Apexification: A Procedure to Save Immature Teeth

Apexification is an endodontic procedure used to induce the formation of a calcified barrier at the apex (tip) of an immature or damaged tooth with an open root. This treatment is commonly performed in young patients whose permanent teeth have not yet fully developed and who have suffered trauma or deep decay that has led to the death of the tooth’s pulp.

Why is Apexification Necessary?

When a tooth is still developing, the apex (root tip) remains open, allowing for continued root growth. If the pulp (the soft tissue inside the tooth) dies prematurely due to trauma or infection, the root development stops. An open apex makes conventional root canal treatment difficult because there is no natural barrier to seal the root canal system. This can lead to persistent infection and tooth loss. Apexification helps create an artificial calcified barrier, allowing the tooth to be treated and saved.

Procedure for Apexification

Apexification is typically performed by an endodontist (a specialist in root canal treatment) and involves the following steps:

1. Diagnosis and Cleaning: The affected tooth is examined through X-rays, and the infected pulp is completely removed under local anesthesia. The root canal is then disinfected to eliminate bacteria.

2. Placement of Medicament: A biocompatible material, such as calcium hydroxide or Mineral Trioxide Aggregate (MTA), is placed inside the canal. These materials encourage the formation of hard tissue at the apex.

3. Monitoring and Barrier Formation: If calcium hydroxide is used, the patient will need periodic visits over 6-12 months to allow the apex to form a calcified barrier. If MTA is used, the process may be completed in fewer visits.

4. Root Canal Filling: Once the apex is closed, the canal is permanently sealed with gutta-percha, a rubber-like filling material, to prevent reinfection.

5. Final Restoration: A crown or other protective restoration is placed to strengthen the tooth and restore its function.