From Void to Victory: Managing Open Apices with Mineral Trioxide Aggregate (MTA)- A Descriptive Case Series

Mineral trioxide aggregate (MTA) apexification is a predictable treatment for immature permanent teeth with necrotic pulps and open apices, offering superior sealing, biocompatibility, and shorter treatment duration than conventional calcium hydroxide. This descriptive case series evaluated three non-vital immature incisors with open apices and periapical radiolucencies following trauma or presenting with discoloration and pain. One tooth received an apical MTA plug followed by gutta-percha obturation, while two underwent MTA obturation. All teeth were restored and clinically and radiographically followed for 6-12 months. All cases demonstrated resolution of symptoms, reduction of periapical radiolucencies, and satisfactory healing, with the treated teeth remaining functional and asymptomatic. No postoperative complications occurred. These findings suggest that MTA apexification and obturation are effective treatment options for immature permanent teeth with necrotic pulps and open apices. Their favourable outcomes, reduced treatment time, and potential to improve the prognosis of structurally compromised teeth support their clinical use.