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Clinical and radiographic evaluation of premixed bioceramic putty as an apical plug in nonvital immature anterior permanent teeth

Sci Rep. 2025 Jul 21;15(1):26487. doi: 10.1038/s41598-025-11407-x.

ABSTRACT

Achieving an apical seal is critical for apexification treatment of nonvital immature teeth. While this is commonly accomplished using biocompatible mineral trioxide aggregate (MTA), its limitations, such as prolonged setting time, discoloration, and challenging handling, have driven the search for alternative materials. This study aimed to compare the clinical and radiographic success of bioceramic putty Well-Root PT apical plug compared to MTA in the treatment of nonvital immature permanent incisors. Fifty immature nonvital maxillary permanent central incisors in thirty-eight children aged 8-11 years were randomly divided into two groups (25 teeth/group). Group I received MTA apical plugs, and Group II was treated with Well-Root PT apical plugs. Both groups were recalled at 6 and 12 months for clinical and radiographic evaluations. Statistical analysis was done for the gathered data. Both groups showed improved clinical signs and symptoms during all follow-up periods with no statistically significant difference. Regarding the periapical radiolucency (PAR) area, at twelve months, the mean PAR area in the Well-Root PT group was (0.14 ± 0.08) compared to (2.3 ± 0.9) in the MTA group, with highly statistically significant differences (p < 0.001). The mean periapical bone radiodensity in the Well-Root PT group was (178.2 ± 5.4) compared to (164.8 ± 9.4) in the MTA group at twelve-month follow-up, with highly statistically significant differences(p < 0.001). Well-Root PT, with its reduced technical sensitivity, demonstrates satisfactory clinical and radiographic success as an apical plug for nonvital immature permanent incisors compared to MTA.

PMID:40691703 | DOI:10.1038/s41598-025-11407-x

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