Mineral trioxide aggregate for the treatment of external root resorption in an avulsed immature tooth: Ten years of follow-up

Abstract

Introduction Root resorption may occur as a consequence of avulsion injury and may lead to the progressive loss of tooth structure. The aim was to report the outcome of root resorption treated with mineral trioxide aggregate in a replanted immature permanent incisor after 10 years of follow-up. Case outline This case presents external root resorption that was detected 18 months after the avulsion injury in a nine-year-old child. Apical portion of the canal was filled with mineral trioxide aggregate and the rest of the canal was filled with a canal sealer and gutta-percha. Control examinations were performed six months after the completion of the endodontic treatment and afterwards yearly. The tooth was asymptomatic clinically and radiographs did not show progression of root resorption up to four years of follow-up. Infraposition of the injured tooth was detected five years after the replantation, but without significant radiographic changes, until the eight-year follow-up, when root resorption was detected again. However, the tooth was still hard and symptomless at the 10-year follow-up. Conclusion Mineral trioxide aggregate may have an important role in the preservation of replanted immature teeth for a prolonged period.

Uvod Resorpcija korena zuba se može javiti kao posledica povrede i može voditi progresivnom gubitku zubnih struktura. Cilj rada je bio da se prikaže klinički ishod replantacije izbijenog stalnog zuba sa nezavršenim rastom korena posle deset godina. Prikaz bolesnika Predstavljen je slučaj eksterne resorpcije korena zuba detektovane 18 meseci posle avulzione povrede kod devetogodišnjeg deteta. Apikalni deo kanala korena zuba je napunjen mineralnim trioksidnim agregatom, dok je ostatak kanala opturiran pastom i gutaperka poenima. Kontrolni pregledi su obavljani šest meseci posle završetka endodontskog lečenja i, posle toga, jednom godišnje. Do četvrte godine praćenja zub je bio bez kliničkih i radiografskih znakova progresije resorpcije korena. Infrapozicija povređenog zuba uočena je pet godina posle replantacije, ali bez značajnih radiografskih promena sve do osme godine praćenja, kada je uočeno napredovanje resorpcije korena. Ipak, posle deset godina zub je i dalje bio klinički bez simptoma. Zaključak Mineralni trioksidni agregat može imati značajnu ulogu u dugotrajnom očuvanju replantiranih zuba sa nezavršenim rastom korena.