The use of mineral trioxide aggregate for treatment of children with complications of dental trauma

Kharkova L.Y.; Korolenkova M.V.

doi:https://doi.org/10.17116/stomat202410304159

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THE AIM

Jf the study was to assess the efficacy of mineral trioxide aggregate for treatment of children with complicated permanent teeth trauma.

MATERIAL AND METHODS

The study comprised 29 children aged 6—13 years (mean age 8.6±1.7 years) with 36 injured constant teeth, from which 30 had immature roots, 27 (75%) teeth had necrotic pulp at baseline examination, 12 (33.3%) teeth showed radiological signs of external imflammatory root resorbtion, 2 teeth were diagnosed with of the root fracture (5.6%). MTA was used for pulp regeneration procedure in 25 (69.5%) teeth, external closure of resorbtion site in 3 (8.3%) teeth, root canal filling in 4 (11.1%) teeth, apical plug creation in 4 teeth (11.1%). The patients were folowed up for 1 to 9 years.

RESULTS

From 36 teeth only one was extracted 9 years after regenerative endodontic procedure because of cervical root fracture. In 2 teeth with external imflammatory resorbtion progession of replacement resorption took place, in 1 tooth necrosis of regenerated pulp tissue occurred 2 years after the procedure because of restoration marginal seal failure. In 25 teeth favorable outcome was registered with stabilisation of external root resorbtion, continous root growth in 24 teeth and radioluscent lesions healing in 6 teeht showing them at baseline examination. Change of external imflammator root resorbtion to replacement resorption was detected in 1 teeth from 3 with external closure of resorbtion site. Root calan filling with MTA was performed in 3 avulsed teeth with replantation delayed for more than 1 day and in 1 tooth with root fracture. All teeth were clinically asymptomatic during more than 5 years follow-up. Favorable outcome was received in all cases of apicl plug formation.

CONCLUSION

MTA is highly effective for preservation of constant teeth in children with clinically complicated situations. In many cases with hopeless long-term prognosis for a teeth MTA allows stabilization of dental tissue level with the teeth being an object for guided tissue regeneration.

Keywords:

dental injury

children

complications of dental trauma

mineral trioxide aggregate

regenerative endodontic procedure

Authors:

Kharkova L.Y.

Central Research Institute of Dentistry and Maxillofacial Surgery

ORCID: 0009-0004-2348-1270

Korolenkova M.V.

Central Research Institute of Dentistry and Maxillofacial Surgery

ORCID: 0000-0001-7705-462X

Received:

04.04.2024

Accepted:

02.05.2024

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References:

Rocha Lima TF, Nagata JY, de Souza-Filho FJ, de Jesus Soares A. Post-traumatic complications of severe luxations and replanted teeth. J Contemp Dent Pract. 2015;16(1):13-19. PMID: 25876944. https://doi.org/10.5005/jp-journals-10024-1628
Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review — Part I: chemical, physical, and antibacterial properties. J Endod. 2010;36(1):16-27. PMID: 20003930. https://doi.org/10.1016/j.joen.2009.09.006
Camilleri J, Montesin FE, Brady K, Sweeney R, Curtis RV, Ford TR. The constitution of mineral trioxide aggregate. Dent Mater. 2005;21(4):297-303. PMID: 15766576. https://doi.org/10.1016/j.dental.2004.05.010
Torabinejad M, Watson TF, Pitt Ford TR. Sealing ability of a mineral trioxide aggregate when used as a root end filling material. J Endod. 1993;19(12): 591-595. PMID: 8151252. https://doi.org/10.1016/S0099-2399(06)80271-2
Accorinte Mde L, Holland R, Reis A, Bortoluzzi MC, Murata SS, Dezan E Jr, Souza V, Alessandro LD. Evaluation of mineral trioxide aggregate and calcium hydroxide cement as pulp-capping agents in human teeth. J Endod. 2008;34(1):1-6. PMID: 18155482. https://doi.org/10.1016/j.joen.2007.09.012
Bargholz C. Perforation repair with mineral trioxide aggregate: a modified matrix concept. Int Endod J. 2005;38(1):59-69. PMID: 15606825. https://doi.org/10.1111/j.1365-2591.2004.00901.x
Barrieshi-Nusair KM, Qudeimat MA. A prospective clinical study of mineral trioxide aggregate for partial pulpotomy in cariously exposed permanent teeth. J Endod. 2006;32(8):731-735. https://doi.org/10.1016/j.joen.2005.12.008
Andreasen JO, Andreasen FM. Root resorption following traumatic dental injuries. Proc Finn Dent Soc. 1992;88(suppl 1):95-114. PMID: 1354871.
Patel S, Saberi N, Pimental T, Teng PH. Present status and future directions: Root resorption. Int Endod J. 2022;55(suppl 4):892-921. https://doi.org/10.1111/iej.13715
Antunes Bortoluzzi E, Juárez Broon N, Antonio Hungaro Duarte M, de Oliveira Demarchi AC, Monteiro Bramante C. The use of a setting accelerator and its effect on pH and calcium ion release of mineral trioxide aggregate and white Portland cement. J Endod. 2006;32(12):1194-1197. Epub 2006 Oct 13. PMID: 17174682. https://doi.org/10.1016/j.joen.2006.07.018
Torabinejad M, Hong CU, McDonald F, Pitt Ford TR. Physical and chemical properties of a new root-end filling material. J Endod. 1995;21(7):349-353. PMID: 7499973. https://doi.org/10.1016/S0099-2399(06)80967-2
Fridland M, Rosado R. MTA solubility: a long-term study. J Endod. 2005; 31(5):376-379. PMID: 15851933. https://doi.org/10.1097/01.don.0000140566.97319.3e
Al-Hezaimi K, Al-Shalan TA, Naghshbandi J, Oglesby S, Simon JH, Rotstein I. Antibacterial effect of two mineral trioxide aggregate (MTA) preparations against Enterococcus faecalis and Streptococcus sanguis in vitro. J ndod. 2006;32(11):1053-1056. Epub 2006 Jul 26. PMID: 17055905. https://doi.org/10.1016/j.joen.2006.06.004
Miyagak DC, de Carvalho EM, Robazza CR, Chavasco JK, Levorato GL. In vitro evaluation of the antimicrobial activity of endodontic sealers. Braz Oral Res. 2006;20(4):303-306. Erratum in: Braz Oral Res. 2007;21(1):9. PMID: 17242789. https://doi.org/10.1590/s1806-83242006000400004
Ribeiro CS, Kuteken FA, Hirata Júnior R, Scelza MF. Comparative evaluation of antimicrobial action of MTA, calcium hydroxide and Portland cement. J Appl Oral Sci. 2006;14(5):330-333. PMID: 19089053; PMCID: PMC4327223. https://doi.org/10.1590/s1678-77572006000500006
Holt DM, Watts JD, Beeson TJ, Kirkpatrick TC, Rutledge RE. The anti-microbial effect against enterococcus faecalis and the compressive strength of two types of mineral trioxide aggregate mixed with sterile water or 2% chlorhexidine liquid. J Endod. 2007;33(7):844-847. Epub 2007 May 18. PMID: 17804326. https://doi.org/10.1016/j.joen.2007.04.006
Korolenkova MV, Kharkova LYu, Rakhmanova MS. Pulp revascularization procedure for external inflammatory dental root resorption treatment. Dentistry = Stomatologiia. 2024;103(2):68-73. (In Russ.). https://doi.org/10.17116/stomat202410302168
Korolenkova MV, Starikova NV, Rakhmanova MS. Sovremennye podkhody k vedeniyu detei s polnym vyvikhom postoyannykh zubov [Modern approach to the treatment of children with constant teeth avulsion]. Stomatologiia (Mosk). 2020;99(6. Vyp. 2):38-43. (In Russ.). https://doi.org/10.17116/stomat20209906238
Korolenkova MV, Rakhmanova MS. Regeneratsiia pul’popodobnoĭ tkani pri lechenii patsientov s periodontitom vsledstvie vyvikha reztsov s nesformirovannymi korniami [Pulp revascularization for the management of avulsed incisors with immature roots and pulp necrosis]. Stomatologiia (Mosk). 2018; 97(4):49-54. (In Russ.). https://doi.org/10.17116/stomat20189704149.
Rahmanova MS, Korolenkova MV. Sovremennyj podhod k lecheniju postojannyh zubov s nesformirovannymi kornjami pri nekroze pul’py. Stomatologija detskogo vozrasta i profilaktika. 2018;3(66):39-42. (In Russ.). https://doi.org/10.25636/PMP.3.2018.3.7
Yang Q, Jian J, Abramson SB, Huang X. Inhibitory effects of iron on bone morphogenetic protein 2-induced osteoblastogenesis. J Bone Miner Res. 2011;26(6):1188-1196. PMID: 21308772. https://doi.org/10.1002/jbmr.337
Hakki SS, Bozkurt SB, Hakki EE, Belli S. Effects of mineral trioxide aggregate on cell survival, gene expression associated with mineralized tissues, and biomineralization of cementoblasts. J Endod. 2009;35(4):513-519. PMID: 19345796. https://doi.org/10.1016/j.joen.2008.12.016
Chen CL, Huang TH, Ding SJ, Shie MY, Kao CT. Comparison of calcium and silicate cement and mineral trioxide aggregate biologic effects and bone markers expression in MG63 cells. J Endod. 2009;35(5):682-685. PMID: 19410082. https://doi.org/10.1016/j.joen.2009.02.002
Paranjpe A, Zhang H, Johnson JD. Effects of mineral trioxide aggregate on human dental pulp cells after pulp-capping procedures. J Endod. 2010;36(6): 1042-1047. Epub 2010 Mar 15. PMID: 20478462. https://doi.org/10.1016/j.joen.2010.02.013
Zare Jahromi M, Kalantar Motamedi MR. Effect of calcium hydroxide on inflammatory root resorption and ankylosis in replanted teeth compared with other intracanal materials: a review. Restor Dent Endod. 2019;44(3):e32. PMID: 31485428; PMCID: PMC6713075. https://doi.org/10.5395/rde.2019.44.e32
Mente J, Hage N, Pfefferle T, Koch MJ, Dreyhaupt J, Staehle HJ, Friedman S. Mineral trioxide aggregate apical plugs in teeth with open apical foramina: a retrospective analysis of treatment outcome. J Endod. 2009;35(10): 1354-1358. PMID: 19801229. https://doi.org/10.1016/j.joen.2009.05.025
Mente J, Leo M, Panagidis D, Ohle M, Schneider S, Lorenzo Bermejo J, Pfefferle T. Treatment outcome of mineral trioxide aggregate in open apex teeth. J Endod. 2013;39(1):20-26. PMID: 23228252. https://doi.org/10.1016/j.joen.2012.10.007
Camilleri J, Pitt Ford TR. Mineral trioxide aggregate: a review of the constituents and biological properties of the material. Int Endod J. 2006;39(10): 747-754. PMID: 16948659. https://doi.org/10.1111/j.1365-2591.2006.01135.x
Roberts HW, Toth JM, Berzins DW, Charlton DG. Mineral trioxide aggregate material use in endodontic treatment: a review of the literature. Dent Mater. 2008;24(2):149-164. Epub 2007 Jun 21. PMID: 17586038. https://doi.org/10.1016/j.dental.2007.04.007
de Souza Costa CA, Duarte PT, de Souza PP, Giro EM, Hebling J. Cytotoxic effects and pulpal response caused by a mineral trioxide aggregate formulation and calcium hydroxide. Am J Dent. 2008;21(4):255-261. PMID: 18795523.
Ribeiro DA, Duarte MA, Matsumoto MA, Marques ME, Salvadori DM. Biocompatibility in vitro tests of mineral trioxide aggregate and regular and white Portland cements. J Endod. 2005;31(8):605-607. PMID: 16044045. https://doi.org/10.1097/01.don.0000153842.06657.e2
Sarkar NK, Caicedo R, Ritwik P, Moiseyeva R, Kawashima I. Physicochemical basis of the biologic properties of mineral trioxide aggregate. J Endod. 2005;31(2):97-100. PMID: 15671817. https://doi.org/10.1097/01.don.0000133155.04468.41
Korolenkova MV, Rakhmanova MS. Iskhody travmy postoiannykh zubov u deteĭ [Outcomes of traumatic dental injuries in children]. Stomatologiia (Mosk). 2019;98(4):116-122. (In Russ.). https://doi.org/10.17116/stomat201998041116
Torabinejad M, Parirokh M. Mineral trioxide aggregate: a comprehensive literature review — part II: leakage and biocompatibility investigations. J Endod. 2010;36(2):190-202. PMID: 20113774. https://doi.org/10.1016/j.joen.2009.09.010
Dadpe AM, Shah DY, Natanasabapathy V, Sureshbabu NM, Hindlekar AN, Modi K. Regenerative Endodontic Procedures in Teeth with Root Resorption: A Systematic Review. Eur Endod J. 2023;8(3):170-186. PMID: 37257034; PMCID: PMC10244915. https://doi.org/10.14744/eej.2023.77486
Altaii M, Richards L, Rossi-Fedele G. Histological assessment of regenerative endodontic treatment in animal studies with different scaffolds: A systematic review. Dent Traumatol. 2017;33(4):235-244. Epub 2017 Apr 20. PMID: 28342218. https://doi.org/10.1111/edt.12338
Juárez Broon N, Bramante CM, de Assis GF, Bortoluzzi EA, Bernardineli N, de Moraes IG, Garcia RB. Healing of root perforations treated with Mineral Trioxide Aggregate (MTA) and Portland cement. J Appl Oral Sci. 2006;14(5):305-311. PMID: 19089049; PMCID: PMC4327219. https://doi.org/10.1590/s1678-77572006000500002
Bargholz C. Perforation repair with mineral trioxide aggregate: a modified matrix concept. Int Endod J. 2005;38(1):59-69. PMID: 15606825. https://doi.org/10.1111/j.1365-2591.2004.00901.x