MTA Apexification
- Apexification is a special type of root canal treatment, indicated for a
tooth with large canal (Fig.1
between black arrowheads) and open apex (blue arrow). This condition
is usually found in a young patient after trauma or with a special type of
tooth malformation
- Use a rubber dam, debride the root canal system using intra-canal
instruments (files, Fig.2: F), and irrigatge with NaOCl (bleach)
- Dry the canal system with large paper points (upside down). For disinfection, place
calcium hydroxide paste (Fig.3: blue *) in the root canal system for one week. Place a
temporary restoration (Cavit, black *) to seal the access opening
- After one week, use a rubber dam, remove the CaOH from the canal system
using NaOCl irrigation and instrument as needed
- Try in a RC (root canal) plugger (5/7, 9/11), attach an endo stopper,
and take PA with plugger
- Dry the canal(s) with largest paper points
- Prepare the ProRoot MTA root repair material according to the
mixing
instructions provided
- Using the carrier (plastic sleeve over carrier), dispense the cement
into the apical region. Condense the ProRoot MTA root repair material
into the apical region of the canal with pluggers (with a stopper, adjust
the length) or paper points. Create a three-to-five-millimeter apical
barrier of ProRoot MTA root repair material
- Confirm placement of the ProRoot MTA root repair material with a
radiograph (Fig.4: M). If an adequate barrier has not been created, rinse the ProRoot MTA root repair material out of the canal and repeat the procedure
- Take a wet cotton pellet, remove excess moisture from the pellet and
place in the canal. Seal the access preparation with a temporary
restoration (Fig.5: *) for a minimum of four hours
- After four hours, or at a later appointment, use a rubber dam and
examine the ProRoot MTA root repair material. This material should be
hard. If not, rinse and repeat the application
- When the ProRoot MTA root repair material is hardened, obuturate the
remaining canal space. The ProRoot MTA root repair material remains as
a permanent part of the root canal filling
- Return to
Assistant Page
Xin Wei, DDS, PhD, MS 1st edition 07/12/2011, last revision
07/12/2011