Apexification Treatment of an Immature Permanent Tooth with Biodentine: A Case Report

Abstract: Apexification treatment of immature permanent teeth with pulp necrosis is an endodontic procedure to achieve apical closure. Calcium hydroxide has been most widely used in apexification of immature permanent teeth. However, some disadvantages also exist with the use of calcium hydroxide including, it require lot of time for dentine bridge formation multiple tunnel defects in the dentin bridges. Recently, mineral trioxide aggregate are used for such treatment. There are several disadvantages of MTA, as well i.e. it has shown high solubility rate, demonstrating 24% loss after 78 days of storage in water, prolonged setting time of approximately 2 hours and 45 minutes. This requires that apexification with MTA either can be done in a two-steps. Newer materials such as, Biodentine? (Septodont: Saint Maurdes Fosses France) with similar composition was introduced with shorter setting time (10 minutes), greater biocompatibility, bioactivity and biomineralization properties than MTA. Moreover, Biodentine shows improved antibacterial property and low cytotoxic effect as compared to MTA. The aim of this case report is to share a successful apexification of maxillary central incisor with a blunderbuss apex and periapical lesion by using Biodentine: radiographically, spontaneous hard tissue barrier has been established, and narrowing canal space and decreasing area of periapical shadow were documented without complications.