Different Treatment Strategies With Mineral Trioxide Aggregate in Children

Objectives: This case series aimed to present different clinical applications of Mineral-Trioxide-Aggregate (MTA) in four children aged 6-12.
Methods: Case-1 was an 11-year-old boy who applied to our clinic one day after the trauma with a complicated-crown fracture in tooth #11. The dentine has been sealed with glass-ionomer-cement (GIC). After removal of GIC, the color of the pulp could be seen. The coronal pulp was removed. The cavity was rinsed with sterile-saline and 2.5%-sodium-hypochlorite (NaOCl). MTA, GIC, and composite-resin-restoration were placed for the coronal pulpotomy procedure.
Case-2 was a 12-year-old boy who applied to our clinic with spontaneous pain in tooth #21. #21 had been treated with regenerative endodontic treatment (RET) after extrusive luxation 4-years ago. After the removal of MTA, the canal was irrigated with 2.5%-NaOCl, sterile-saline, and 17%-ethylenediaminetetraacetic-acid solution (EDTA). Calcium-hydroxide (CaOH₂) was used for intracanal medicament. When the tooth is symptom free root-canal was obturated with MTA. Then GIC and composite-resin-restoration used for restoration.
Case-3 was an 11-year-old boy with deep dentin caries in immature tooth #46 with sensitivity to vertical percussion. Caries and coronal pulp was removed, the cavity was rinsed with sterile-saline and 2.5%-NaOCl. MTA, GIC, and composite-resin-restoration were placed for the pulpotomy procedure.
Case-4 was a 6-year-old girl with an abscess in immature tooth #36. The root-canal was irrigated with 2.5%-NaOCl, sterile-saline, and %17-EDTA. Ca(OH)₂ was applied for dressing. After 3-weeks, the root-canal was irrigated with %17-EDTA. The apical bleeding was achieved over-instrumentation with a sterile file. After filling the entire canal with blood to the level of cement-enamel-junction, MTA, GIC, and composite-resin-restoration were placed.
Results: Recalls were made at 1^st, 3^rd, 6^th, and 12^th months. No signs or symptoms of the pulpal disease were observed in all cases.
Conclusions: MTA could be a successful alternative material for pulpotomy, apexification, and RET in children.