What material is used for apexification?

A lot of materials have been proposed for use during apical barrier formation like calcium hydroxide and mineral trioxide aggregate (MTA). MTA remains the widely accepted material for apexification and apexogenesis. There has been a high success rate with the use of mineral trioxide aggregate.

Does calcium hydroxide cause root resorption?

Its main disadvantage is when used in primary teeth with hyperemic pulp, calcium hydroxide can come in contact with some vital pulp tissue remnants and can trigger the cascade of inflammatory root resorption [12] . …

What does calcium hydroxide provide for the tooth?

Calcium hydroxide cements are used for lining specific areas of deep cavities or for direct pulp capping. The antibacterial action of calcium hydroxide makes these cements useful in indirect pulp-capping procedures involving carious dentin.

Why do we use apexification?

Apexification is a method of treatment for immature permanent teeth in which root growth and development ceased due to pulp necrosis. Its purpose is to induce root end closure with no canal wall thickening or continuous root lengthening.

Why is apexification important?

The main purpose of apexification includes restoring the original physiologic structures and functions of the pulp-dentin complex of the teeth.

Is calcium hydroxide used in primary teeth?

However, the usage of calcium hydroxide is not routinely recommended for primary dentition because its application frequently results in the development of chronic pulpal inflammation and internal root resorption.

How is calcium hydroxide removed from root canal?

Intracanal calcium hydroxide is usually removed from the root canal by the use of copious manual irrigation with either sodium hypochlorite combined with hand instrumentation and a final rinse with EDTA.

How does calcium hydroxide work?

Calcium hydroxide has a hard tissue inducing effect. It is a powder, that can be mixed with a physiological saline to a paste. The paste is highly alkaline with a pH 12.5 and its application to the pulp results in necrosis of the part of coronal pulp tissue shows no or only a milled inflammatory reaction.

How does calcium hydroxide form reparative dentin?

Indirect capping produced reactionary dentin, while direct pulp capping led to the formation of reparative dentin by a dentinal bridge, closing almost the whole pulp exposure. Since the pioneering work of Hermann (Hermann 1930), calcium hydroxide [Ca(OH)2] is recognized as a beneficial pulp capping agent in dentistry.

What is a apexification in dentistry?

Apexification is a method of inducing a calcified barrier at the apex of a nonvital tooth with incomplete root formation. Apexogenesis refers to a vital pulp therapy procedure performed to encourage physiological development and formation of the root end.

Why is calcium hydroxide placed in the root canal?

The calcium hydroxide is placed in the root canal in order to stimulate apexification – that is, the formation of a hard (osteoid or cementoid) tissue barrier across the open apical foramen prior to the placement of a root canal filling (Figs. 1-5).

How effective is the apexification technique with calcium hydroxide?

For decades, the apexification technique with calcium hydroxide has proven its effectiveness in solving these problems. It is the most studied and less expensive technique to induce a calcified apical barrier with a success rate of 74\% [ 2

Are long-term calcium hydroxide dressings safe for root canals with open apex?

The use of long-term calcium hydroxide dressings in root canals with an “open apex” has been an accepted endodontic procedure for many years.

How do you use calcium hydroxide to induce apical closure?

Calcium hydroxide can be mixed with a number of different substances (camphorated mono chlorophenol, distilled water, saline, anesthetic solutions, chlorhexidene and cresatin) to induce apical closure.[3] In recent times, interest has centered on the use of mineral trioxide aggregate (MTA) for apexification.