Intraradicular reinforcement of traumatized immature anterior teeth after MTA apexification

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS
Kanet Chotvorrarak, Supatra Danwittayakorn, Danuchit Banomyong, Warattama Suksaphar
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Abstract

This review article describes the methods and clinical recommendations for reinforcing traumatized anterior immature teeth with pulp necrosis treated with mineral trioxide aggregate (MTA) apexification. Traumatic injury can cause pulp necrosis and incomplete root formation in immature teeth. MTA apexification is the treatment of choice for necrotic immature teeth, particularly during the middle or late stages of root development. MTA apexification has a high success rate; however, failures due to cervical or root fractures occasionally occur. The risk of fracture is higher in immature teeth with thin root dentin, particularly those with external root resorption. Furthermore, the loading force from any parafunctional habit also increases fracture risk. Therefore, intra-radicular reinforcement may be necessary after MTA apexification. In vitro, intraradicular restoration with a resin composite/core build-up material or a prefabricated fiber post demonstrated better root reinforcement than root canal obturation materials (i.e., gutta-percha and sealer). However, the root-reinforcement effect of MTA orthograde filling in the entire root canal remains unclear. In vivo, the survival of fractured teeth with intraradicular restorations (resin composite/core build-up material or prefabricated fiber posts) is extremely high. Moreover, the survival of teeth with gutta-percha/sealer obturation or MTA orthograde filling and restoration with resin composite extending into the cervical third of the root canal approximately 1–2 mm below the cemento-enamel junction is acceptably high. Based on this evidence, the remaining tooth/root structure and loading force should be carefully examined when considering intra-radicular reinforcement of immature anterior teeth treated with MTA apexification.

Abstract Image

在 MTA 顶点成形术后对创伤性未成熟前牙进行关节内加固。
这篇综述文章介绍了用三氧化矿物骨料(MTA)顶点强化术治疗牙髓坏死的创伤性前牙未成熟牙的方法和临床建议。外伤可导致牙髓坏死和未成熟牙牙根形成不完全。对于坏死的未成熟牙齿,尤其是在牙根发育的中期或晚期,MTA 尖端化是首选的治疗方法。MTA 尖端成形术的成功率很高;但偶尔也会出现因牙颈部或牙根折断而导致的失败。牙根牙本质薄的未成熟牙齿,尤其是外根吸收的牙齿,发生折断的风险更高。此外,任何副功能习惯所产生的负荷力也会增加骨折风险。因此,MTA 尖端化后可能需要进行根内加固。在体外,与根管封固材料(即古塔波卡和封闭剂)相比,使用树脂复合材料/桩核构建材料或预制纤维桩进行的根管内修复具有更好的根管加固效果。然而,MTA 正交充填对整个根管的根部加固效果仍不明确。在体内,使用根管内修复体(树脂复合材料/桩核材料或预制纤维桩)的折断牙存活率极高。此外,使用古塔漆/密封剂封闭或 MTA 正交充填,并将树脂复合材料伸入根管颈部三分之一处(低于牙本质-釉质交界处约 1-2 毫米)进行修复的牙齿存活率也很高。基于这些证据,在考虑对采用 MTA 尖端化治疗的未成熟前牙进行根管内加固时,应仔细检查剩余的牙齿/牙根结构和加载力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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