6533b82efe1ef96bd1293e36

RESEARCH PRODUCT

Induced post-traumatic apexification: 20 year follow-up and morphological study after new fracture.

Riccardo Fabian-fonzarLeopoldo FornerMari Carmen LlenaFederica Fonzar

subject

0301 basic medicineMaleTertiary dentineRoot canalDentistryCalcium Hydroxide03 medical and health scienceschemistry.chemical_compoundTooth Fractures0302 clinical medicinestomatognathic systemDental Pulp NecrosisMedicineHumansMaxillary central incisorTooth RootChildDental PulpPulp necrosisCalcium hydroxidebusiness.industryApexification030206 dentistryGeneral MedicineApex (geometry)Root Canal TherapyIncisorstomatognathic diseasesmedicine.anatomical_structurechemistryCoronal planeMicroscopy Electron ScanningApexification030101 anatomy & morphologyAnatomybusinessDevelopmental BiologyFollow-Up Studies

description

Apexification is an endodontic technique used in immature necrotic teeth, the primary goal of which is to induce a calcified barrier in roots with open apices and to promote the continuation of apical root development. A 7-year-old patient with a coronal fracture in a maxillary central incisor was treated with an apexification technique using calcium hydroxide. The apical closure was obtained after one year, then a permanent root canal filling was performed. The tooth was monitored for a period of 20 years, up to when a trauma caused its extraction. The newly formed root was analyzed macroscopically, histologically and through scanning electron microscopy. A morphologically normal root was observed, with a large apex and accessory foramina, showing a combination of tissue structures similar to secondary and tertiary dentine, close to amorphous mineralized areas. Despite the final evolution of the case, calcium hydroxide apexification is a good therapy in order to treat pulp necrosis in an immature tooth, leading to complete development of the root and allowing the tooth to be kept in the mouth.

10.1016/j.aanat.2017.12.005https://pubmed.ncbi.nlm.nih.gov/29301094