Articles

The Differences of the Calcium Hydroxide and the Mineral Trioxide Aggregate in the Apical Closure of Immature, Non-Vital Permanent Teeth

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When an immature tooth comes into contact with trauma, the dental pulp in the developing tooth can die, which can cause the absence of root and apical closure. Apexification is a technique used to repair these abnormalities. This method allows us to promote the growth of a hardened root end block. MTA and Ca (OH)2 are two materials that can be used in this process. Either MTA or calcium hydroxide have a good chance of producing positive clinical results. MTA is favored over calcium hydroxide for its significantly shorter time for apical barrier formation, low solubility, easy approach, and ability to prevent root fracture, while calcium hydroxide is preferred over MTA for root length elongation in open apex teeth. The limitations of calcium hydroxide include the fact that it takes more time and multiple visits to form the root-end barrier, is more prone to fracture, and has the potential for reinfection. The goal of this review is to collect revisions on inducing root formation and synthetic barrier approaches and consider the advantages and disadvantages of calcium hydroxide versus MTA.

Single Visit Apexification Using MTA: A Case Report

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Trauma to the dentition during the period of root formation may cause incomplete development of root resulting in open apex. In order to eliminate infection from root canal endodontic treatment is a tooth-saving treatment modality. The absence of a natural apical constriction in a nonvital permanent tooth makes endodontic treatment a challenge. Therefore, it is necessary to induce or create an apical barrier against, which the obturating material can be condensed. Traditionally, calcium hydroxide is considered as the gold standard to induce apexification. Due to certain drawbacks such as very long treatment period, possibility of tooth fracture, and incomplete apical barrier formation, it is being replaced by materials, which have a more predictable outcome like mineral trioxide aggregate (MTA). One-step apexification with MTA reduces the treatment time when compared with traditional calcium hydroxide apexification, which requires an average time of 12–19 months. Also, MTA has various other superior properties compared to calcium hydroxide that are discussed below in detail along with successful treatment of an immature permanent tooth with open apex wherein MTA was used for one-step apexification.