Mineral trioxide aggregate apexification: a 20‐year case review

Abstract

Apexification strategies in traumatised non‐vital immature permanent teeth can promote root‐end closure and continued root development. However, traumatic injuries may compromise the integrity of generative cells of the apical papilla responsible for root maturation. This report describes the long‐term treatment outcome of mineral trioxide aggregate (MTA) apexification managed with late‐term surgical intervention. A seven‐year‐old male reported with swelling and suppuration associated with a traumatised maxillary left central incisor (#21). After palliative treatment and MTA apexification procedures, the incisor demonstrated normal function during a 14.5‐year period with radiographic evidence of atypical radicular elongation. Seventeen years after initial treatment, the patient presented with mid‐plate buccal swelling and surgical treatment was completed involving root resection, biopsy of a spherical mineralised tissue specimen and placement of MTA root‐end filling. Periapical healing and normal tooth function was evident at the 20‐year review.