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      Mineral Trioxide Aggregate as an Apexogenesis Agent for Complicated Crown Fractures in Young Permanent Incisor

      case-report
      ,
      Case Reports in Dentistry
      Hindawi

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          Abstract

          Traumatic dental injuries are extremely common in children, and trauma to developing permanent teeth can disrupt root maturation; vital pulp therapy is an appropriate treatment for these teeth. This case report describes a 9-year-old boy who suffered dental trauma while playing football, resulting in an enamel–dentin fracture with pulp exposure in the left central incisor with an open apex (Cvek's stage 3) and an enamel–dentin fracture in the right central incisor with an open apex (Cvek's stage 3). Apexogenesis with mineral trioxide aggregate was performed to preserve the neurovascular bundle, allowing normal radicular formation in the left central incisor. During a 2-year follow-up, the tooth showed no signs and symptoms, and radiographic examinations revealed no evidence of radiolucent lesions in the periapical region. This case study provides compelling evidence that the utilization of the described agent yields significant efficacy in treating traumatic fractures accompanied by pulp exposure.

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          Most cited references27

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          Sealing ability of a mineral trioxide aggregate when used as a root end filling material.

          This in vitro study used rhodamine B fluorescent dye and a confocal microscope to evaluate the sealing ability of amalgam, super EBA, and a mineral trioxide aggregate when used as root end filling materials. Thirty single-canal teeth were cleaned, shaped, and obturated with gutta-percha and root canal sealer. After application of nail polish to the external surface, the apical 3 mm of each root was resected and 3-mm deep root end preparations were made. The roots were randomly divided into three groups and the root end preparations filled with the experimental materials. All roots were then exposed to an aqueous solution of rhodamine B fluorescent dye for 24 h, longitudinally sectioned, and the extent of dye penetration measured using a confocal microscope. Statistical analysis showed that the mineral trioxide aggregate leaked significantly less than amalgam and super EBA.
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            International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations

            Traumatic dental injuries (TDIs) of permanent teeth occur frequently in children and young adults. Crown fractures and luxations of these teeth are the most commonly occurring of all dental injuries. Proper diagnosis, treatment planning, and follow up are important for achieving a favorable outcome. Guidelines should assist dentists and patients in decision making and in providing the best care possible, both effectively and efficiently. The International Association of Dental Traumatology (IADT) has developed these Guidelines as a consensus statement after a comprehensive review of the dental literature and working group discussions. Experienced researchers and clinicians from various specialties and the general dentistry community were included in the working group. In cases where the published data did not appear conclusive, recommendations were based on the consensus opinions of the working group. They were then reviewed and approved by the members of the IADT Board of Directors. These Guidelines represent the best current evidence based on literature search and expert opinion. The primary goal of these Guidelines is to delineate an approach for the immediate or urgent care of TDIs. In this first article, the IADT Guidelines cover the management of fractures and luxations of permanent teeth. The IADT does not, and cannot, guarantee favorable outcomes from adherence to the Guidelines. However, the IADT believes that their application can maximize the probability of favorable outcomes.
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              Comparison of CaOH with MTA for direct pulp capping: a PBRN randomized clinical trial.

              This practice-based, randomized clinical trial evaluated and compared the success of direct pulp capping in permanent teeth with MTA (mineral trioxide aggregate) or CaOH (calcium hydroxide). Thirty-five practices in Northwest PRECEDENT were randomized to perform direct pulp caps with either CaOH (16 practices) or MTA (19 practices). Three hundred seventy-six individuals received a direct pulp cap with CaOH (n = 181) or MTA (n = 195). They were followed for up to 2 yrs at regular recall appointments, or as dictated by tooth symptoms. The primary outcomes were the need for extraction or root canal therapy. Teeth were also evaluated for pulp vitality, and radiographs were taken at the dentist's discretion. The probability of failure at 24 mos was 31.5% for CaOH vs. 19.7% for MTA (permutation log-rank test, p = .046). This large randomized clinical trial provided confirmatory evidence for a superior performance with MTA as a direct pulp-capping agent as compared with CaOH when evaluated in a practice-based research network for up to 2 yrs.
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                Author and article information

                Contributors
                Journal
                Case Rep Dent
                Case Rep Dent
                CRID
                Case Reports in Dentistry
                Hindawi
                2090-6447
                2090-6455
                2023
                3 July 2023
                : 2023
                : 5597996
                Affiliations
                Department of Pediatric and Preventive Dentistry, BBD College of Dental Sciences, BBD University, Lucknow, Uttar Pradesh, India
                Author notes

                Academic Editor: Sivakumar Nuvvula

                Author information
                https://orcid.org/0000-0002-4415-9449
                Article
                10.1155/2023/5597996
                10332921
                706e64b4-2ac6-474c-b4c3-48f7383757d0
                Copyright © 2023 Bibhav Dubey and Monika Rathore.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 9 April 2023
                : 14 June 2023
                : 15 June 2023
                Categories
                Case Report

                Dentistry
                Dentistry

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