Apexification of immature teeth with calcium hydroxide or mineral trioxide aggregate: systematic review and meta-analysis

Chala et al., 2011 | Oral Surg Oral Med Oral Pathol Oral Radiol Endod | Meta Analysis

Citation

Chala Sanaa, Abouqal Redouane, Rida Sana. Apexification of immature teeth with calcium hydroxide or mineral trioxide aggregate: systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011-Oct;112(4):e36-42. doi:10.1016/j.tripleo.2011.03.047

Abstract

OBJECTIVE: The aim of this study was to conduct a quantitative systematic review, including published data, comparing the efficacy of mineral trioxide aggregate and calcium hydroxide as material used for the endodontic management of immature teeth. STUDY DESIGN: Relevant studies published through November 2009 were identified through literature searches using Pubmed (Medline) and Scopus databases. Controlled trials in which calcium hydroxide versus mineral trioxide aggregate were used for the apexification of immature permanent teeth were selected for this study. The evaluation included clinical outcome and apical barrier formation. The principal measure of treatment effect was risk difference. The overall effect was tested by using Z score. Heterogeneity was tested by using the χ(2) statistic and I square (I(2)). A fixed-effect model was used when the studies in the subgroup were sufficiently similar. A random-effects model was used in the summary analysis when there was heterogeneity between the subgroups. RESULTS: Based on reduction of relative risk with 95% confidence intervals we found that the rate of clinical success (P = .29) and apical barrier formation (P = .76) of the 2 interventions had no perceivable discrepancy. Regarding success and apical barrier formation, either calcium hydroxide or mineral trioxide aggregate may be used for the apexification of immature teeth.

Key Findings

Based on reduction of relative risk with 95% confidence intervals we found that the rate of clinical success (P = .29) and apical barrier formation (P = .76) of the 2 interventions had no perceivable discrepancy. Regarding success and apical barrier formation, either calcium hydroxide or mineral trioxide aggregate may be used for the apexification of immature teeth.

Outcomes Measured

Requires manual extraction

Population

Field	Value
Population	See abstract
Sample Size	See abstract
Age Range	See abstract
Condition	See abstract

MeSH Terms

Apexification
Calcium Hydroxide
Dentin, Secondary
Glutamates
Guanine
Humans
Pemetrexed
Root Canal Filling Materials
Tooth Apex
Tooth Root
Treatment Outcome

Evidence Classification

Level: Meta Analysis
Publication Types: Comparative Study, Journal Article, Meta-Analysis, Systematic Review
Vertical: calcium

Provenance

PMID: 21778090
DOI: 10.1016/j.tripleo.2011.03.047
PMCID: Not in PMC
Verified: 2026-04-09 via PubMed E-utilities API

Source extracted via PubMed E-utilities API on 2026-04-09