Endodontic treatment with MTA of a mandibular first premolar with open apex: case report

The classical apexification process with calcium hydroxide is associated with some problems, such as long-term treatment and the risk of teeth fracture. Recently, using mineral trioxide aggregate (MTA) as an apical plug to treat necrotized teeth with open apices has been suggested. The result indicated that this method can achieve a high degree of success and save treatment time. This report involves a mandibular first premolar with immature root development. The pulp was injured due to a cusp fracture and the tooth was subsequently treated with MTA. After the root canal was instrumented and irrigated with 2.5% NaOCl, calcium hydroxide was placed in the canal for 2 weeks. At the second visit the apical 4 mm of the root canal was filled with MTA. The postoperative period was asymptomatic, and radiographic examination demonstrated apparent regeneration of periapical tissue 30 months after the treatment. The result demonstrated that the use of MTA for apical plugging may be a valid treatment method.