Apexification with calcium hydroxide and mineral trioxide aggregate: Report of two cases
An 11-year-old male patient reported with a chief complaint of discolored right maxillary central incisor with a history of trauma 1 year back. The concerned tooth did not respond to both electric and heat test. The periapical radiograph revealed a large blunderbuss canal of the same tooth []. On clinical examination, Ellis Class IV fracture in permanent right maxillary central incisor was evident. Apexification with MTA was planned. Access opening was prepared under rubber dam isolation and working length was determined. Pus was extruded from the root canal immediately after the access preparation; irrigation was done with saline. Biomechanical preparation was carried out using 80 size k file with circumferential filing motion. Root canal debridement was done using alternative irrigation with 2.5% NaoCl and saline. Calcium hydroxide was placed in the root canal and patient recalled after 5 days. At subsequent appointment, canal was irrigated with 2.5% NaoCl and 2% chlorhexidine. The canal was dried with paper points and MTA placed with pluggers until thickness of 6 mm []. A wet cotton pellet was placed in the canal and access cavity was sealed with temporary cement. In next appointment, root canal was obturated with GP using lateral condensation technique. Access cavity sealed with glass ionomer cement [].