Treatment of open apex teeth using two types of white mineral trioxide aggregate after initial dressing with calcium hydroxide in children.

BACKGROUND: The clinical and radiographic success of two types of white mineral trioxide aggregate (MTA) as apical barriers in non-vital immature permanent incisors in children was investigated.

MATERIALS AND METHODS: Following an initial dressing with calcium hydroxide, MTA apical barriers were placed in 22 non-vital traumatized, permanent incisors with open apices in 21 children (mean age 10years). Teeth were alternately assigned to either white MTA ProRoot(®) or white MTA Angelus groups and treated by two operators. Clinical and radiographic reviews took place at baseline, 3 months and every 6months thereafter. Two other calibrated, blinded examiners evaluated all radiographs. Examiner agreement was assessed using Kappa-Cohen tests. Results were analysed using Fisher's exact tests and repeated measures anova.

RESULTS: The mean follow-up time was 23.4months. There were no statistically significant differences in clinical or radiographic outcomes between the two groups. The overall clinical success and relative radiographic success rate was 95.5%. Statistically significant reduction in periapical pathosis was shown over time in both groups (P<0.05). A significant relationship was identified between non-divergent apical anatomy and ideal positioning of the MTA plug in all teeth (P=0.04). Interestingly, coronal discolouration was observed in 22.7% of teeth following white MTA placement.

CONCLUSIONS: Apical barrier placement using both white MTA ProRoot(®) and white MTA Angelus after an initial calcium hydroxide dressing showed similar favourable clinical and radiographic outcomes.