Can MTA Resolution Affect the Prognosis of Regenerative Endodontic Procedures in Long Term: Case Report

Year 2025, Volume: 14 Issue: 2, 130 - 135, 26.05.2025

Alev Alacam

https://doi.org/10.54617/adoklinikbilimler.1641916

Abstract

Introduction: This report aims to evaluate the clinical and radiological results of cases in which Mineral Trioxide Aggregate (MTA) was found to dissolve in the root canals in the long term after Regenerative Endodontic Procedures (REP).
Case Report: The first case is an 8-year-old boy who applied to our clinic with the diagnosis of symptomatic pulpitis in the lower left first molar. The second case was an 11-year-old girl with
asymptomatic necrosis in her left lower jaw second molar. The prescribed method of treatment was blood clot revascularization. In both cases, triple antibiotic paste, and MTA were used for REP. After four to six years of follow-up, the teeth were clinically asymptomatic, but radiographic evaluation showed resolution of the MTA in both cases. While root development was considered complete in the first case, root dilaceration was observed in the second case.
Conclusion: The evaluation of these cases suggested that, despite long-term clinical adverse effects, MTA dissolution did not affect the clinical and radiographic success of REP treatments.

Keywords

MTA , solubility , porosity , regenerative endodontic procedure , resolutıon

MTA Çözünürlüğü Rejeneratif Endodontik İşlemlerin Uzun Vadede Prognozunu Etkileyebilir mi?: Vaka Raporu

Abstract

Giriş: Bu rapor, rejeneratif endodontik prosedürler (REP) sonrası uzun vadede Mineral Trioksit Agregat 'ın (MTA) kök kanallarında çözündüğü saptanan olguların klinik ve radyolojik sonuçlarını değerlendirmeyi amaçlamaktadır.
Vaka Raporu: İlk olgu, sol mandibular birinci büyük azı dişinde semptomatik pulpitis tanısı ile kliniğimize başvuran 8 yaşında erkek çocuğu, ikinci olgu ise sol mandibular ikinci büyük azı dişinde asemptomatik nekroz olan 11 yaşında bir kız çocuğuydu. Tedavi için öngörülen yöntem kan pıhtısı revaskülarizasyonuydu.
Her iki olguda da REP için üçlü antibiyotikli pat ve MTA kullanıldı. Dört ila altı yıllık takip süresinin ardından dişler klinik olarak asemptomatikti, ancak radyografik değerlendirme her iki olguda da MTA'nın çözüldüğünü gösterdi. İlk olguda kök gelişimi tamamlanmış kabul edilirken, ikinci olguda kök dilesarasyonu gözlendi.
Sonuç: Bu olguların değerlendirilme sonuçları, uzun vadede klinik olumsuzluklara rağmen MTA çözünmesinin REP tedavilerinde klinik ve radyografik başarıyı etkilemediğini göstermiştir.

Keywords

MTA , Çözünme , Çözünürlük , Porözite

References

• Staffoli S, Plotino G, Nunez Torrijos BG, Grande NM, Bossù M, Gambarini G, et al. Regenerative endodontic procedures using contemporary endodontic materials. Materials 2019;12:908.
• Moazzami F, Rajabzadeh Z, Daneshmanesh H, Ghahramani Y. Evaluation of the solubility and the porosity of the nano fast cement compared to the mineral trioxide aggregate: an in vitro study. J Dent (Shiraz) 2023;24:28-33.
• Camilleri J. Hydration mechanisms of mineral trioxide aggregate. Int Endod J 2007;40: 462–70.
• Chung SY, Kim YH, Chae YK, Jo SS, Choi SC, Nam OH. Void characteristics and tortuosity of calcium silicate- based cements for regenerative endodontics: a micro-computed tomography analysis. BMC Oral Health 2021;21:565.
• Milani AS, Rahimi S, Froughreyhani M, Vahid Pakdel M. Effect of blood contamination on marginal adaptation and surface microstructure of mineral trioxide aggregate: a SEM study. J Dent Res Dent Clin Dent Prospect 2013;7:157-63.
• Nagendrababu V, Chong BS, McCabe P, Shah PK, Priya E, Jayaraman J, et al. PRICE 2020 Guidelines for reporting case reports in endodontics: explanation and elaboration. Int Endodod J 2020;53:922-47.
• American Association of Endodontists. AAE clinical considerations for a regenerative procedure,https://www.aae.org/specialty/clinical-resources/regenerative- endodontics/ (2021)
• Chen MYH, Chen KL, Chen CA, Tayebaty F, Rosenberg PA, Lin LM, et al. Responses of immature permanent teeth with infected necrotic pulp tissue and apical periodontitis/abscess to revascularization procedures. Int Endod J 2012;45:294–305.
• Tong HJ, Rajan S, Bhujel N, Kang J, Duggal M, Nazzal H. Regenerative endodontic therapy in the management of nonvital immature permanent teeth: a systematic review-outcome evaluation and meta-analysis. J Endod 2017;43:1453-64.
• Torabinejad M, Nosrat A, Verma P, Udochukwu O. Regenerative endodontic treatment or mineral trioxide aggregate apical plug-in teeth with necrotic pulps and open apices: a systematic review and meta-analysis. J Endod 2017;43:1806-20.
• Zbanska J, Herman K, Kuropka P, Dobrzynski M. Regenerative endodontics as the future treatment of immature permanent teeth. Appl Sci 2021;11:6211.
• Hameed MH, Gul M, Ghafoor R, Badar SB. Management of immature necrotic permanent teeth with regenerative endodontic procedures—a review of literature. J Pak Med Assoc 2019;69:1514–20.
• Amini Ghazvini S, Abdo Tabrizi M, Kobarfard F, Akbarzadeh Baghban A, Asgary S. Ion release and pH of a new endodontic cement, MTA, and Portland cement. Iranian Endod J 2009;4:74-8.
• Khalil I, Naaman A, Camilleri J. Investigation of a novel mechanically mixed mineral trioxide aggregate (MM-MTA(™) ). Int Endod J 2015;48:757-67.
• Fridland M, Rosado R. Mineral trioxide aggregate (MTA) solubility and porosity with different water-to-powder ratios. J Endod 2003;29:814–7.
• Fridland M, Rosado R. MTA solubility: a long-term study. J Endod 2005;31:376–9.
• Cavenago BC, Pereira TC, Duarte MA, Ordinola-Zapata R, Marciano MA, Bramante CM, et al. Influence of powder-to-water ratio on radiopacity, setting time, pH, calcium ion release and a micro-CT volumetric solubility of white mineral trioxide aggregate. Int Endod J 2014;47:120-6.
• Chung SY, Abd Elrahman M, Stephan D, Kamm PH. Investigation of characteristics and responses of insulating cement paste specimens with Aer solids using X-ray micro- computed tomography. Constr Build Mater 2016;118:204-15.