PDF: Apexogenesis treatment with mineral trioxide aggregate: long-term follow-up of two cases


Apexogenesis is the treatment of choice for traumatized or carious teeth which, at the time of exposure, have a vital pulp and open apex.


This article describes two cases of permanent teeth with carious exposures, treated with direct pulp capping procedures using mineral trioxide aggregate (MTA).


Radiographic and clinical examination, including testing reaction to cold, showed that both teeth were immature and in a stage of reversible pulpitis.

The caries was identified using caries detector dye and removed using a rotary bur. Sodium hypochlorite solution was applied to the exposed pulp to achieve haemostasis.


MTA paste was then placed on the pulp exposure and surrounding dentine. In the first case, the MTA was covered with a glass-ionomer restorative material; in the second case, the MTA was covered with a glass-ionomer cement and restored with composite resin.

Vital pulp therapy on immature teeth allows for continuation of root formation, which leads to apical closure, preservation and maintenance of pulp vitality, stronger root structure and greater structural integrity.


This article presents two case reports where MTA was used as a direct, single-visit pulp capping material in cariously exposed teeth with immature roots.




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