title: Comparison of clinical outcomes for 40 necrotic immature permanent incisors treated with calcium hydroxide or mineral trioxide aggregate apexification/apexogenesis.
abstract: OBJECTIVE
  Traumatic injury often results in pulp necrosis of immature permanent incisors in children. This study compared clinical outcomes for 40 necrotic immature permanent incisors treated with calcium hydroxide [Ca(OH)2] or mineral trioxide aggregate (MTA) apexification/apexogenesis.
  
  
  METHODS
  Forty necrotic open-apex incisors from 40 children aged 6.5-10 years were divided evenly into four groups with each group containing teeth of similar type and similar root apex width in patients of similar age. Group 1 incisors were treated with ultrasonic filing and MTA placement; Group 2 were treated with ultrasonic filing and Ca(OH)2 medication; Group 3 were treated with hand filing and MTA placement; and Group 4 were treated with hand filing and Ca(OH)2 medication.
  
  
  RESULTS
  Group 1 incisors needed the shortest mean duration (5.4 ± 1.1 weeks) for apical hard tissue barrier formation, followed by Group 3 incisors (7.8 ± 1.8 weeks), Group 2 incisors (11.3 ± 1.3 weeks), and Group 4 incisors (13.1 ± 1.5 weeks). Group 1 incisors had a significantly shorter mean elongated root length (2.1 ± 0.2 mm) after treatment than Group 2 incisors (3.5 ± 0.3 mm, p < 0.001), and Group 3 incisors had a significantly shorter mean elongated root length (2.1 ± 0.1 mm) after treatment than Group 4 incisors (3.7 ± 0.3 mm, p < 0.001).
  
  
  CONCLUSIONS
  Necrotic open-apex incisors treated with ultrasonic filing plus MTA placement need the shortest mean duration for apical hard tissue barrier formation. For elongation of apical root length, Ca(OH)2 apexification/apexogenesis is better than MTA apexification/apexogenesis, regardless if either ultrasonic or hand filing are used.
authors.affiliation: Department of Dentistry, Taipei City Hospital, Renai Branch, Taipei, Taiwan.
authors.forename: Li-Wan
authors.initials: LW
authors.lastname: Lee
authors.affiliation: School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan; Division of Endodontics, Department of Dentistry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Sung-Chih
authors.initials: SC
authors.lastname: Hsieh
authors.affiliation: School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan; Division of Oral Pathology, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Yun-Ho
authors.initials: YH
authors.lastname: Lin
authors.affiliation: School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan; Division of Family and Operative Dentistry, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Chiung-Fang
authors.initials: CF
authors.lastname: Huang
authors.affiliation: Department of Neurosurgery, Taipei City Hospital, Renai Branch, Taipei, Taiwan.
authors.forename: Sheng-Huang
authors.initials: SH
authors.lastname: Hsiao
authors.affiliation: School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan; Division of Endodontics, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan. Electronic address: chase.hwc415@msa.hinet.net.
authors.forename: Wei-Chiang
authors.initials: WC
authors.lastname: Hung
mesh_terms: D017607:Aluminum Compounds / Q000627:therapeutic use*; D056624:Apexification / Q000379:methods*; D017610:Calcium Compounds / Q000627:therapeutic use*; D002126:Calcium Hydroxide / Q000627:therapeutic use*; D002648:Child; D003790:Dental Pulp Necrosis / Q000628:therapy*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007180:Incisor / Q000293:injuries*; D008297:Male; D010087:Oxides / Q000627:therapeutic use*; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D017640:Silicates / Q000627:therapeutic use*; D014092:Tooth Root / Q000000981:diagnostic imaging*
chemical_list: D017607:Aluminum Compounds; D017610:Calcium Compounds; D004338:Drug Combinations; D010087:Oxides; D012387:Root Canal Filling Materials; D017640:Silicates; C086631:mineral trioxide aggregate; D002126:Calcium Hydroxide
keywords: apexification; apexogenesis; calcium hydroxide; mineral trioxide aggregate; sodium hypochlorite; ultrasonics