Partial Pulpotomy of Immature Teeth with Apical Periodontitis using Bioceramics and Mineral Trioxide Aggregate: A Report of Three Cases

Pulpal necrosis of an immature permanent tooth with an open apex poses a challenge for the clinician. The conventional apexification technique using calcium hydroxide has yielded short-term success, but this technique has inevitable shortcomings. Hence, this case series aimed to evaluate the effectiveness of using bioceramics (iRoot BP) or mineral trioxide aggregate (MTA) for partial pulpotomies. Three boys aged 9 to 11 years old presented with partial pulp necrosis and symptomatic apical periodontitis of the mandibular right and left second premolar. The involved teeth were treated with a partial pulpotomy using either iRoot BP (case 1 and 2) or MTA (case 3). At the 8-month follow-up, no abnormal clinical signs or symptoms were observed. Periapical radiographs revealed a significant reduction in periapical radiolucency, a marked increase in the root canal wall thickness and ongoing closure of the apical opening. The bioceramic material (iRoot BP) and MTA both produced successful outcomes in the partial pulpotomy of immature teeth with partial pulp necrosis and apical periodontitis. However, iRoot BP was superior in terms of ease of clinical application, and would therefore be a better treatment alternative than MTA.