Objective: This retrospective study aimed to evaluate the clinical outcomes of the apical plug performed using MTA with or without collagen sponge in immature anterior maxillary teeth with necrotic pulp. Study design: The study included apical obturation of 20 upper incisor teeth from 18 patients and outcomes of 12-month follow-up. The teeth were divided into 2 groups with 10 cases in each group according to the apexification protocol (Group 1; apical plug with MTA, Group 2; collagen sponge and apical plug with MTA). The artificial apical barrier, approximately 4-mm-thick, was created with MTA in each group. Based on clinical and radiographic criteria, the outcome was assessed using the periapical index (PAI) by 2 calibrated investigators. Results: In this study, 3 of the 6 teeth (50%) in Group 1 and 5 of the 8 teeth (62.5%) in Group 2 healed at the 12-month follow-up. However, there was no statistically significant difference between the groups at the post-treatment follow-up times. Conclusion: The use of collagen as an apical matrix prior to the MTA plug can be suggested due to favorable clinical outcomes.

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