INDUCED POST-TRAUMATIC APEXIFICATION: 20 YEAR FOLLOW-UP AND MORPHOLOGICAL STUDY AFTER NEW FRACTURE

Publication date: Available online 1 January 2018
Source:Annals of Anatomy - Anatomischer Anzeiger
Author(s): Federica Fonzar, Leopoldo Forner, Riccardo Fabian-Fonzar, Carmen Llena
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.



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