Intraradicular reinforcement of traumatized immature anterior teeth after MTA apexification
Issued Date
2024-01-01
Resource Type
ISSN
16004469
eISSN
16009657
Scopus ID
2-s2.0-85187116646
Journal Title
Dental Traumatology
Rights Holder(s)
SCOPUS
Bibliographic Citation
Dental Traumatology (2024)
Suggested Citation
Chotvorrarak K., Danwittayakorn S., Banomyong D., Suksaphar W. Intraradicular reinforcement of traumatized immature anterior teeth after MTA apexification. Dental Traumatology (2024). doi:10.1111/edt.12947 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/97637
Title
Intraradicular reinforcement of traumatized immature anterior teeth after MTA apexification
Corresponding Author(s)
Other Contributor(s)
Abstract
This review article describes the methods and clinical recommendations for reinforcing traumatized anterior immature teeth with pulp necrosis treated with mineral trioxide aggregate (MTA) apexification. Traumatic injury can cause pulp necrosis and incomplete root formation in immature teeth. MTA apexification is the treatment of choice for necrotic immature teeth, particularly during the middle or late stages of root development. MTA apexification has a high success rate; however, failures due to cervical or root fractures occasionally occur. The risk of fracture is higher in immature teeth with thin root dentin, particularly those with external root resorption. Furthermore, the loading force from any parafunctional habit also increases fracture risk. Therefore, intra-radicular reinforcement may be necessary after MTA apexification. In vitro, intraradicular restoration with a resin composite/core build-up material or a prefabricated fiber post demonstrated better root reinforcement than root canal obturation materials (i.e., gutta-percha and sealer). However, the root-reinforcement effect of MTA orthograde filling in the entire root canal remains unclear. In vivo, the survival of fractured teeth with intraradicular restorations (resin composite/core build-up material or prefabricated fiber posts) is extremely high. Moreover, the survival of teeth with gutta-percha/sealer obturation or MTA orthograde filling and restoration with resin composite extending into the cervical third of the root canal approximately 1–2 mm below the cemento-enamel junction is acceptably high. Based on this evidence, the remaining tooth/root structure and loading force should be carefully examined when considering intra-radicular reinforcement of immature anterior teeth treated with MTA apexification.