Successful apexification with resolution of the periapical lesion using mineral trioxide aggregate and demineralized freeze-dried bone allograft

Abstract

Immature teeth with necrotic pulp and large periapical lesion are difficult to treat via conventional endodontic therapy. The role of materials such as calcium hydroxide and mineral trioxide aggregate in apexification is indispensable. This case report presents the successful healing and apexification with combined use of white mineral trioxide aggregate and demineralized freeze-dried bone allograft.

Intracannal pain remission in child with amelogenesis imperfecta. Case report

“…However, the latter suggest broader clinical trials to evaluate long term success. In our case, apical barrier had 5 mm for being, according to some authors, stronger than that of 2 mm 32,33 . To induce apexification, MTA acts converting tricalcium oxide into calcium hydroxide when in contact with tissue fluids 28 .…”

The Management of Crown Fracture of Immature Teeth by MTA and Calcium Hydroxide: Case Reports

“…Ca(OH) 2 was applied as root canal medicament dressing for two months. According to Moorrees et al when the root formation is in stages between 3 and 4, the use of Ca(OH) 2 for one or two months before the application of MTA helps the apex closure, the drying process, keeping the root canal free from microorganisms and most of endodontic pathogens [8,21,25,29]. This results in avoiding infections induced by acidic environment which could adversely affect the setting of MTA [25].…”

“…Despite the higher success rate of apical barrier formation using Ca(OH) 2 , it still has its inherent clinical problems, like the possibility of cervical root fracture of the weakened teeth because of the desiccating properties of high pH Ca(OH) 2 ,failure to control infection, multiple appointments, which complicated the treatment, the nature of barrier which might be porous or sometimes contains soft tissues [13,14,20,29,31,35,36]. The presence of Ca(OH) 2 paste in the root for more than 30 days, and the long-term treatment procedures raise the tooth susceptibility to fracture [15,35,36].…”

Non-surgical Management of Large Periapical Lesions with the Agreement Evaluation of the Methods

“…Thus these materials are increasingly used in the management of large periapical lesions. They are considered more advantageous considering the time taken for apical closure and the superior apical seal they offer [16]. However, compared with calcium hydroxide the cost of these two treatment modalities are higher.…”