Apexification: A comprehensive review

Abstract

Necrotic pulp in permanent teeth with incompletely formed or wide-open apices results in the death of cells that are effective in the improvement of root. This slows down the possibility of apical closure as well as improvement of root. Endodontic management consisting of diseased or dead pulp with adolescent permanent teeth along with an open expanded root apex is a challenging concern. During obturation in that tooth,it is unimaginable to obtain a proper seal at the tip. There are various techniques to treat an immature tooth with open apex which involve the application of (1) a custom-made cone(blunt end); (2) a short fill technique; (3) periapical surgery; (4) apexification; and (5) one-visit apexification. Mostly recommended treatment of choice is ‘apexification’ which is a method to induce root apex development of an immature nonvital tooth by formation of osteocementum or bone-like tissue. The most recommended medicament is calcium hydroxide that facilitates the development of a calcific barrier found in the root apex. According to the survey of the clinical involvement and information of journalists, management of an incomplete nonvital tooth can bring noticeable outcomes from the disinfectant and ossification promoting activity of Ca(OH)2.