Evaluation of Biodentine and Mineral Trioxide Aggregate in Revascularization of Non Vital Immature Anterior Teeth
Condition: Pulp Necrosis
MeSH terms: Dental Pulp Necrosis; Necrosis
Study type: Interventional

Summary: 
      the object of this study is to evaluate clinically and radiographically the effect of using
      Biodentine and Mineral Trioxide Aggregate as coronal plug materials in revascularization of
      non-vital immature teeth
    

Detailed description: 
      Traumatic injury to the anterior teeth is commonly found among young children, represent one
      third in boys and one fourth in girls. Because the root development completed two years after
      eruption of the tooth into the oral cavity, an incomplete root development is one of the most
      common complication seen in traumatized teeth. Loss of pulp vitality before dentine
      deposition is completed, leaves a weak root more susceptible to fracture as a result of the
      thin dentinal walls. It will also lead to a poor crown/root ratio, with possible periodontal
      injury as a result of increased mobility.

      Several techniques have been advocated to manage the open apex of immature teeth, including
      calcium hydroxide (Ca(OH)2) apexification or apical barrier technique with Mineral Trioxide
      Aggregate (MTA). Although these techniques were successful in obtaining apical closure and
      healing of the apical pathosis, they have certain disadvantages, as the root walls of the
      immature tooth remain thin and short as hard tissue barrier formation only occurs apically,
      with no further root development.

      As an replacement to traditional methods, the use of a regenerative endodontic procedure has
      been recommended as it may strengthen the root walls through the deposition of hard tissue
      and promote the development of a normal apical morphology. MTA was chosen to be placed over
      blood clot to provide excellent seal and it was considered the recommended material for
      regenerative procedures.The application of MTA over a blood clot was technically difficult,
      and condensation resulted in displacement of the material apically. Another important note
      was the prolonged setting time of MTA which resulted in postponing placement of composite
      restoration to next appointments and post-treatment tooth discoloration.

      Biodentine has the same mechanical properties as human dentine, very low cytotoxicity and
      overcome clinical drawbacks of white MTA. It had better consistency and allow its
      condensation without any apical displacement. Biodentine sets within twelve minutes, which
      allow placement of composite restoration in the same appointment. Biodentine is tooth-colored
      and doesn't cause the discoloration resulted from the presence of the material at level of
      the orifice.
    

Intervention name(s): Biodentine; Mineral Trioxide Aggregate
Intervention type(s): Drug; Drug
Intervention description(s): a procedure used to regenerate a pulp-dentine complex that restores functional properties of this tissue, fosters continued root development for immature teeth, and prevents or resolves apical periodontitis.; a procedure used to regenerate a pulp-dentine complex that restores functional properties of this tissue, fosters continued root development for immature teeth, and prevents or resolves apical periodontitis.
Other intervention name(s): Dentine substitute material; MTA
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: revascularization; necrotic; immature; coronal plug