Apexification of Immature Teeth with MTA : One Year Follow-up

Objectives: The purpose of this pilot study was to compare the efficacy of a new apexification method using Mineral Trioxyde Aggregate (Proroot® MTA, Dentsply) with the reference treatment based on calcium hydroxyde repeated stimulations. Methods: Since January 2003, 10 patients presenting a non vital immature tooth have been treated with MTA. After a calcium hydroxyde canal conditionning (1 to 4 weeks), a 4mm plug of MTA was condensed at the apical part of the root and 48 hours later, the root canal was filled with gutta-percha. Follow-up visits were performed at 1, 3, 6, 9, 12 and 24 months to record clinical symptoms (such as pain, swelling, sinus tract, …) and to follow thanks to radiography, the formation of a calcified barrier or the development of a radiolucent lesion. Data from 20 age-matched patients treated for calcium hydroxyde apexification in our clinical department were used as controls. Results: The clinical follow-up showed the disappearance of the clinical symptoms in all the patients treated with MTA from the very first recall visit. On the contrary, those symptoms were reported during calcium hydroxyde apexification in 8 of the control cases. Moreover, after MTA filling, a calcified apical barrier was initiated as soon as the third month's follow-up visit in some of the cases and was observed in all cases after 12 months. With calcium hydroxyde, the formation of an apical closure was achieved in 65% of the cases after an average 17 month period (6 to 30 months). Conclusions: In all cases, MTA has allowed an immediate permanent filling of the root canal and the achievement of a calcified barrier, faster and with a reduced number of visits when compared to calcium hydroxyde. These data require to be confirmed after a 24 month period.