Apicoectomy and Direct pulp cap
What techniques and products are best for endodontic microsurgery? – MTA Super EBA
Microsurgery has better outcomes than retreatment, which makes sense for many reasons and I agree with UNLESS can see reason for failure like a missed canal. Curtis JOE 2018
BP-RPM is comparable to MTA for endodontic microsurgery according to Zhoe JOE 2017
There is no difference in success with MTA or Super EBA at 4 years 182 teeth RCT based on Kim JOE 2016 Success was determined by following healing using peri-apical x-rays from three angles.
Super EBA = MTA 260 RC study
ProRoot MTA beats SuperEBA May 12 170 RCT
Hemostatic agents epi and AlCl were comparable in terms of impact they have on healing. Peñarrocha-Diago JOE 2018
Endodontic microsurgery : When to give up on a tooth and do the dental implant
Dental implant is a superior option to endodontic microsurgery with respect to survival. Literature does not allow comparison of other relevant outcomes such as psycho-social, economic, and need for additional interventions. Systemic Review Torabinejad Jan 2015 JOE
Endodontic microsurgery survival rates are reported around 96% at 2-4 years and 88% at 4-6 years.
Studies on endodontic surgical treatment
Jang JOE Aug 2015
ProRoot MTA = Endocem
Class V DPC less successful
ProRoot MTA = calcium silicate-based cement
Endocem = fast-setting pozzolan-based MTA
Biodentine = calcium silicate based
RetroMTA = 60-80wt% calcium carbonate, calcium zirconia 20-30%, silicon dioxide 5-15%, aluminum oxide 5-10%
TheraCal = resin-modified calcium silicate liner type III portland cement 45 wt%, resin 40%, radiopacifier 10%, silica 5%
Biodentine = MTA > CaOH2 > Bonding agent at forming dentin Human trial good study Nowicka JOE Aug 2015
ProRoot MTA=RetroMTA>TheraCal dog study in calific barrier formation and lack of inflammation http://www.jendodon.com/article/S0099-2399%2815%2900342-8/abstractLee JOE Aug 2015
MTA pulp cap and Biodentine direct pulp cap
MTA pulp cap procedural steps
Post-Exposure
- Mix MTA and place thin layer
- TheraCal LC over that and cure
- Selective etch technique with gluma after etch
Research on MTA pulp cap procedure
Can bond immediately over MTA Tsujimoto 2013
Meta-analysis – Appears to me that MTA is the best but “not statistically significant”. and 2014 EBD
Meta-analysis – MTA better than CH Zhaofei Sept 15 Didileschu JADA 2018
MTA beats CH Mente JOE 2014
MTA = Endocem but only 3 month study Song JOE 2015 Jan
Review MTA better than CH EBD 2016
MTA=Biodentine Katge 2017 JOE
MTA=CH but Biodentine better Brizuela JOE 2017
Pulpotomy
Biodentine and MTA beat Theracal likely due to resin. Bakhtiar JOE 2017
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