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Apexification_Details (1)

Apexification is a dental procedure aimed at creating a calcified barrier in teeth with open apices and necrotic pulp, facilitating healing and maintaining tooth function. It is indicated for immature permanent teeth with pulpal necrosis but contraindicated in vital teeth and those with non-restorable fractures. The procedure can be performed using Calcium Hydroxide or MTA, with MTA offering higher predictability and lower risk of fracture compared to Calcium Hydroxide.

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5 views

Apexification_Details (1)

Apexification is a dental procedure aimed at creating a calcified barrier in teeth with open apices and necrotic pulp, facilitating healing and maintaining tooth function. It is indicated for immature permanent teeth with pulpal necrosis but contraindicated in vital teeth and those with non-restorable fractures. The procedure can be performed using Calcium Hydroxide or MTA, with MTA offering higher predictability and lower risk of fracture compared to Calcium Hydroxide.

Uploaded by

46 Udhaya Kumar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Apexification

Definition
Apexification is a method of inducing a calcified barrier in a root with an open apex or the
continued apical development of an incompletely formed root in teeth with necrotic pulp.

Objectives
To induce the formation of a hard tissue barrier at the root apex.
To create an environment that allows for apical closure in immature, non-vital teeth.
To prevent overextension of root canal filling materials.
To promote healing of periapical tissues.
To maintain tooth function and aesthetics.

Indications
Immature permanent teeth with necrotic pulp and open apices.
Traumatized immature teeth resulting in pulpal necrosis.
Cases where root canal obturation is difficult due to lack of an apical stop.
Periapical pathology in immature teeth.

Contraindications
Vital teeth (for those, apexogenesis is preferred).
Teeth with no potential for restoration.
Non-restorable crown-root fractures.
Presence of vertical root fractures.
Uncooperative patients or poor follow-up compliance.
Teeth with wide-open apices not suitable for apexification due to thin root walls (risk of
fracture).

Procedure for Apexification - Using Calcium Hydroxide


Step 1: Diagnosis and Access - Confirm pulpal necrosis and open apex; isolate the tooth; gain
access.
Step 2: Debridement - Clean canal gently, irrigate with NaOCl, avoid forcing irrigants beyond
the apex.
Step 3: Placement of Calcium Hydroxide - Dry canal, place calcium hydroxide, seal
temporarily.
Step 4: Follow-up and Replacements - Recall every 3 months, evaluate for barrier formation.
Step 5: Obturation - Confirm apical closure, remove medicament, obturate canal and restore
tooth.

Procedure for Apexification - Using MTA


Step 1: Diagnosis and Access - As above.
Step 2: Debridement - Clean and irrigate the canal.
Step 3: Apical Barrier Formation with MTA - Dry canal, place MTA plug (3–5 mm) at apex.
Step 4: Setting Time - Place moist cotton, seal temporarily, allow MTA to set for 24–48
hours.
Step 5: Final Obturation - Check barrier, backfill with gutta-percha, restore tooth.

Comparison: Calcium Hydroxide vs MTA


Feature Calcium Hydroxide MTA

Time Required 6–24 months 1–2 visits

Predictability Variable High

Material Resorption Possible over time Stable

Risk of Fracture Higher due to long-term use Lower

Cost Low High

Strength of Root Weakened over time Better preservation

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