Management of a Traumatized Open Apex Tooth with a Combination of Mineral Trioxide Aggregate Apical Plug and Platelet-rich Fibrin Apical Matrix

Abstract

The absence of a natural apical constriction in permanent tooth makes endodontic treatment a challenge. Traditionally, calcium hydroxide was used for inducing the formation of an apical barrier. Currently, mineral trioxide aggregate (MTA) has shown promising results for apexification procedures. In an open apex, it is imperative to limit the MTA placement within the confines of the root canal for predictable healing. The placement of an internal matrix may limit the extrusion to some extent. Many materials can be used as internal matrix such as collagen membrane, calcium sulphate, hydroxyapatite, freeze dried bone, and platelet-rich fibrin (PRF) among others. This case report presents a successful demonstration of the management of an open apex using MTA placed over an internal apical matrix of PRF.