Apexogenesis treatment with mineral trioxide aggregate : long-term follow-up of two cases

Abstract

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.