Mineral trioxide aggregate apical plugs in teeth with open apical foramina: a retrospective analysis of treatment outcome.
BACKGROUND
Teeth with open apical foramina present a challenge during root canal treatment, and little is known about the clinical outcome of treatment in such teeth. This retrospective study assessed healing of teeth with open apices managed by the placement of mineral trioxide aggregate apical plugs.


METHODS
Seventy-two patients with 78 teeth with apical resorption or excessive apical enlargement, treated between 2000 and 2006, were contacted for follow-up examination 12 to 68 months after treatment (median 30.9 months). Treatments were provided by supervised undergraduate students (27%), general dentists (32%), or dentists who had focused on endodontics (41%). The outcome based on clinical and radiographic criteria was assessed by calibrated examiners and dichotomized as "healed" or "disease."


RESULTS
Of 56 teeth examined (72% recall), 84% were healed. Teeth without or with preoperative periapical radiolucency had a healed rate of 100% and 78%, respectively. None of the variables analyzed had a significant effect on the outcome.


CONCLUSIONS
The results supported the management of open apical foramina with mineral trioxide aggregate apical plugs.
Department of Conservative Dentistry, Ruprecht-Karls-University of Heidelberg, Germany. johannes_mente@med.uni-heidelberg.de
Johannes
J
Mente
Nathalie
N
Hage
Thorsten
T
Pfefferle
Martin Jean
MJ
Koch
Jens
J
Dreyhaupt
Hans Joerg
HJ
Staehle
Shimon
S
Friedman
D017607:Aluminum Compounds / Q000627:therapeutic use*; D056624:Apexification / Q000379:methods*; D017610:Calcium Compounds / Q000627:therapeutic use*; D002126:Calcium Hydroxide / Q000627:therapeutic use; D002710:Chlorhexidine / Q000627:therapeutic use; D015331:Cohort Studies; D003188:Composite Resins / Q000737:chemistry; D003791:Dental Pulp Test; D003793:Dental Restoration, Permanent; D004338:Drug Combinations; D004853:Epoxy Resins / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D017823:Furcation Defects / Q000145:classification; D006171:Gutta-Percha / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010087:Oxides / Q000627:therapeutic use*; D010485:Periapical Periodontitis / Q000628:therapy; D017622:Periodontal Attachment Loss / Q000145:classification; D010514:Periodontal Pocket / Q000145:classification; D011859:Radiography; D019233:Retreatment; D012189:Retrospective Studies; D012387:Root Canal Filling Materials / Q000627:therapeutic use*; D012388:Root Canal Irrigants / Q000627:therapeutic use; D018915:Root Canal Preparation / Q000009:adverse effects; D012391:Root Resorption / Q000628:therapy; D017640:Silicates / Q000627:therapeutic use*; D019227:Tooth Apex / Q000000981:diagnostic imaging / Q000187:drug effects*; D014086:Tooth Mobility / Q000145:classification; D016896:Treatment Outcome
D017607:Aluminum Compounds; D017610:Calcium Compounds; D003188:Composite Resins; D004338:Drug Combinations; D004853:Epoxy Resins; D010087:Oxides; D012387:Root Canal Filling Materials; D012388:Root Canal Irrigants; D017640:Silicates; C534916:epoxy resin-based root canal sealer; C086631:mineral trioxide aggregate; D006171:Gutta-Percha; D002126:Calcium Hydroxide; D002710:Chlorhexidine