Treatment of dens invaginatus with MTA.
Patient came to the clinic complaining of pain on palpation of the right upper gingiva and report of endodontic treatment performed on tooth 12 about a year ago. On clinical examination, an enlarged crown size and inflammation in the apical gingival area were noted. Radiographic and tomographic examinations revealed a dens invaginatus malformation in the tooth, as well as endodontic treatment and a fractured instrument in the lateral canal.
The main canal was then retracted, the lateral canals decontaminated related to the dens invaginatus, with ultrasound. After unsuccessful attempts to remove the file, it was bypassed and decontamination of the area was performed with abundant irrigation. Then all spaces were filled with MTA under vibration of an ultrasonic tip.
The MTA (Mineral Trioxide Aggregate) is a material derived from Portland cement that revolutionized the treatment of various cases in endodontics both in adult teeth and in teeth with incomplete rhizogenesis. It is a material with bioactive properties, that is, it promotes the union between bone and the material, promotes tissue repair in areas with bone inflammation, has a basic pH, around 12, with slow release of calcium hydroxide and excellent resistance and sealing properties, unique among dental materials.
The materials derived from MTA are called bioceramics. Today, bioceramic cements can be used as a more viscous material, for conventional obturation, known as obturating cements, or with more hardness, for other purposes, known as restorative cements. Among its main indications are pulp capping, pulpotomy, furcation and lateral perforations, inflammatory cervical resorption, inflammatory internal and external resorption, and apicification in teeth with incomplete root formation. For contact with MTA, the best materials are resinous materials. Adhesives can be applied on it without the need for acid etching.
This class discusses various aspects related to MTA and bioceramic materials, their composition, properties, physical, chemical and biological properties, modes of application, and their practical use in the different cases in which it is indicated.
Case performed by the students Amanda Andrade, Marcus Alves and Silvana Mendes from classes IV and V of the specialization in endodontics at HPG Brasília.
https://ferrariendodontia.com.br/mta-e-bioceramicos-na-endodontia/
