Apexification of A Permanent Immature Central Incisor
A Case Report
Aim: To report the induction of apical root development in an open apex central incisor with necrosed pulp by calcium hydroxide
Summary: A 27-year‐old female patient came to dental OPD with ache and discoloration of tooth #11 with a history of dental trauma. There was negative response on pulp sensitivity test on tooth #11. Periapical radiograph showed incomplete root formation with wide canal, divergent foramina, and fragile dentinal walls tooth #11. After giving local anesthesia on her first appointment, access was opened, working length was measured and pulp was extirpated. Chemo-mechanical debridement was done with 2.5% sodium hypochlorite solution and application of calcium hydroxide paste was placed. Access was then closed and patient was recalled for subsequent appointments. After a duration of 9-months, radiograph showed the evidence of complete root development with closure of foramina opening. Canal was filled with sealer and Gutta-Percha by thermo-chemical compaction.
Thomas JM, Arumugam EAP, Harris A, Ravi VV. Management of traumatizedimmature vital tooth: A case report. J Pharm Bioallied Sci. 2019;11(2):481–484.
Guerrero F MA, Ribas D, Aspiazu K. Apexification: A Systemic Review. J Conserv Dent. 2018;21(5):4.
Peralta Cervantes A, Curiel Torres S. Management of the postraumatic dentalcomplication. A case report. Odontología Vital. 2019; 1(30):7-14.
Linsuwanont P, Kulvitit S, Santiwong B. Reinforcement of simulated immaturepermanent teeth after mineral trioxide aggregate apexification. J Endod. 2018;44(1):163-7.
Mounir MM, Farsi JM, Alhazzazi TY, Matar MA, El-Housseiny AA.Characterization of the apical bridge barrier formed following amelogenin apexification.BMC Oral Health. 2018;18(1):1-8.
Ramnani K, Shetty R, Shetty S. Evaluation of Outcomes of Recent Materials used for Single Visit Apexification. J Adv Med Dent Sci Res. 2018;6(6):76-80.
Flores-Arriaga JC, de Jesús Pozos-Guillén A, González-Ortega O, Escobar-GarcíaDM, Masuoka-Ito D, del Campo-Téllez BIM, et al. Calcium sustained release, pHchanges and cell viability induced by chitosan-based pastes for apexification.Odontology. 2019;107(2):223-30.
Sharma V, Sharma S, Dudeja P, Grover S. Endodontic management of nonvital permanent teeth having immature roots with one step apexification, using mineral trioxide aggregate apical plug and autogenous platelet-rich fibrin membrane as an internal matrix: Case series. Contemp Clin Dent. 2016;7(1):67.
Jamal S, Umer F. Orthograde apical plug in a traumatized tooth with necrotic pulp and immature apex using calcium silicate cement: A case report. J Pak Med Assoc. 2020;70(2):S125-S128.
Katge FA, Patil DP. Comparative analysis of 2 calcium silicate–based cements (Biodentine and Mineral Trioxide Aggregate) as direct pulp-capping agent in young permanent molars: a split mouth study. J Endod. 2017;43(4):507-13.
Safwat O, Elkateb M, Dowidar K, El Meligy O. Clinical evaluation of ozone on dentinal lesions in young permanent molars using the stepwise excavation. J Clin Pediatr Dent. 2017;41(6):429-441.
Guerrero F, Mendoza A, Ribas D, Aspiazu K. Apexification: A systematic review. J Conserv Dent. 2018;21(5):462.
Elgailani RA, Awooda EM. Mineral trioxide aggregate plug and conventional root canal treatment of traumatized maxillary central incisor with an open apex: Three-year follow-up. Saudi Endod J. 2020;10(1):77.
Mohammadi Z, Dummer PMH. Properties and applications of calcium hydroxide in endodontics and dental traumatology. Int Endod J. 2011;44(8):697-730.
Muhamad A-H, Ayah J, Mai A, Azzaldeen A. Management of open apex in permenanet teeth with calcium hydroxide paste. Int J Dent Health Sci 2016;44(8):697-730.
Masmoudi F, Cherni L, Sebai A, Baccouche Z, Maatouk F. The complications of apexification with calcium hydroxide: Two case reports. Sch J Dent Sci. 2017;4(8):369-376.
Ajram J, Khalil I, Gergi R, Zogheib C. Management of an immature necrotic permanent molar with apical periodontitis treated by regenerative endodontic protocol using calcium hydroxide and MM-MTA: A case report with two years follow up. Dent J (Basel). 2019;7(1):1-6.
Digka A, Sakka D, Lyroudia K. Histological assessment of human regenerative endodontic procedures (REP) of immature permanent teeth with necrotic pulp/apical periodontitis: A systematic review. Aust Endod J. 2020;46(1):140-153.
Naseri M, Eftekhar L, Gholami F, Atai M, Dianat O. The effect of calcium hydroxide and nano–calcium hydroxide on microhardness and superficial chemical structure of root canal dentin: an ex vivo study. J Endod. 2019;45(9):1148-1154.
Yassen GH, Platt JA. The effect of nonsetting calcium hydroxide on root fracture and mechanical properties of radicular dentine: a systematic review. Int Endod J.2013;46(2):112-118.
Kahler SL, Shetty S, Andreasen FM, Kahler B. The effect of long-term dressing with calcium hydroxide on the fracture susceptibility of teeth. J Endod. 2018;44(3):464-469.
Lin JC, Lu JX, Zeng Q, Zhao W, Li WQ, Ling JQ. Comparison of mineral trioxide aggregate and calcium hydroxide for apexification of immature permanent teeth: A systematic review and meta-analysis. J Formos Med Assoc. 2016;115(7):523-530.
Lee LW, Hsieh SC, Lin YH, Huang CF, Hsiao SH, Hung WC. Comparison of clinical outcomes for 40 necrotic immature permanent incisors treated with calcium hydroxide or mineral trioxide aggregate apexification/apexogenesis. J Formos Med Assoc. 2015;114(2):139-146.
Liu Y, Liu X, Bi J, Yu S, Yang N, Song B et al. Cell migration and osteo/odontogenesis stimulation of iRoot FS as a potential apical barrier material in apexification. Int Endod J. 2020;53(4):467-477.
Digka A, Sakka D, Lyroudia K. Histological assessment of human regenerative endodontic procedures (REP) of immature permanent teeth with necrotic pulp/apical periodontitis: A systematic review. Aust ENdod J. 2020;46(1):140-53.
Duggal M, Tong HJ, Al-Ansary M, Twati W, Day P, Nazzal H. Interventions for the endodontic management of non-vital traumatised immature permanent anterior teeth in children and adolescents: a systematic review of the evidence and guidelines of the European Academy of Paediatric Dentistry. Eur Arch Paediatr Dent. 2017;18(3):139-151.