Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jan;53(1):5-18.
doi: 10.1111/iej.13201. Epub 2019 Sep 3.

Treatment of immature teeth with nonvital pulps in adults: a prospective comparative clinical study comparing MTA with Ca(OH)2

G Kandemir Demirci  1 , M E Kaval  1 , P Güneri  2 , M K Çalışkan  1
Affiliations

Treatment of immature teeth with nonvital pulps in adults: a prospective comparative clinical study comparing MTA with Ca(OH)2

G Kandemir Demirci et al. Int Endod J. 2020 Jan.

Abstract

Aim: To evaluate and compare the influence of various predictors on outcomes of apexification using either mineral trioxide aggregate (MTA) or calcium hydroxide (CH) in permanent immature anterior teeth with necrotic pulps and periapical lesions of adults.

Methodology: Ninety immature teeth with necrotic pulps and periapical lesions on adult patients (aged 18-40 years) were treated with MTA (45 teeth) or CH (45 teeth) between 2015 and 2018. Patients of both groups were recalled for follow-up examinations after the first intervention at 1,3,6 and 12 months for the first year, every 6 months for the second year and every year thereafter until the end of the study (median 32.3 months). The treatment outcome based on clinical and radiographic criteria was assessed by calibrated examiners and dichotomized as 'healed+healing' or 'not healed'. The age, gender, stage of root development, preoperative signs and symptoms of apical periodontitis and size of periapical lesion were recorded. The cumulative success proportion and mean time were analysed with the Kaplan-Meier test. The generalized logrank statistic was used to describe prognostic clinical variables. Fisher's exact test was applied for the evaluation of the healing rates.

Results: Thirty-nine of the 45 teeth treated with MTA were available for recall. Of these, 29 teeth (74%) revealed calcific apical barrier formation with complete resolution of periapical lesions, 7 teeth (18%) were healing, and 3 teeth (8%) had persistent disease. Thirty-four of the 45 teeth in the CH group were available for recall. Of these, 27 teeth (79%) had complete healing of periapical lesions and had calcific barrier formation, 4 teeth (12%) were healing, and the remaining 3 teeth (9%) had not healed. The survival rate of teeth treated with MTA was similar to the survival rates observed in teeth treated with CH (90% and 91%, respectively, P > 0.05). The generalized logrank statistic revealed that the cumulative success rate of both materials was not significantly different (P > 0.05). None of the tested predictors had an influence on the treatment outcomes of teeth in both groups (P > 0.05).

Conclusions: Apexification with both MTA and CH was associated with similar treatment outcomes. MTA may be proposed as a material for apexification treatment in immature teeth of adult patients due to the shorter treatment time associated with its use.

Keywords: MTA; adult tooth; apexification; calcium hydroxide; immature tooth; open apex; periapical healing.

PubMed Disclaimer

References

    1. Al-Kahtani A, Shostad S, Schifferle R, Bhambhani S (2005) In-vitro evaluation of microleakage of an orthograde apical plug of mineral trioxide aggregate in permanent teeth with stimulated immature apices. Journal of Endodontics 31, 117-9.
    1. Al-Jundi SH (2004) Type of treatment, prognosis, and estimation of time spent to manage dental trauma in late presentation cases at a dental teaching hospital: a longitudinal and retrospective study. Endodontic Dental Traumatology 20, 1-5.
    1. Andersen M, Lund A, Andreasen JO, Andreasen FM (1992) In vitro solubility of human pulp tissue in calcium hydroxide and sodium hypochlorite. Endodontic Dental Traumatology 8, 104-8.
    1. Andreasen FM, Kahler B (2015) Pulpal response after acute dental injury in the permanent dentition: clinical implications- a review. Journal of Endodontics 41, 299-308.
    1. Andreasen LO, Farik B, Munksgaard EC (2002) Long-term calcium hydroxide as a root canal dressing may increase risk of root fracture. Dental Traumatology 18, 134-7.

LinkOut - more resources