Open apex solutions: One-step apexification, salvaging necrosed teeth with open apex

Abstract

Open apices are a constant challenge to an endodontist. The one-step apexification technique in which an apical barrier is placed to achieve an adequate apical stop has become a popular procedure nowadays. This case series describes eight clinical cases with immature necrosed pulp which were subjected to one-step apexification procedure using different materials and techniques. The materials used varied from mineral trioxide aggregate (MTA) with hydroxyapatite (matrix), biodentine with hydroxyapatite (matrix), MTA alone, tailor-made gutta-percha with platelet-rich fibrin (matrix), and gutta-percha alone. All the cases were successful regarding the resolution of symptoms and periapical healing concluding that one-step apexification has successfully replaced the traditional methods of apexification. No matter what barrier is used or matrix is placed or not, healing takes place if the procedure is followed carefully using recommended protocols.