Outcomes of necrotic immature open-apex central incisors treated by MTA apexification using poly(ε-caprolactone) fiber mesh as an apical barrier

Abstract

Background/purpose: Although unset mineral trioxide aggregate (MTA) has some cytotoxicity, MTA is still a biocompatible material suitable for doing apexification. This study assessed the outcomes for 8 necrotic immature open-apex permanent maxillary central incisors treated by MTA apexification using poly(ε-caprolactone) fiber mesh (PCL-FM) as an apical barrier (so-called PCL-FM/MTA apexification) to prevent extrusion of MTA materials into the periapical tissues of open-apex teeth. Methods: Eight necrotic immature open-apex permanent maxillary central incisors with the open apices measuring 2.5 mm–3.5 mm in diameter in 8 patients (6 boys and 2 girls; age range, 8–10 years) were first cleaned using ultrasonic activated irrigation with 2.5% sodium hypochlorite solution and then treated by PCL-FM/MTA apexification procedure. Results: All the 8 permanent maxillary central incisors showed successful outcomes after PCL-FM/MTA apexification procedure. The mean duration for apical hard tissue barrier formation of the 8 incisors was 6.8 ± 0.5 weeks (range 6–7 weeks). The mean increased root length was 1.8 ± 0.7 mm (range 1–3 mm) at 7 weeks and 3.1 ± 0.6 mm (range 2–4 mm) at 3 months. The mean increased dentinal wall thickness at the most apical portion of the root was 1.3 ± 0.5 mm (range 1–2 mm) at 7 weeks and 2.4 ± 0.6 mm (range 1.5–3 mm) at 3 months. None of the teeth treated by PCL-FM/MTA apexification showed tooth discoloration after a follow-up period of 3 months. Conclusion: PCL-FM/MTA apexification is an excellent technique for treatment of necrotic immature open-apex permanent maxillary central incisors. Keywords: Clinical outcome, Apical tooth root formation, Dentinal wall thickness, Apexification, Mineral trioxide aggregate, poly(ε-caprolactone) fiber mesh