EVALUATION OF THE EFFECT OF MTA AND CALCIUM HYDROXIDE ON CLINICAL SUCCESS IN ENDODONTIC TREATMENTS
Caries or traumatic injuries teeth would cause reversible or irreversible injuries within the pulps of permanent mature or immature teeth. In teeth with reversible pulpitis, conventional endodontic treatment requires indirect-direct pulp capping, partial coroner or total coroner vital amputation treatment in order to ensure pulp vitality. These treatment modalities provide continuation of apexogenesis, in other words, root development in vital teeth with open apices. However, the high success rate of vital pulp treatment as an alternative to root canal treatment in teeth with irreversible pulpitis has changed the diagnostic classification of pulpitis.
Since there is no apical constriction in non-vital teeth with open apices, a hermetic root canal filling is not possible during endodontic treatment. In such cases, induction of calcific barrier formation at the apex by using calcium hydroxide and completion of the root canal treatment with the general apexification is the treatment of choice. In recent years, as an alternative to this conventional method, apexification is provided by applying MTA which is a biocompatible barrier to the apical third of the root. This method eliminates the long calcium hydroxide use and the risk of coronal microleakage and fracture because of the temporary restorations.
Since 2004, especially in teeth with non-vital pulps, open apices and periapical lesions, revascularization treatment is suggested as an alternative to apexification treatment with calcium hydroxide and MTA in various case reports. This treatment is advocated as a biologically based alternative approach that provides apexification of the teeth. In recent years, some reports state the successful outcomes of revascularization treatment in mature teeth with periapical lesions, even presenting the presence of pulpal vitality following the treatment.
In this presentation, I would like to share my experiences and knowledge about the vital pulp treatments in vital teeth with reversible-irreversible pulpitis and with completed-incompleted root development, and also, the clinical and radiological prognosis of apexification treatment with calcium hydroxide, MTA and revascularization in non-vital teeth with open apices and periapical lesions under the light of my papers that are published in distinguished international journals.
