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  MTA again ....

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From: Marga Ree
To: ROOTS
Sent: Saturday, May 05, 2007 10:22 PM
Subject: [roots] MTA again

This 10 year old boy sustained a trauma one year ago, luxation of 11,  21 was intruded, and there were
oncomplicated crown fractures on 11, 21 and 22.

One year later, a radiolucency was present on 21, and his dentist referred him for an apexification.

Severe bleeding and drainage of pus upon opening, Ca(OH)2 for 1 month. Second session: placement of a
barrier of CaSO4 and an apical plug of MTA.

Today I finished treatment. Because this tooth might need a facing or crown in the future,
I placed a post on top of the MTA. You can see that the CaSO4 has resolved in a few weeks. - Marga




Marga, I would like to use CaSO4 as well, Marga. Is it expensive ? How do you use it - is it hard to place ?
How do you order it (there are several types of Calcium Sulfate)? - Thomas

What a control...how do you stabilize the gg while taking the wirefilm? a rubberstop? - vipin

How do you control your length when placing MTA into such a large apex? I have never used MTA,
so this may be a silly question - Craig Anderson

No silly question at all. I use an extraradicular
matrix, calcium sulphate, which I apply just outside
the foramen, in the periradicular tissues.  In this
way, I can control the placement of MTA much better.
Just compare it with a matrix when making a
restoration, the only difference is that this matrix
is outside the root, and resolves in a few weeks. - Marga

Hi Marga et al.!  We sometimes face another hurdle and would like to get
your approach /opinion. Since we like to perform a 2 step procedure using CaOH
we often see remains of this medicament "stuck" to the surrounding tissue.
(see picture)  Do you see the need to remove it and if so, how do you
do it (as it can not be rinsed out)? - Chris



Hi Chris, I also see this regularly. What I do is trying to remove as much as
possible, usually I take a precurved file or a long, precurved explorer to
fish the big chunks out. Then I use anolyte to rinse the remnants out. You
can also use saline. But, the question is: should it be removed, because it
is supposed to dissolve.

I have had a couple of cases, in which I found hard chunks of Ca(OH)2
embedded in the tissues, even after 6 months. It appeared to create an
inflammatory response. So I'll go for removal.- Marga