A study of endodontically apexified teeth

Abstract

This study was undertaken to determine the clinical and radiographic success of calcium hydroxide apexification in a group of 48 patients requiring endodontic therapy because of pulpal necrosis prior to root-end closure. The study examined tooth number, etiology of pulpal necrosis, age, sex, size of root-end opening, size of radiolucency, crown discoloration, interappointment symptoms, and total treatment time from initial instrumentation to completion of apexification. Apexification required an average of 1 year +/- 7 months. A statistically significant relationship was found between: the presence of a radiolucency and development of interappointment symptoms (p less than 0.04); and the size of apex opening and development of interappointment symptoms (p less than 0.02). If symptoms did develop, apexification was delayed an additional 5 months when compared to patients who did not have symptoms. Calcium hydroxide apexification was found to be statistically highly successful regardless of the clinical variables encountered.

Suggesting a new therapeutic protocol for permanent teeth with incomplete root apex and lateral luxation: A case report

“…19,[28][29][30][31] Periodic changes every 1 to 3 months are widely recommended. 21,24,25,32 However, Yates, 21 Chawla 33 and Webber 34 recommend intracanal dressing change every time a radiographic examination reveals incomplete filling. Furthermore, according to Sidley,35 periodic changes every 4 to 6 months during 18 months yield satisfactory treatment outcomes for severely traumatized teeth.…”

Revascularization and Treatment Methods

“…11,12 Ek olarak bu yöntem uzun süre (6-24 ay; ortalama 1 yıl ± 7 ay) bir çok ara seans gerektirmektedir. 13,14 Bu tedavi sürecinde dişler geçici olarak kapatıldığı için yeniden enfekte olma riski vardır ve Ayrıca daimi restorasyon geciktiği için dişlerin kırılma riski de artmaktadır. 15 Apeksifikasyon tedavisinde Ca(OH)₂ kullanımına alternatif olarak mineral trioxide aggregate (MTA) ile yapay bir apikal tıkama oluşturulması önerilmektedir.…”

Weakened anterior roots – intraradicular rehabilitation

“…[9][10][11] It has been suggested by some authors that an apical barrier will form quicker in cases where the calcium hydroxide is changed more often, 8 while others believe that this may in fact disturb the mineralisation process. 9 According to Ghose et al (1987) 9 and Kleier and Barr (1991) 6 the rate of closure does not appear to be related to the size of the apical opening. Closure may not happen at all in cases that have suffered displacement injuries 7 or when a periapical abscess develops.…”

“…8 Undiagnosed horizontal or vertical root fractures may also prevent successful treatment. 6 One-visit apexification An alternative to apexification over multiple visits has been the placement of a biocompatible material into the apical part of the root canal. The formation of an instant apical barrier allows immediate obturation of the canal space.…”

“…8 This widely accepted technique has its disadvantages including the fact that the calcium hydroxide paste must be changed every three to six months until a calcific barrier can be detected. 6,8 The time taken for closure is variable, ranging from five to 19 months. 9 This requires multiple visits over a long period of time, which some younger patients may find inconvenient.…”