Apexification In Non-Vital Tooth With Open Apex: A Report Of Two Cases
Apexification is a method of inducing apical closure for non-vital immature permanent teeth. During this treatment a mineralized barrier is induced [with long term calcium hydroxide (CH) treatment]; or artificially created [with mineral trioxide aggregate (MTA) plug].
Method : Two patients presented for evaluation of central incisor with discoloration with mild swelling and a nontraceable sinus tract. Both have a history of trauma. After intraoral examination and radiographic assessment a diagnosis of pulp necrosis with open apex was made. At the initial visit access cavity preparation and biomechanical preparation was done and calcium hydroxide dressing was placed. In the next appointment MTA plug was made and obturation was done after 72 hours and the tooth was build up with composites and a porclein fused to metal crown was delivered. MTA is used for creating an apical plug, the functional goal of this procedure is to provide a hard tissue barrier that will provide an apical stop for effective obturation of the canal allowing the patient to maintain the tooth.
Conclusion: MTA can be used effectively for creating a hard calcific barrier in cases of open apex. MTA also has low cytotoxic and superior biocompatibility as compared to calcium hydroxide used before.