Fig. 1

Pre op xray shows root resorption and necrosis with an apical lesion. Diastema and tooth discoloration represented additional problems to manage.

Fig. 2

Rubber dam was secured over tooth 21 with a 210  rubber dam clamp (K-CLAMP) and liquid rubber dam was used to ensure the isolation.

Fig. 3

The access cavity was drilled using a round carbide bur through the composite core. The pulp chamber was fully accessed and refined using a stainless steel diamond coated ultrasonic tip  with and without water spray.

Fig. 4

The apical portion of the root canal is prepared to create a space for the MTA apical plug. The size of the apical plug is determined based on the tooth's anatomy and the extent of apical enlargement desired.

Fig. 5

The pluger inside the canal with full WL 

Fig. 6

Collagen sponge in placement at the apical region of the root canal

Fig. 7

The MTA cement is mixed according to the manufacturer's instructions and is then placed in the prepared apical area using a suitable carrier. The MTA cement gradually sets and hardens over time, forming a solid barrier at the apex of the tooth.

Fig. 8

After the MTA has set, the remaining root canal is filled with a suitable root canal filling material, such as gutta-percha and sealer.

Fig. 9

Healing process and final restoration after 6 months.

Fig. 10

Bachelor of dental surgery (BDS) Ivan Horbachevsky Ternopil State Medical University UKRAIN  2011-2016

-Awarded the certificate of equivalency for the diploma Faculty of Dentistry \University of Baghdad  IRAQ 2019 

-MSc master in advanced Endodontics University of Siena \ ITALY 2021\2023



The MTA apical plug technique, when combined with internal tooth bleaching, offers an innovative and effective solution for endodontic treatment and tooth discoloration. The MTA apical plug provides an excellent seal and promotes tissue healing, while internal tooth bleaching addresses intrinsic tooth discoloration, yielding a desirable aesthetic outcome. By incorporating these techniques, dental professionals can achieve successful results with improved patient satisfaction. further research and advancements in this field will continue to enhance the efficiency and success rates of MTA apical plug with internal tooth bleaching, providing even better outcomes in the future.


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