Amy Dukoff, D.M.D.
MTA’s Advantage in Treating the Immature Apex
INERAL TRIOXIDE AGGREGATE (MTA) has been enormously successful as a vital necessity in the treatment for adult dentition. It has famously been noted for its ability to seal internally in the pulp chamber and along the root canal wall. As a barrier seal, it has proven its outstanding ability to prevent microleakage and is also valuable for its antimicrobial properties. The use of MTA as a root-end closure in immature apices should be considered as an alternative to the traditional calcium hydroxide apexification technique.
Creating an artificial barrier that is biocompatible is a necessity when treating the immature apex. Establishing a hard apical barrier is necessary in order to obturate the pulpal chamber. MTA is biocompatible, and it has the ability to stimulate hard tissue formation. Furthermore, normal periodontal ligament space has been found after mineral trioxide aggregate placement. Just as important, MTA placement can be done in one visit; both the practitioner and the patient benefit from fewer clinical treatment visits incomparison to the number of visits required by long-term apexification treatment application. Calcium hydroxide apexification treatment technique typically included multiple appointments over months and also required continual appointments to monitor its progress. After calcium hydroxide treatments, mineral trioxide aggregate can be introduced to create an artificial barrier. The two materials can work synergistically to create the desired result for both the practitioner and clinician.
Mineral trioxide aggregate is an important material that should be considered when planning treatment for teeth that have immature apices. Both gray and white MTA provide a seal against microleakage. Both materials create an artificial barrier that can become an apical barrier useful in the treatment of teeth that have an immature apex.
July - October 2008
MTA can create an apical barrier useful in the treatment of teeth that have an immature apex.
Temporarily seal the access opening with a layer of Cavit overlaid with a harder cement, such as Ketac or ZOP. Cavit can have a better seal, but the material is softer and may not hold up to chewing forces between visits as well as the harder cement will. Additionally, once the harder cement layer is removed at the next visit, the softer cavit is easier to remove and a good indicator that you have reached the medicated pulp chamber.
(with thanks to GT)
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