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Case Reports
. 2017 Spring;12(2):248-252.
doi: 10.22037/iej.2017.48.

Endodontic Management of Open Apex Teeth Using Lyophilized Collagen Sponge and MTA Cement: Report of Two Cases

Miriam Graziele Magro  1 , Milton Carlos Kuga  1 , Weber Adad Ricci  1 , Kátia Cristina Keine  1 , Mateus Rodrigues Tonetto  2 , Suellen Linares Lima  3 , Alvaro Henrique Borges  2 , Lauriê Garcia Belizário  1 , Matheus Coêlho Bandeca  3
Affiliations
Case Reports

Endodontic Management of Open Apex Teeth Using Lyophilized Collagen Sponge and MTA Cement: Report of Two Cases

Miriam Graziele Magro et al. Iran Endod J. 2017 Spring.

Abstract

Teeth with open apices, such as in immature teeth or those with apical root resorption are clinical cases with difficult immediate resolution. With the use of mineral trioxide aggregate (MTA) in dentistry, it was possible to optimize the treatment time of these cases by immediate placement of apical plug and the root canal filling. However, some negative effects can occur if MTA is extruded beyond the apex. To avoid this accident, it has been recommended to use of an apical matrix prior to placement of MTA. This study reports two clinical cases of apical plug placement in teeth with pulp necrosis and open apices. One case had an immature apex due to dental trauma and the other case had apical resorption due to the presence of endodontic infection in the root canal. MTA apical plug with approximately 4 mm thickness, was placed in the apical zone of the root and immediately the canal was obturated with gutta-percha and endodontic sealer. Follow-up evaluations showed clinical and radiographic evidence of success.

Keywords: Apex; Collagen; Endodontics; Mineral Trioxide Aggregate.

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Conflict of interest statement

‘None declared’.

Figures

Figure 1
Figure 1
A)Open-apex immature tooth and presence of apical periodontitis; B) Horizontal dental crown fracture; C) Working length determination; D) Calcium hydroxide dressing; E) Lyophilized collagen sponge; F) Insertion of lyophilized collagen sponge in root canal; G) Device for insertion of MTA apical plug
Figure 2
Figure 2
A) Lyophilized collagen sponge and MTA cement apical barrier; B) Apical barrier checking with gutta-percha point; C) Immediate root canal filling with calcium silicate-based sealer; D) Radiographic image after18 months
Figure 3
Figure 3
A) Coronal access; B) Apical periodontitis and apical root resorption; C) Working length determination; D) Checking working length with gutta-percha point
Figure 4
Figure 4
A) Insertion of lyophilized collagen sponge in the root canal; B) MTA cement insertion method; C) Immediate root canal filling with apical barrier; D) Six-month follow-up radiography
See this image and copyright information in PMC

References

    1. Love RM, Firth N. Histopathological profile of surgically removed persistent periapical radiolucent lesions of endodontic origin. Int Endod J. 2009;42(3):198–202. - PubMed
    1. Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review--Part III: Clinical applications, drawbacks, and mechanism of action. J Endod. 2010;36(3):400–13. - PubMed
    1. Trope M. Treatment of the immature tooth with a non-vital pulp and apical periodontitis. Dent Clin North Am. 2010;54(2):313–24. - PubMed
    1. Tomson RM, Polycarpou N, Tomson PL. Contemporary obturation of the root canal system. Br Dent J. 2014;216(6):315–22. - PubMed
    1. Chutich MJ, Kaminski EJ, Miller DA, Lautenschlager EP. Risk assessment of the toxicity of solvents of gutta-percha used in endodontic retreatment. J Endod. 1998;24(4):213–6. - PubMed

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