Although numerous studies have been conducted on apexification using mineral trioxide aggregate (MTA), direct observation of extracted human teeth after the procedure has been rarely reported. This case report describes a mandibular premolar treated 2.5 years ago and extracted recently for orthodontic treatment. The tubercle of the right mandibular premolar of a 12-year-old boy with dens evaginatus was fractured and the pulp was exposed. The tooth was diagnosed with pulp necrosis and asymptomatic periapical abscess. During the first visit, copious irrigation was performed with 2.5% sodium hypochlorite. Calcium hydroxide paste was placed as an intracanal medicament. The sinus tract had disappeared at the second visit after 3 weeks. MTA was applied on to the bleeding point as a 4-mm-thick layer, followed by a 3-mm-thick gutta-percha filling and resin core build-up. After 2.5 years, the tooth and three other premolars were extracted for orthodontic treatment. The right and left mandibular premolars were scanned with micro-computed tomography to determine the root shape and canal anatomy. Irregular root growth was observed and the root outline of the right mandibular premolar differed from that of the contralateral tooth. Apexification with MTA leads to the formation of roots with irregular morphology, without any pulpal space.

Citations

Citations to this article as recorded by  

• Incorporation of amoxicillin-loaded microspheres in mineral trioxide aggregate cement: an in vitro study
  Fábio Rocha Bohns, Vicente Castelo Branco Leitune, Isadora Martini Garcia, Bruna Genari, Nélio Bairros Dornelles, Silvia Stanisçuaski Guterres, Fabrício Aulo Ogliari, Mary Anne Sampaio de Melo, Fabrício Mezzomo Collares
  Restorative Dentistry & Endodontics.2020;[Epub]     CrossRef

Caries remains prevalent throughout modern society and is the main disease in the field of dentistry. Although studies of this disease have used diverse methodology, recently, X-ray microtomography has gained popularity as a non-destructive, 3-dimensional (3D) analytical technique, and has several advantages over the conventional methods. According to X-ray source, it is classified as monochromatic or polychromatic with the latter being more widely used due to the high cost of the monochromatic source despite some advantages. The determination of mineral density profiles based on changes in X-ray attenuation is the principle of this method and calibration and image processing procedures are needed for the better image and reproducible measurements. Using this tool, 3D reconstruction is also possible and it enables to visualize the internal structures of dental caries. With the advances in the computer technology, more diverse applications are being studied, such automated caries assessment algorithms.

Citations

Citations to this article as recorded by  

• Synchrotron X-ray Studies of the Structural and Functional Hierarchies in Mineralised Human Dental Enamel: A State-of-the-Art Review
  Cyril Besnard, Ali Marie, Sisini Sasidharan, Robert A. Harper, Richard M. Shelton, Gabriel Landini, Alexander M. Korsunsky
  Dentistry Journal.2023; 11(4): 98.     CrossRef
• Revelation of microcracks as tooth structural element by X-ray tomography and machine learning
  Irma Dumbryte, Donatas Narbutis, Arturas Vailionis, Saulius Juodkazis, Mangirdas Malinauskas
  Scientific Reports.2022;[Epub]     CrossRef
• Three-dimensional non-destructive visualization of teeth enamel microcracks using X-ray micro-computed tomography
  Irma Dumbryte, Arturas Vailionis, Edvinas Skliutas, Saulius Juodkazis, Mangirdas Malinauskas
  Scientific Reports.2021;[Epub]     CrossRef
• Radiological Appraisal of Biodentine and Pulpotec Individually or in Combination with Photo-activated Disinfection as Pulp-capping Cements in Mature Teeth
  Pratik Agrawal, Gaurav Patri, Surabhi Soumya, Prasanti K Pradhan, Vijeta Patri
  The Journal of Contemporary Dental Practice.2021; 22(9): 1014.     CrossRef
• Ex vivoevaluation of new 2D and 3D dental radiographic technology for detecting caries
  Laurence Gaalaas, Donald Tyndall, André Mol, Eric T Everett, Ananta Bangdiwala
  Dentomaxillofacial Radiology.2016; 45(3): 20150281.     CrossRef
• Stationary intraoral digital tomosynthesis using a carbon nanotube X-ray source array
  J Shan, A W Tucker, L R Gaalaas, G Wu, E Platin, A Mol, J Lu, O Zhou
  Dentomaxillofacial Radiology.2015; 44(9): 20150098.     CrossRef
• Comparative efficacy of photo-activated disinfection and calcium hydroxide for disinfection of remaining carious dentin in deep cavities: a clinical study
  Sidhartha Sharma, Ajay Logani, Naseem Shah
  Restorative Dentistry & Endodontics.2014; 39(3): 195.     CrossRef
• Current status of dental caries diagnosis using cone beam computed tomography
  Young-Seok Park, Jin-Soo Ahn, Ho-Beom Kwon, Seung-Pyo Lee
  Imaging Science in Dentistry.2011; 41(2): 43.     CrossRef