Apexogenesis is the treatment of choice for traumatized or
carious teeth which, at the time of exposure, have a vital pulp
and open apex. This article describes two cases of permanent
teeth with carious exposures, treated with direct pulp capping
procedures using mineral trioxide aggregate (MTA).
METHODS : Radiographic and clinical examination, including testing
reaction to cold, showed that both teeth were immature and
in a stage of reversible pulpitis. The caries was identified using
caries detector dye and removed using a rotary bur. Sodium
hypochlorite solution was applied to the exposed pulp to
achieve haemostasis. MTA paste was then placed on the pulp
exposure and surrounding dentine. In the first case, the MTA
was covered with a glass-ionomer restorative material; in
the second case, the MTA was covered with a glass-ionomer
cement and restored with composite resin.
RESULTS : Radiographic and clinical examinations on the initial and longterm
follow-up visits showed that root development continued
and apices formed. The teeth remained vital and functional,
and no further endodontic intervention was necessary.
CONCLUSION : Under the conditions of this study, MTA proved to be a reliable
pulp-capping material on direct carious exposures in immature
permanent teeth using a one-visit protocol.