Revascularization and Apexification: A Boon to the Treatment of Immature Young Permanent Teeth

Management of young permanent teeth with an open apex associated with apical periodontitis poses clinical challenges because of several reasons: difficult to achieve proper cleaning and disinfection of the overall dentinal wall, particularly at the diverged apex. In this case, specific approaches with minimal instrumentation and apical sealing through apexification by means of hard tissue barrier induction with calcium hydroxide or MTA and reinforcement of the thin dentinal walls. Eventhough, apexification with calcium hydroxide is a successful procedure but it is time-consuming and there is no root lengthening and it has been estimated that 30 % of the teeth that have undergone calcium hydroxide apexification can fracture during or after endodontic treatment. in this study compared clinical and radiographic outcomes of endodontic treatment performed in immature non-vital permanent teeth, by apexification (calcium hydroxide or apical barrier with MTA), versus revascularization.