A Randomized Comparative Study of Apexification with MTA and Calcium-Hydroxide

Methods: This study, promoted by AP-HP, was approved by the ethical committee (CPP Paris Ile de France IV). 34 children aged from 6 to 18 and presenting a non-vital permanent incisor were selected. Prior to treatment, an appropriate written consent was obtained from parents and children. Patients were randomly assigned to either the MTA (experimental) or CH (control) groups. Recalls were performed after 3, 6 and 12 months to determine the presence or absence of a calcified apical barrier through the use of clinical and radiographic exams. Additional criteria such as clinical symptoms, apical radiolucencies, periapical index (PAI) were also noted.

Results: Preliminary results correspond to a 6-month evaluation of the first patients (10 from each group). Disappearance of all clinical symptoms (abscess, sinus tract, mobility, pain) was observed in all 20 patients. When considering the PAI and the presence of an apical lesion, healing occurred in 8 out of 10 patients regardless of the treatment group. After 6 months, an apical barrier could be observed in 6 out of 10 teeth treated with MTA® as opposed to only 1 tooth in the CH group.

Conclusion: Apexification using an MTA® plug would thus proved effective in the treatment of necrotic immature incisors and would allow the formation of an apical barrier faster than with calcium hydroxide.