The purpose of this report is to present the case of a patient wherein apexification of an immature permanent maxillary left central incisor tooth was induced by the Metapex paste (Calcium hydroxide and Iodoform). It has been reported in the literature of dentistry that apexification treatment in teeth with open apex is more than 40 years old. Apexification procedures had been carried out in different ways using various techniques and materials. Regardless of the type of materials used for apexification method by different authors, apexification procedures appear to be the most subtle and accepted clinical practice in non-vital young permanent teeth. In our case, radiographic examination showed the start of apical closure 6 months after the completion of the treatment protocol. The growth of root end and complete apical closure was confirmed 16 months after the treatment, indicating the implausible potential of Metapex to induce apical growth and closure in young permanent tooth with periapical lesion.

Management of the severely destructed primary teeth poses a challenge for the paediatric dentist as three important considerations have to be kept in mind, patient’s behavioural management, preservation of the tooth structure and parental satisfaction. Various crowns have been introduced to the field of dentistry such as stainless-steel crowns and aesthetic crowns. Prefabricated stainless steel crowns (SSC) can be adapted to individual primary teeth and cemented in place to provide a definitive restoration. The SSC is extremely durable, relatively inexpensive, subject to minimal technique sensitivity during placement, and offers the advantage of full coronal coverage. SSC are often used to restore primary and permanent teeth in children and adolescents where intra-coronal restorations would otherwise fail. This article brings the update of this definitive restoration.