A nonsurgical endodontic treatment in open-apex and immature teeth affected by dens invaginatus: using a collagen membrane as an apical barrier.
BACKGROUND
The authors' objective in this case report is to demonstrate an effective nonsurgical endodontic treatment in open-apex teeth affected by dens invaginatus (DI) by using a collagen membrane as an apical barrier and using a mineral trioxide aggregate (MTA) apical plug.


METHODS
.  The authors present two cases of DI with open apexes in maxillary lateral incisors. In the first case, an adolescent had bilateral Oehlers type II DI and extensive periradicular radiolucency, internal root resorption and a vestibular fistula in the left maxillary lateral incisor. In the second case, an adult had Oehlers type II DI and an incomplete apex in the left maxillary lateral incisor. For both patients, the clinician placed a collagen membrane through the apexes of the left maxillary incisors to provide a resorbable extraradicular barrier against which MTA cement could be packed. The clinician obturated the adolescent's right lateral incisor.


RESULTS
In the adolescent, the vestibular sinus tract was closed after one week. At subsequent follow-up examinations, the periradicular regions were completely healed, and postoperative radiographs revealed good bone healing in the lateral incisors. The teeth were asymptomatic and healing was achieved without any need for further endodontic surgical intervention. In the adult patient, the tooth was symptom free after one week, and radiography performed six months after the procedure showed complete healing.


CONCLUSIONS
and


CONCLUSIONS
Despite complex anatomy and diagnoses of DI and open apexes, both patients successfully underwent nonsurgical endodontic treatment involving the use of a collagen membrane and an MTA apical plug. Using an extraradicular barrier clinically can help improve the adaptation of MTA in the apexes of open-apex teeth to achieve a complete seal.
Dental Research Center and Department of Endodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran.
Maryam
M
Gharechahi
Jamileh
J
Ghoddusi
D020341:Absorbable Implants; D000293:Adolescent; D017607:Aluminum Compounds / Q000627:therapeutic use; D056624:Apexification / Q000379:methods; D017610:Calcium Compounds / Q000627:therapeutic use; D003094:Collagen; D003719:Dens in Dente / Q000473:pathology / Q000628:therapy*; D003751:Dental Fistula / Q000628:therapy; D003790:Dental Pulp Necrosis / Q000628:therapy; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007180:Incisor / Q000002:abnormalities* / Q000473:pathology; D008567:Membranes, Artificial; D010087:Oxides / Q000627:therapeutic use; D010485:Periapical Periodontitis / Q000628:therapy; D011176:Post and Core Technique; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D018915:Root Canal Preparation / Q000379:methods; D012390:Root Canal Therapy / Q000379:methods*; D017640:Silicates / Q000627:therapeutic use; D019227:Tooth Apex / Q000473:pathology*; D055815:Young Adult
D017607:Aluminum Compounds; D017610:Calcium Compounds; D004338:Drug Combinations; D008567:Membranes, Artificial; D010087:Oxides; D012387:Root Canal Filling Materials; D017640:Silicates; C086631:mineral trioxide aggregate; D003094:Collagen