Modified Apexification Procedure for Immature Permanent Teeth with a Necrotic Pulp/Apical Periodontitis: A Case Series

Kamolthip Songtrakul, Talayeh Azarpajouh, Matthew Malek, Asgeir Sigurdsson, Bill Kahler, Louis M. Lin

Research output: Contribution to journalArticle

Abstract

The current American Association of Endodontists clinical considerations for a regenerative endodontic procedure state that a regenerative procedure is suitable for immature permanent teeth with necrotic pulp when the pulp space is not needed for a post/core in the final restoration. Therefore, many immature permanent teeth with necrotic pulp that have sustained a substantial loss of coronal tooth structure either from caries or trauma are treated by apexification or mineral trioxide aggregate/Biodentine (Septodent, Lancaster, PA) apical barrier techniques in which no further root maturation would occur. This case series presents 10 immature permanent teeth with necrotic pulp in which a post/core was likely required in the future for adequate coronal restoration because of loss of substantial coronal tooth structure and a modified apexification procedure was used. All 10 cases after the modified apexification procedure showed no clinical symptoms/signs and showed radiographic evidence of healed/healing of periapical lesion after a 2-year review. Eight cases showed increased thickness of the apical root canal walls, increased apical root length, and apical closure. The overall percentage change in root length was 7.52%, in root width at the apical one third it was 18.89%, and in radiographic root area it was 15.04% at the 24- to 72-month follow-up period. This modified apexification procedure allows for the tooth to be restored with a post/core if required for the final restoration in the future as well as continued root development.

Original languageEnglish (US)
Pages (from-to)116-123
Number of pages8
JournalJournal of Endodontics
Volume46
Issue number1
DOIs
StatePublished - Jan 2020

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Apexification
Periapical Periodontitis
Tooth
Tooth Loss
Dental Pulp Cavity
Endodontics
Signs and Symptoms
Wounds and Injuries

Keywords

  • Apexification
  • apical barrier techniques
  • modified apexification procedure
  • post restoration
  • regenerative endodontic procedure

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Modified Apexification Procedure for Immature Permanent Teeth with a Necrotic Pulp/Apical Periodontitis : A Case Series. / Songtrakul, Kamolthip; Azarpajouh, Talayeh; Malek, Matthew; Sigurdsson, Asgeir; Kahler, Bill; Lin, Louis M.

In: Journal of Endodontics, Vol. 46, No. 1, 01.2020, p. 116-123.

Research output: Contribution to journalArticle

Songtrakul, Kamolthip ; Azarpajouh, Talayeh ; Malek, Matthew ; Sigurdsson, Asgeir ; Kahler, Bill ; Lin, Louis M. / Modified Apexification Procedure for Immature Permanent Teeth with a Necrotic Pulp/Apical Periodontitis : A Case Series. In: Journal of Endodontics. 2020 ; Vol. 46, No. 1. pp. 116-123.
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