Case Report
Apexification using silicate-based apical plugs: case series
Jorge Carlos Alberdi1,2,3,4
Arminia Ema Baroffi2
Maria de los Angeles Guardiola2,5
Flávio Rodrigues Ferreira Alves6,7
https://doi.org/10.71347/rt97e4b6
1 Facultad de Ciencias de la Salud, Universidad Católica de Córdoba (UCC), Argentina.
2 Círculo Odontológico de Rosario (COR), Rosario, Argentina
3 Instituto Troiano Odontología (ITO), Rosario, Argentina
4 Endochat Research Group, Rio de Janeiro, Brazil
5 Department of Endodontics, School of Dentistry, Italian University Institute (IUNIR), Rosario, Argentina
6 Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Brazil
7 Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Brazil
Corresponding author:
lávio Rodrigues Ferreira Alves, PhD, DDS, MSc. Postgraduate Program in Dentistry, University of Grande Rio, Rua Professor José de Souza Herdy, 1160, Duque de Caxias, 25071-202, Brazil. E-mail: flavioferreiraalves@gmail.com. Tel: +55 21 23915920
Key words: Apexification; immature teeth; root canal treatment; root canal retreatment; silicate-based materials
Acknowledgements: In memory of Dra. Mini Baroffi (1948-2023).
This study was supported by grants from Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).
Abstract
The endodontic management of necrotic teeth with open apices presents substantial disinfection, shaping, and obturation challenges due to the thin dentin walls and wide canals. Fourteen necrotic teeth with open apices underwent primary treatment or retreatment through apexification using silicate-based apical plugs. Cone-beam computed tomography was utilized as needed for diagnostics and treatment planning. Disinfection involved irrigation with 2.5% sodium hypochlorite, followed by 17% EDTA, and a final rinse with saline. After drying, calcium hydroxide was frequently applied as an intracanal medication or barrier. The apical portions were sealed with a plug of mineral trioxide aggregate (MTA) or a bioceramic material (Bio C Repair), except in one case that was entirely filled with MTA. The coronal and middle thirds were obturated using fiber posts, gutta-percha, or MTA. All cases demonstrated favorable clinical and radiographic outcomes except one, which developed extensive root resorption.
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