Pulp Necrosis Clinical Trial
Official title:
Clinical and Radiographic Evaluation of Biodentine and Mineral Trioxide Aggregate in Revascularization of Non Vital Immature Permanent Anterior Teeth (Randomized Clinical Study)
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
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.
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