Comparison of mineral trioxide aggregate and calcium hydroxide for apexification of immature permanent teeth: A systematic review and meta-analysis.

ABSTRACT

BACKGROUND/PURPOSE: Calcium hydroxide and mineral trioxide aggregate (MTA) are used for inducing a calcific barrier at an open tooth root (apexification). The purpose of this study was to compare the efficacy of calcium hydroxide and MTA for apexification of immature permanent teeth. METHODS: Medline, Cochrane, EMBASE, and Google Scholar were searched until November 24, 2015, using the keywords apexification, permanent teeth, MTA, and calcium hydroxide. RESULTS: Of 216 studies identified, four studies were included. There were no differences in the clinical success rate [pooled odds ratio (OR) = 3.03, 95% confidence interval (CI) 0.42-21.72, p = 0.271], radiographic success rate (pooled OR = 4.30, 95% CI 0.45-41.36, p = 0.206), or apical barrier formation rate (pooled OR = 1.71, 95% CI 0.59-4.96, p = 0.322) between calcium hydroxide and MTA groups. The time required for apical barrier formation was significantly less in the MTA group (pooled difference in means = -3.58, 95% CI from -4.91 to -2.25, p < 0.001). CONCLUSION: While both materials provide similar success rates, the shorter treatment time with MTA may translate into higher overall success rates because of better patient compliance.