA as an agent for Apexification and its effect on periapical healing.
Intraradicular Rehabilitation of Weakened Immature Teeth: A case report
Anterior teeth frequently present with weakened coronal and radicular tooth structure. Restoring such teeth can be challenging owing to the compromised geometry. The flared canal can be due to developmental defects, internal resorption or open apex. Trauma is very common in young age leading to incomplete root formation. Apexification using calcium hydroxide is a long process and the quality of calcific barrier obtained may be inadequate. Nowadays, one visit apexification with MTA is generally preferred. Earlier, metal post or prefabricated fibre post were used to rehabilitate such teeth. However, they do not adapt to the canal anatomy causing inadequate stress distribution. The root canal of such debilitated teeth can be reinforced by intraradicular rehabilitation. This paper presents a technique of restoring grossly mutilated teeth with Ribbond fiber and composite resin.
International Journal of Research in Medical Sciences, 2017
Root development and apex closure after the eruption of teeth takes a minimum of 3-4 years. If trauma to the pulp occurs during this period, it becomes a challenge for the clinician to treat the pulpal injury. Apexification is the treatment of choice for necrotic teeth with immature apex. Apexification done with calcium hydroxide encounters certain difficulties like very long treatment time, possibility of tooth fracture and incomplete calcification of the bridge. Mineral trioxide aggregate (MTA) was introduced as an alternative material to traditional materials for the apexification of immature permanent teeth. This case report presents successful management of a case with open apex using MTA followed by Tailor made gutta-percha.
MM-MTA® for a Complete Endodontic Obturation of an Avulsed Immature Permanent Incisor: A Case Report
The purpose of this report was to present the treatment of an avulsed immature necrotic permanent central incisor using the new mineral trioxide aggregate (MMMTA ®, Micro-Mega, Besançon, France) as an orthograde root filling. In such cases, the canal remains large, with thin and fragile walls, and the apex architecture remains divergent. This case demonstrates the efficacy of MTA in this particular situation as an effective material to support regeneration of apical tissue in immature necrotic teeth. External inflammatory resorption was detected after 3 months of the endodontic treatment. At the one-year followup, there were no clinical symptoms with radiographic healing of periradicular tissues, new hard-tissue formation in the apical area of the affected tooth and stabilization of the resorption.
The restoration of permanent immature anterior teeth, root filled using MTA: A review
Journal of Dentistry, 2009
Immature anterior teeth are at high risk of root fracture following root canal treatment. The literature was explored to determine the current status for post-endodontic restorative management of these teeth. The authors explored multiple search engine databases to November 2008. Experiments included in the review involved simulated human or animal immature teeth with mineral trioxide aggregate as an apical plug. The experiments were designed to assess and compare the fracture strength of teeth restored with various materials. Studies that did not fulfil inclusion criteria were omitted from the review. Four in vitro studies fulfilled selection criteria and were systematically reviewed. All studies differed in sources of teeth, their simulated immature tooth model and mode of force application. Current evidence, mostly from laboratory studies, suggests the use of composite resin materials placed deep into the coronal aspect of the root canal to impart superior fracture resistance. Further clinical research is needed to assess other reinforcing materials, which include a variety of post systems and luting agents.
MANAGEMENT OF NECROTIC IMMATURE PERMANENT TEETH-A CASE REPORT
International Journal Of Biology, Pharmacy and Allied Sciences, 2023
Regenerative endodontic Procedures provide an unconventional approach which relies on the principle of tissue engineering. Pulp necrosis of immature permanent teeth may impair root development and apical closure of root canals. Completion of root development takes around 3 years after eruption of permanent teeth. Management of immature non vital teeth is very challenging for a clinician because teeth may have wide open apex and thin root canal walls that may diverge towards the apex. Conventional cleaning and shaping of the canals and obturation may not be possible because of the lack of apical stop. Since debridement of pulp canal space is difficult, there is an increased possibility of root perforation and cervical root fracture, besides the presence of an open immature root apex jeopardize the apical seal of a root canal treatment resulting in subsequent failure. The purpose of this report is to present the case of a patient wherein apexification of an immature permanent maxillary left central incisor tooth was induced by the Metapex paste (Calcium hydroxide and Iodoform).
Complex endodontic and conservative treatment of a traumatized central incisor
2014
Objectives: The functional recovery of a tooth with open-apex already endodontically treated is possible thanks to the materials, such as the MTA, able to produce an effective seal of the apex which can induce a restitutio-ad-integrum. A direct composite resin restoration may then provide a coronal seal immediate and effective in time, able to ensure a complete healing of the endodontic pathology. Materials and methods: The hereby-clinical case describes a combined approach (endodontic and conservative) for the aesthetic-functional recovery of a severely fractured upper incisor of a child of 11 years. Results and conclusions: At the control visit, after 12 months from the completion of the coronal restoration, a complete healing of periradicular bone tissue is observed through Rx. Clinical examination showed gingival tissue without inflammation and the probing depth is not increased, despite the presence of a cavity margin placed below the gingival margin.
Management of Non-Vital Immature Teeth-A Review
The major challenges associated with endodontic treatment of teeth with open apices are achieving adequate access to the wide canal, complete debridement, canal disinfection and optimal sealing of the root canal system. In the absence of a natural apical constriction, it is imperative to create an apical barrier and allow threedimensional adaptation of obturating material within the root canal system. The aim of this review is to discuss the aetiology, anatomic features, diagnosis and management of teeth with immature open root apices. The contemporary concepts of management of immature non-vital teeth include either apexification or regenerative endodontics. Single visit apexification procedure aims at formation of an apical barrier using bioceramic materials like mineral trioxide aggregate (MTA) and Biodentine against which the obturating material can be condensed. Regenerative endodontics is a biologically based endodontic therapy that aims to promote normal physiological development in immature permanent teeth with pulpal necrosis.
Iranian Endodontic Journal, 2011
Apexification with calcium hydroxide is associated with certain difficulties, such as longer treatment time, risk of tooth fracture and incomplete calcification of apical bridge. Mineral trioxide aggregate (MTA) is an alternative material that can be used for apexification of open apices due to its biocompatibility, non-mutagenicity, non-neurotoxicity, regenerative abilities, and good sealing properties. This case report demonstrates application of MTA apical plug and anatomic post and core for the reconstruction of maxillary central incisor. The patient was recalled after six months and no complications were noted. Periapical radiographs demonstrated good adaptation of anatomical post and core to post space and the complete healing of the periapical lesion. This new technique is particularly advantageous in teeth which have open apex, root canals that are not round, wide canals and thin radicular dentin. It is also useful for who request in patients fewer visits.