Wangidjaja, Bryan and Widyastuti, Wiena and Istanto, Elline and Zulkifly, Dinie Qurratuaini (2026) The evaluation of apical plug formation during endodontic treatment of immature teeth: a case report. Jurnal Kedokteran Gigi Universitas Padjadjaran, 38 (1). pp. 182-189. ISSN 0854-6002 E-ISSN 2549-6514
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Abstract
Introduction: Trauma can cause significant changes in pulpal blood microcirculation, leading to pulp necrosis, arrested root formation, and the development of an open apex. One of the materials recommended for creating an apical plug is mineral trioxide aggregate (MTA). Apical plug formation using biomaterials such as MTA is a common technique for inducing apical closure and facilitating healing. The aim of this case report is to describe the use of the apical plug technique in immature teeth after trauma and to evaluate its effectiveness in achieving apical closure and healing. Case report: A 26-year-old woman visited the Department of Conservative Dentistry due to pain in her upper right anterior tooth. She had dental trauma. Tooth 11 presented with a Class IV composite restoration, and periapical radiographic examination revealed an open apex. A diagnosis of pulp necrosis with symptomatic apical periodontitis and an open apex was established. The apical size of the teeth was determined to be #80. Biomechanical preparation involved circumferential filling technique up to size #100 K-file. MTA with a 4 mm thickness was applied at the open apex, followed by continued obturation. The final restoration was completed using a direct composite restoration. Trauma can result in pulp necrosis, leading to incomplete root development in the immature teeth, which is characterized by thin apex wall and open apex. MTA offers advantages such as antibacterial properties, high marginal adaptation, and a pH of 12.5. In this case, a 6-month follow-up demonstrated healing progression in the periapical region. Conclusion: MTA is an excellent material for use in cases of immature teeth. The success of apical plug formation in this case can be evaluated by the resolution of patient complaints and the healing progress of the periapical region.
| Item Type: | Article (Case Report) |
|---|---|
| Uncontrolled Keywords: | apical plug, endodontic treatment, immature teeth, mineral trioxide aggregate, trauma |
| Subjects: | R Medicine > RK Dentistry |
| Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): | Kulliyyah of Dentistry Kulliyyah of Dentistry > Department of Restorative Dentistry |
| Depositing User: | DR DINIE QURRATUAINI ZULKIFLY |
| Date Deposited: | 05 Nov 2026 12:36 |
| Last Update: | 05 Nov 2026 12:36 |
| Queue Number: | 2026-10-Q6018 |
| URI: | http://irep.iium.edu.my/id/eprint/132482 |
| Indexed In: | Google Scholar |
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