CDA Essentials 2015 • Volume 2 • Issue 5

31 / 48

31 Volume 2 Issue 5 |
Supporting Your Practice
Treatment options
Frank Technique
In this traditional approach, calcium hydroxide
is placed in a lightly cleansed canal to induce
apexification. The calcium hydroxide is replenished
every 3–6 months within the canal. It has been shown
that it requires approximately 18–24 months of active
treatment to gain adequate apical closure before gutta
percha obturation can be performed.
However, this long-term treatment can be
unpredictable with respect to the formation
of an apical seal. Also, the treatment period required
to achieve an apical seal is variable and can lead to
difficulty in appropriate follow-up (see ➊, ➋).
Apical Plug
Mineral Trioxide Aggregate (MTA) has been effective
in inducing apexification of roots when used
as an apical plug. Treatment with MTA has the
advantages of a shorter treatment time, fewer patient
appointments, and more predictable outcomes in
creating an apical barrier, especially in immature
permanent teeth with necrotic pulps. However,
similar to treatment with calcium hydroxide, MTA
only addresses the creation of an apical seal and not
root formation along the length of the root.
Follow-up radiograph taken
24 months after completion of
treatment.
Do you have any burning clinical questions related to your everyday practice? Are you facing a challenging
clinical case and need advice? Send your queries to Oasis Discussions for expert guidance. The following
question was submitted to Oasis Discussions by a general dentist. Drs. Michael Casas and SuhamAlexander
provided a response.
➋
Question
Response
Apexification
is the process of inducing
apical root closure in a
necrotic immature tooth.
For traumatically induced
pulp necrosis, the tooth
requiring apexification is
most commonly an incisor.
Traumatic injuries account
for approximately 5% of the
dental treatments sought
by patients.
Oasis Discussions
Ask Your Colleagues
Preoperative diagnostic
radiograph showing teeth 11 and
12 with open apices and periapical
radiolucencies.
➊
Case 1
Erratum
CDA Essentials did not reference the source JCDA article where the images shown in Case 1 originally appeared. The images
presented in Case 1 were adapted from:
Raldi DP, Mello I, Habitante SM, Lage-Marques JL, Coil J. Treatment options for teeth with open apices and apical
periodontitis.
CDA Essentials apologizes to the authors for this oversight.