Aim: A comparison between mineral trioxide aggregate (MTA) apexification and regenerative endodontic therapy (RET) in immature permanent teeth is pivotal for optimising treatment outcomes and enhancing clinical decision-making. Understanding the efficacy, limitations and long-term implications of each approach is essential for achieving predictable, successful outcomes when managing immature teeth with necrotic pulps. The aim of this retrospective study was to compare the changes in the periapical bone using fractal dimension (FD) on the periapical radiographs of patients who underwent apexification and RET.
Materials: The lesion area was evaluated using fractal analysis on periapical radiographs obtained before and one year after treatment with the ImageJ program. Additionally, periapical status was classified using the periapical index (PAI). The significance level was set at 0.05.
Conclusion: In the present study, we found that the changes in FD and PAI over a one-year observation period were independent of the specific root canal treatment technique used. According to the fractal analysis, neither MTA apexification nor RET with tripleantibiotic paste is superior for immature teeth with pulp necrosis resulting from dental trauma.
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http://dx.doi.org/10.23804/ejpd.2024.2178 | DOI Listing |
Cureus
December 2024
Department of Conservative Dentistry and Endodontics, School of Dental Science, Krishna Vishwa Vidyapeeth (Deemed To Be University), Karad, IND.
Apexification is a crucial procedure for achieving apical healing in non-vital teeth with open apices. Traditionally, calcium hydroxide has been used for this purpose, but it has significant drawbacks, including prolonged treatment duration, increased risk of root fracture, and the potential for porous barrier formation. Mineral trioxide aggregate (MTA) has emerged as a superior alternative due to its biocompatibility, faster setting time, and better sealing properties.
View Article and Find Full Text PDFBMC Oral Health
January 2025
Department of Endodontics, Faculty of Dentistry, Ordu University, Ordu, 52200, Turkey.
Background: Immature maxillary central teeth can be managed by using several treatment options. The aim of this finite element stress analysis study was to evaluate the effect of different treatment procedures on the stresses on immature maxillary incisor teeth models that generated on cone beam computed tomography, by trauma and bite forces.
Methods: A total of 11 different models consisting of revascularization treatment using MTA and biodentine and the state of the root apex formed with cement after treatment, apexification, modified apexification, traditional root canal treatment and two different control groups have been created.
Dent Traumatol
December 2024
School of Engineering, The University of Sydney, Sydney, Australia.
Calcium hydroxide apexification has been used in the treatment of immature teeth with pulp necrosis and apical periodontitis for more than 50 years. However, the guidelines of the European Academy of Paediatric Dentistry (EAPD) and the American Association of Endodontists (AAE) 'Clinical recommendations for a regenerative procedure' recommend against calcium hydroxide apexification. The American Association of Endodontists "Clinical considerations for a regenerative procedure" do not list calcium hydroxide apexification as a treatment option for immature teeth with pulp necrosis.
View Article and Find Full Text PDFEur J Paediatr Dent
December 2024
Prof., Department of Pediatric Dentistry, Faculty of Dentistry, Istinye University, Istanbul, Turkey.
Aim: A comparison between mineral trioxide aggregate (MTA) apexification and regenerative endodontic therapy (RET) in immature permanent teeth is pivotal for optimising treatment outcomes and enhancing clinical decision-making. Understanding the efficacy, limitations and long-term implications of each approach is essential for achieving predictable, successful outcomes when managing immature teeth with necrotic pulps. The aim of this retrospective study was to compare the changes in the periapical bone using fractal dimension (FD) on the periapical radiographs of patients who underwent apexification and RET.
View Article and Find Full Text PDFCureus
October 2024
Department of Conservative Dentistry and Endodontics, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, IND.
Apexification is the process of forming mineralized tissue at the apical portion of a tooth with an incompletely formed root. Although various materials and techniques for the endodontic treatment of such teeth have been employed for some time, selecting the appropriate material remains challenging due to limited literature. This report presents a case that evaluates the efficacy of a modified apexification procedure using mineral trioxide aggregate (MTA), followed by a walking-bleach technique to address discoloration resulting from trauma to anterior teeth.
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