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Michaelson PL. 7.5- to 11.5-Year Follow-up of the Fracture Removal Treatment for Propagated Crown Fractures. J Endod 2024; 50:527-532. [PMID: 38278318 DOI: 10.1016/j.joen.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/18/2023] [Accepted: 01/15/2024] [Indexed: 01/28/2024]
Abstract
A definitive method to predictably treat propagated longitudinal fractures remains elusive. A proof-of-concept case report series documenting nonsurgical removal of propagated longitudinal fractures has shown up to 5 years of clinical and radiographic success. This installment of the case report series further documents these teeth with 7.5-year to 11.5-year recall evaluations. Three previously reported cases of fracture removal were followed at 11.5 years (1 case), 9.75 years (1 case), and 7.5 years (1 case) after treatment to determine the long-term clinical and radiographic success of nonsurgical fracture removal. This case report series has demonstrated 10-year success (clinically and radiographically) for the treatment of progressive longitudinal fractures. Propagated fractures can be nonsurgically removed and the iatrogenic defect repaired with long-term success providing a foundation for treatment and further investigation.
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Prado MC, Campos P, Pasetto S, Marciano MA, Sinhoreti MAC, Geraldeli S, de-Jesus-Soares A, Abuna G. Development of nanobiosilicate, tricalcium phosphate and chlorhexidine materials for biomineralization with crystallographic similarity to hydroxyapatite and biomodified collagen. Dent Mater 2024; 40:267-275. [PMID: 37989699 DOI: 10.1016/j.dental.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/24/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVES The aim of this work is to test experimental cements, doped with a silicate based bioactive nanoparticle (NanoBiosilicate). Methods, we synthesized a glass nanoparticle by Sol-Gel Stöber method, used to be incorporated in a dental material for endodontic uses. MATERIALS AND METHODS We assess the mineralizing properties and biocompatibility. Besides the crystallography characterization of the resultant new crystals. Results, After analysis, and comparison with commercial materials, the material tested was similar in mechanical properties required by ISO, The ion release was effective after 2 hr. of setting and the novel material was cell compatible accepted by ISO. RESULTS We found new formed Calcium Phosphate peaks in the spectroscopic analysis (FTIR), remarkably the crystals formed were comparable to hydroxyapatite when analyzed with a Selected Area Electron Diffractometer, with rings of 2.84 Å for 002, and the 2.77 Å is also visible for 210. The 6.83 Å and 6.88 Å, for respective 222 and 004. The incorporation of Chlorhexidine was not detrimental for this property, Significance, the features mentioned represented a progress in biomineralization field that was associated to an improved mineral structure formation with increased crystallographic similarity to natural hydroxyapatite. When chlorhexidine was added a favorable biomodification of the remaining collagen in dentinal walls and antimicrobial activity potential were also observed.
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Affiliation(s)
- Marina C Prado
- Department of Restorative Dentistry - Endodontics Division, Piracicaba Dental School - State University of Campinas (FOP-UNICAMP), Piracicaba, SP, Brazil; Department of General Dentistry, School of Dental Medicine - East Carolina University (ECU-SoDM), Greenville, NC, USA.
| | - Paulo Campos
- Department of Restorative Dentistry - Dental Materials Division, Piracicaba Dental School - State University of Campinas (FOP-UNICAMP), Piracicaba, SP, Brazil
| | - Silvana Pasetto
- Department of Biology, East Carolina University (ECU-SoDM), Greenville, NC, USA
| | - Marina A Marciano
- Department of Restorative Dentistry - Endodontics Division, Piracicaba Dental School - State University of Campinas (FOP-UNICAMP), Piracicaba, SP, Brazil
| | - Mário A C Sinhoreti
- Department of Restorative Dentistry - Dental Materials Division, Piracicaba Dental School - State University of Campinas (FOP-UNICAMP), Piracicaba, SP, Brazil
| | - Saulo Geraldeli
- Department of General Dentistry, School of Dental Medicine - East Carolina University (ECU-SoDM), Greenville, NC, USA
| | - Adriana de-Jesus-Soares
- Department of Restorative Dentistry - Endodontics Division, Piracicaba Dental School - State University of Campinas (FOP-UNICAMP), Piracicaba, SP, Brazil
| | - Gabriel Abuna
- Department of General Dentistry, School of Dental Medicine - East Carolina University (ECU-SoDM), Greenville, NC, USA.
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Krastl G, Weiger R, Filippi A, Van Waes H, Ebeleseder K, Ree M, Connert T, Widbiller M, Tjäderhane L, Dummer PMH, Galler K. Endodontic management of traumatized permanent teeth: a comprehensive review. Int Endod J 2021; 54:1221-1245. [PMID: 33683731 DOI: 10.1111/iej.13508] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 03/05/2021] [Indexed: 12/15/2022]
Abstract
The pulp plays a key role in the treatment of traumatic dental injuries (TDIs) and is strongly associated with the outcome, particularly in severe cases. A correct pulp diagnosis is essential as it forms the basis for developing the appropriate management strategy. However, many TDIs are complex, and their treatment requires a profound knowledge of the physiological and pathological responses of the affected tissues. This comprehensive review will look at the dentine-pulp complex and its interaction with the surrounding tissues following TDIs. The literature up to 2020 was reviewed based on several searches on PubMed and the Cochrane Library using relevant terms. In addition to the recently revised guidelines of the International Association of Dental Traumatology, this article aims to provide background information with a focus on endodontic aspects and to gather evidence on which a clinician can make decisions on the choice of the appropriate endodontic approach for traumatized permanent teeth.
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Affiliation(s)
- G Krastl
- Department of Conservative Dentistry and Periodontology, Center of Dental Traumatology, University Hospital of Würzburg, Würzburg, Germany
| | - R Weiger
- Department of Periodontology, Endodontology and Cardiology, University School of Dental Medicine, Basel, Switzerland.,Center of Dental Traumatology, University School of Dental Medicine, Basel, Switzerland
| | - A Filippi
- Center of Dental Traumatology, University School of Dental Medicine, Basel, Switzerland.,Department of Oral Surgery, University School of Dental Medicine, Basel, Switzerland
| | - H Van Waes
- Department of Paediatric Dentistry, Clinic for Orthodontics and Paediatric Dentistry, University of Zürich, Zürich, Switzerland
| | - K Ebeleseder
- University Clinic of Dental Medicine and Oral Health, Medical University Graz, Graz, Austria
| | - M Ree
- Private Practice, Purmerend, Netherlands
| | - T Connert
- Department of Periodontology, Endodontology and Cardiology, University School of Dental Medicine, Basel, Switzerland.,Center of Dental Traumatology, University School of Dental Medicine, Basel, Switzerland
| | - M Widbiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - L Tjäderhane
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.,Research Unit of Oral Health Sciences, Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, University of Oulu, Oulu, Finland
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - K Galler
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
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Effect of mineral trioxide aggregate and biodentine™ on fracture resistance of immature teeth dentine over time: in vitro study. Eur Arch Paediatr Dent 2021; 22:603-609. [PMID: 33387346 DOI: 10.1007/s40368-020-00597-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 12/02/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of this in vitro study was to evaluate the effect of root filling with White Mineral Trioxide Aggregate (WMTA) and Biodentine™ (BD) on the fracture resistance of simulated immature teeth over different time periods. METHODS Sixty sound-extracted human single-rooted premolars were randomly allocated into 3 groups, 2 experimental and 1 control group, with 20 teeth each. Simulation of roots into immature apices were done using Peeso reamers. After preparation, the root canals of teeth in the experimental groups were completely filled with either WMTA or BD. The control group was subdivided into positive controls (n = 10) which received no treatment and negative controls (n = 10) which were prepared the same way and filled with normal saline. The specimens were subjected to fracture testing using a universal testing machine after 2 weeks and 3 months. The peak load to fracture and the fracture location were recorded. RESULTS Regarding fracture resistance, the MTA group had the highest fracture resistance at 2 weeks testing, while at 3 months there was no significant difference between the groups (P > 0.05). Regarding fracture location, at 2 weeks there was no significant difference in the fracture location between the groups, while at 3 months, the difference was significant (P < 0.05), the middle root fracture being the most frequent (63.3%). CONCLUSION No significant difference in fracture resistant of simulated immature teeth was observed after 3 months when they were filled with Biodentine or WMTA, indicating that Biodentine could be a suitable substitute for MTA. There was no difference in the possible fracture location at 2 weeks, while after 3 months middle root fractures were more frequent.
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Chaniotis A, Petridis X. Cervical Level Biological Repair of the Access Opening after Regenerative Endodontic Procedures: Three Cases with the Same Repair Pattern. J Endod 2019; 45:1219-1227. [DOI: 10.1016/j.joen.2019.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 06/23/2019] [Accepted: 07/01/2019] [Indexed: 12/25/2022]
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Fracture resistance of simulated immature roots using Biodentine and fiber post compared with different canal-filling materials under aging conditions. Clin Oral Investig 2019; 24:1333-1338. [DOI: 10.1007/s00784-019-03014-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/08/2019] [Indexed: 12/27/2022]
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Linsuwanont P, Kulvitit S, Santiwong B. Reinforcement of Simulated Immature Permanent Teeth after Mineral Trioxide Aggregate Apexification. J Endod 2017; 44:163-167. [PMID: 29153732 DOI: 10.1016/j.joen.2017.08.031] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/02/2017] [Accepted: 08/28/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The objectives of this study were to compare the fracture resistance of simulated human immature teeth that have undergone mineral trioxide aggregate (MTA) apexification and have been root-filled with fiber post, composite resin, MTA, or gutta-percha. METHODS Fifty-six human permanent maxillary incisors were selected. Ten teeth received no treatment (intact teeth group). The root canals of 46 teeth were prepared to an internal diameter of 1.75 mm. Six teeth were used as simulated immature teeth group. The remaining teeth received MTA apexification and were divided into 4 groups: MTA, fiber post, composite resin, and gutta-percha groups. The root canals of each group were filled with each test material. All teeth were thermocycled and received cyclic loading before compression testing by an Instron universal testing machine. The load to fracture was recorded. Data were subjected to statistical analysis by using one-way analysis of variance and Tukey multiple comparison test. RESULTS All teeth fractured at the cervical area of the root. The mean load to fracture of the intact tooth, MTA, fiber post, composite resin, gutta-percha, and the simulated immature tooth groups was 1988 N, 1921 N, 1691 N, 1623 N, 1476 N, and 962 N, respectively. Statistically, load to fracture of the simulated immature tooth group was significantly lower than in the intact tooth, MTA, fiber post, and composite resin groups but was not significantly different from the gutta-percha group. CONCLUSIONS Within the limit of this study, after MTA apexification, intraradicular reinforcement with MTA, fiber post, or composite resin increased the fracture resistance of simulated immature teeth.
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Affiliation(s)
- Pairoj Linsuwanont
- Faculty of Dentistry, Department of Restorative Dentistry, Chulalongkorn University, Bangkok, Thailand.
| | - Sirinya Kulvitit
- Faculty of Dentistry, Department of Restorative Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Busayarat Santiwong
- Faculty of Dentistry, Department of Pediatric Dentistry, Chulalongkorn University, Bangkok, Thailand
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An Innovative Regenerative Endodontic Procedure Using Leukocyte and Platelet-rich Fibrin Associated with Apical Surgery: A Case Report. J Endod 2017; 43:1828-1834. [PMID: 28965773 DOI: 10.1016/j.joen.2017.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/28/2017] [Accepted: 07/02/2017] [Indexed: 12/16/2022]
Abstract
Regenerative endodontic procedures (REPs) associated with apical surgery could represent an alternative treatment strategy for patients whose teeth present incomplete root formation and extensive apical lesions. Leukocyte platelet-rich fibrin (L-PRF) has potential benefits in REPs; it could promote apical root formation and optimal bone healing. The aim of this case report was to describe innovative regenerative endodontic therapy using L-PRF in the root canal and an extensive apical lesion in an immature tooth with dens invaginatus and asymptomatic apical periodontitis. A healthy 20-year-old woman was referred to the dental clinic of the Universidad de Los Andes, Santiago, Chile, for endodontic treatment in tooth # 22 with incomplete root development and an extensive apical lesion. The diagnosis was asymptomatic apical periodontitis associated with dens invaginatus type II. The patient was treated with an innovative approach using L-PRF in REPs associated with apical surgery. Follow-ups were performed at 6 months and 1 year later. They included periapical radiographs, cone-beam computed tomographic imaging, sensitivity, and vitality tests. The clinical evaluations performed at 6 months and 1 year revealed an absence of symptoms. The radiographic evaluations showed that the apical lesion was resolved. The cone-beam images indicated that the root length increased and the walls had thickened. The sensitivity tests were positive, and the laser Doppler flowmetry showed positive blood flow after 1 year. The success of the results in this case report indicate that L-PRF can be used as a complement in apical surgery and REPs and could provide an innovative alternative treatment strategy for complex clinical cases like these.
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Long-term Evaluation of Fracture Removal Treatment for Propagated Crown Fractures. J Endod 2017; 43:1214-1217. [DOI: 10.1016/j.joen.2017.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 12/15/2016] [Accepted: 02/07/2017] [Indexed: 11/18/2022]
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Junqueira RB, de Carvalho RF, Marinho CC, Valera MC, Carvalho CAT. Influence of glass fibre post length and remaining dentine thickness on the fracture resistance of root filled teeth. Int Endod J 2016; 50:569-577. [DOI: 10.1111/iej.12653] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Accepted: 04/19/2016] [Indexed: 11/30/2022]
Affiliation(s)
- R. B. Junqueira
- Department of Restorative Dentistry; Institute of Science and Technology; University Estadual Paulista (UNESP); São José dos Campos Brazil
| | - R. F. de Carvalho
- Department of Restorative Dentistry; Institute of Science and Technology; University Estadual Paulista (UNESP); São José dos Campos Brazil
| | - C. C. Marinho
- Department of Restorative Dentistry; Institute of Science and Technology; University Estadual Paulista (UNESP); São José dos Campos Brazil
| | - M. C. Valera
- Department of Restorative Dentistry; Institute of Science and Technology; University Estadual Paulista (UNESP); São José dos Campos Brazil
| | - C. A. T. Carvalho
- Department of Restorative Dentistry; Institute of Science and Technology; University Estadual Paulista (UNESP); São José dos Campos Brazil
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Mazzoleni S, Graf F, Salomon E, Simionato F, Bacci C, Stellini E. Influence of Root Canal Posts on the Reattachment of Fragments to Endodontically Treated Fractured Incisors: An in vitro Experimental Comparison. J ESTHET RESTOR DENT 2015; 28:92-101. [PMID: 26575585 DOI: 10.1111/jerd.12181] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to establish the benefits of inserting a fiberglass post when bonding tooth fragments after complicated coronal fractures. METHODS Thirty bovine incisors were randomly assigned to three groups: a control group of intact teeth (A), and two experimental groups (B and C). Coronal fragments were cut from the teeth in groups B and C, which then underwent root canal treatment, inserting posts in the teeth in group C. The coronal fragments were bonded to the teeth in both experimental groups using the same materials and technique, then the specimens were submitted to mechanical loading until fracture. RESULTS The specimens in the experimental groups had a lower resistance to mechanical loading than the intact teeth. The mean failure load was: 352.77 (SD ± 62.22) N in group A, 151.04 (SD ± 45.76) N in group B, and 168.61 (SD ± 33.59) N in group C. The difference between group A and the other two groups was statistically significant (analysis of variance test: p < 0.0001), whereas there was no statistically significant difference in the force needed to fracture the teeth in groups B and C (Tukey's test: p = 0.34). When the failure mode under loading was examined, the fractures in group C never involved new tooth substance beneath the adhesion interface, whereas in group B, this was only true in one in two cases. CONCLUSIONS Inserting a post does not significantly improve the strength of restored teeth, but it may result in a more favorable fracture mode. CLINICAL SIGNIFICANCE Within the limitations of this in vitro study, reattaching the fragment of a fractured tooth does not seem to restore the tooth to its original load resistance. The findings of this study indicate that inserting a fiberglass post for reinforcement purposes in fractured teeth undergoing root canal treatment is unable to significantly improve their load-bearing capacity by comparison with teeth repaired without inserting a post. However, the results of the present study suggest that inserting a post may result in a more favorable fracture mode in the event of further trauma.
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Affiliation(s)
- Sergio Mazzoleni
- Department of Pediatric Dentistry, School of Dentistry-School of Dental Hygiene, University of Padova, Padova, Italy
| | - Francesco Graf
- Department of Pediatric Dentistry, School of Dentistry-School of Dental Hygiene, University of Padova, Padova, Italy
| | - Elena Salomon
- Department of Pediatric Dentistry, School of Dentistry-School of Dental Hygiene, University of Padova, Padova, Italy
| | - Francesco Simionato
- Department of Clinical Dentistry, School of Dentistry-School of Dental Hygiene, University of Padova, Padova, Italy
| | - Christian Bacci
- Department of Clinical Dentistry, School of Dentistry-School of Dental Hygiene, University of Padova, Padova, Italy
| | - Edoardo Stellini
- Department of Clinical Dentistry, School of Dentistry-School of Dental Hygiene, University of Padova, Padova, Italy
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Elnaghy AM, Elsaka SE. Fracture resistance of simulated immature teeth filled with Biodentine and white mineral trioxide aggregate - anin vitrostudy. Dent Traumatol 2015; 32:116-20. [DOI: 10.1111/edt.12224] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2015] [Indexed: 01/30/2023]
Affiliation(s)
- Amr M. Elnaghy
- Department of Conservative Dentistry and Endodontics; Faculty of Dentistry; Mansoura University; Mansoura Egypt
| | - Shaymaa E. Elsaka
- Department of Dental Biomaterials; Faculty of Dentistry; Mansoura University; Mansoura Egypt
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Comparison of Fracture Sites and Post Lengths in Longitudinal Root Fractures. J Endod 2015; 41:159-63. [DOI: 10.1016/j.joen.2014.09.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 09/18/2014] [Accepted: 09/21/2014] [Indexed: 11/22/2022]
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A Novel Treatment for Propagated Crown Fractures. J Endod 2015; 41:130-4. [DOI: 10.1016/j.joen.2014.06.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 06/17/2014] [Accepted: 06/25/2014] [Indexed: 10/24/2022]
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Pace R, Giuliani V, Nieri M, Di Nasso L, Pagavino G. Mineral trioxide aggregate as apical plug in teeth with necrotic pulp and immature apices: a 10-year case series. J Endod 2014; 40:1250-4. [PMID: 25069943 DOI: 10.1016/j.joen.2013.12.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 12/07/2013] [Accepted: 12/11/2013] [Indexed: 12/16/2022]
Abstract
INTRODUCTION This 10-year study evaluated the clinical and radiologic outcomes of teeth with necrotic pulp, immature apices, and periapical lesions treated with the mineral trioxide aggregate (MTA) apical plug technique. METHODS Seventeen single-rooted immature teeth with necrotic pulp and periapical lesion from 17 patients treated between January 2001 and December 2001 were included in this study. Apical obturation on all teeth included in the study was completed in 2 visits: first using calcium hydroxide as an interappointment intracanal medication and a second visit for the creation of the artificial apical barrier with MTA. The outcome, based on clinical and radiographic criteria, was assessed by 2 calibrated investigators using the periapical index (PAI). The Friedman test was used to verify the differences between baseline and the 1-, 5-, and 10-year PAI scores. RESULTS Of the 17 patients treated, 1 patient dropped out at 5 years. At the 10-year follow-up, 15 teeth were healed (PAI ≤2), and 1 tooth had been extracted because of the presence of a longitudinal root fracture. The PAI score exhibited a significant decrease between baseline and 1 year and between 1 and 5 years. The difference between 5 and 10 years was not significant. CONCLUSIONS The apical plug with MTA was a successful and effective technique for long-term management of this group of teeth with necrotic pulps with immature root development and periapical lesions.
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Affiliation(s)
- Riccardo Pace
- Department of Endodontics, University of Florence, Florence, Italy
| | | | - Michele Nieri
- Department of Endodontics, University of Florence, Florence, Italy
| | - Luca Di Nasso
- Department of Endodontics, University of Florence, Florence, Italy
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