Evaluation the Effect of Using of Apical Matrix With Apexification Procedure on Apical Healing of Necrotic Immature Teeth
Condition: Pulp Necrosis; Apexification
MeSH terms: Dental Pulp Necrosis; Necrosis
Study type: Interventional
Phase: Phase 2/Phase 3

Summary: 
      This study was conducted to evaluate the effect of the use of apical matrix, with Mineral
      Trioxide Aggregate (MTA) or calcium hydroxide Ca(OH)2 Apexification on apical healing and
      calcific barrier formation of immature teeth with non- vital pulp.
    

Detailed description: 
      Conventional root canal ﬁlling procedures are challenging in cases of teeth with necrotic
      pulp, immature apices, and periapical lesions because of the absence of natural apical
      constriction and the presence of moisture contamination. In these cases, the risk of
      extrusion of the root ﬁlling materials and the difﬁculty in managing apical seals compromise
      the long-term outcome of treatment.

      Management of immature teeth with non-vital pulp were confined to custom fitting the filling
      material, paste fills and apical surgery. The limited success enjoyed by these procedures
      resulted in significant interest in the phenomenon of establishment of an apical barrier like
      apexification or continued apical development. Apexification defined as a procedure to induce
      a calcified barrier in a root with an open apex and necrotic pulp Traditionally, the most
      commonly used material for apexification is Ca(OH)2 .Despite the high success rate of The
      long-term Ca(OH)2 apexification , there are several disadvantages to this technique; Length
      of time for induction of apical hard tissue barriers. Incomplete apical hard tissue barriers
      because of vascular inclusions.To avoid the challenges associated with long-term Ca(OH)2
      apexification procedures, a non-surgical, one-step apexification using MTA as apical plug.

      The major problem in cases of a wide open apex is the need to limit the apexification
      material at the apex, thus avoiding the extrusion of a large amount of material into the
      periodontal tissue. The use of a matrix is advisable since its placement in the area of bone
      destruction provides a base on which the sealing material can be packed .

      This randomized controlled trial study was carried out to compare the clinical and
      radiographic outcome of Ca(OH)2 and MTA with or without internal matrix in non-vital immature
      maxillary incisors.
    

Intervention name(s): Apexification; MTA; Ca(OH)2; Apical matrix
Intervention type(s): Procedure; Drug; Drug; Drug
Intervention description(s): collagen membrane (Biocollagen; Bioteck:Turin, Italy)
Other intervention name(s): Proroot MTA; Ca(OH)2 dressing; internal matrix
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: participants are allocated at random to receive one of 4 interventions according to the research plan.
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Open apex; Immature teeth; Non vital pulp; Apical plug; Internal matrix