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Apexogenesis vs Apexification Procedures

This document discusses two endodontic procedures called apexogenesis and apexification. Apexogenesis aims to encourage continued root development in immature permanent teeth with healthy pulps through removal of inflamed tissue and placement of calcium hydroxide. Apexification induces formation of a calcified barrier at the apex of nonvital teeth with open apices using calcium hydroxide or mineral trioxide aggregate (MTA) placed in the canal. MTA is now preferred over calcium hydroxide due to its superior sealing ability and biocompatibility, and apexification can sometimes be completed in a single visit when using MTA.

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2K views20 pages

Apexogenesis vs Apexification Procedures

This document discusses two endodontic procedures called apexogenesis and apexification. Apexogenesis aims to encourage continued root development in immature permanent teeth with healthy pulps through removal of inflamed tissue and placement of calcium hydroxide. Apexification induces formation of a calcified barrier at the apex of nonvital teeth with open apices using calcium hydroxide or mineral trioxide aggregate (MTA) placed in the canal. MTA is now preferred over calcium hydroxide due to its superior sealing ability and biocompatibility, and apexification can sometimes be completed in a single visit when using MTA.

Uploaded by

Tooba Sd
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
  • Procedure for Apexogenesis
  • Apexogenesis
  • Complications
  • Apexification
  • Multiple-step Apexification

Dr.

Sharaz Ahmed
Operative Dentistry

A vital pulp therapy procedure performed to


encourage physiological development and
formation of the root end.
OR

The stimulation to make the end of a tooth


root close in a traumatized tooth with healthy
pulp.

The goal of apexogenesis is the


preservation of vital pulp tissue so that
continued root development with apical
closure may occur.
Carious exposure or trauma to immature
permanent teeth in which root canal therapy
cant be done.

Apexogenesis is a procedure that addresses the


shortcomings involved with capping the inflamed
dental pulp of an incompletely developed tooth.
Most or all of the coronal pulp is removed, often to
the level of the canal orifices, and calcium hydroxide
paste is placed.
An aseptic technique combining the use of the rubber
dam and sterile burs is strongly recommended.

Abrasive diamond bur at high speed with


adequate water-cooling.
Following coronal pulp amputation, the
pulp chamber is rinsed with sterile saline.
The excess liquid should then be carefully
removed via vacuum or sterile cotton
pellets.
Once the pulpal bleeding is controlled,
calcium hydroxide paste is placed over the
amputation site.

A restorative base material should be placed over the


calcium hydroxide and then allowed to set
completely.
A coronal restoration should then be placed that will
ensure the maximum long-term seal.
The patient should be re-evaluated every three
months for the first year, and then every 6 months
for 2 to 4 years to determine if successful root
formation is taking place.

Pulp necrosis
Root resorption
Periradicular pathosis

Apexification is a method of inducing a


calcified barrier at the apex of a nonvital
tooth with incomplete root formation.

If apexification is successful, a hard


substance histologically described variously
as bone, dentin, cementum, or osteodentin
will develop against which obturation of root
canal can be done.
Materials used for apexification are
Calcium hydroxide
Mineralo trioxide aggregates (MTA)

The tooth is isolated with rubber dam, and access


is gained into the pulp chamber.
2. Using large reamers & files, remove the debris from
the coronal half of the pulp & establish the file
length radiographically.
3. Clean the canal, irrigate it & then dry it with a paper
point.
4. Calcium hydroxide powder mix with salin to form
paste or commercially availabe paste fill the canals
upto working [Link] calcium hydroxide is
removed from the pulp chamber and then sealed
with intermediate restorative material.
5. Recall after 3 months and take a radiograph to
determine whether calcific barier has developed if
1.

[Link] a 6 month recall, you should see radiographic


evidence of an apical closure.
[Link] you have accomplished apical closure, the root
canal filling is completed.

MTA is now the material of choice for


induction of an apical barier because of
better ability to seal and good
biocompatibility
Apexification can be possible in single visit
with MTA

Anesthesia and isolation, appropriate access cavity


Removal of necrotic pulp; barbed broach or H files
Workinglength determination 2mm short of apex then
cleaning, shaping and copious irrigation and then dry the
canals.
MTA is mixed according to manufacturer instructions then
introduced into the canal with MTA carrier checked with
radiographs.
Pluggers are used to condense MTA into an apical 3-4 mm
barrier.
A moist cotton pellet is place and left to ensure setting
Recall after 48 hrs for obturating the remaining part of the
root canal and placement of permanent restoration.

Dr.Sharaz Ahmed Operative Dentistry
A vital pulp therapy procedure performed to encourage physiological development and formation of the root end.
The goal of apexogenesis is the preservation of vital pulp tissue so that continued root development with apical closure
Apexogenesis is a procedure that addresses the shortcomings involved with capping the inflamed dental pulp of an incomplet
Abrasive diamond bur at high speed with adequate water-cooling. Following coronal pulp amputation, the pulp chamber i
A restorative base material should be placed over the calcium hydroxide and then allowed to set completely. A coronal r
Pulp necrosis Root resorption Periradicular pathosis

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