Apexification & apexogenesis. refers to a vital pulp therapy procedure performed to encourage physiological development and formation of the root end . This article will describe requirements for case selection and review the procedures for apexogenesis and apexification in immature permanent teeth. Dent Clin North Am. Oct;28(4) Apexogenesis versus apexification. Webber RT. PMID: ; [Indexed for MEDLINE]. MeSH terms. Adolescent.
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This procedure encourages the root to continue development as the pulp is healed. If the exposure was carious, or the traumatic exposure crown fracture, exposed pulp is longer than 24 hours, then the coronal pulpal tissues are too inflammed to survive a simple capping procedure.
Maintenance of pulp vitality will allow continued root development along the entire root length. Nonclinical and clinical data will be presented to support the recommendations, and outcomes will be presented vz clinical studies.
When an immature tooth is affected apfxification caries or trauma, the pulp requires proper management according to the degree of inflammation and its vitality. If the pulp heals, no additional treatment will be necessary. Apexogenesis This procedure encourages the root to continue development as the pulp is healed. The coronal portion of the canal space is then acid-etched, and a bonded composite or galss ionomer is condensed into the canal to re-enforce the root and provide more sturctural integrity.
In turn, the walls of the root canal will thicken, and the tooth will become stronger. The MTA is sealed with a leak-proof restoration glass ionomer, for example and the patient is recalled at appropriate intervals to re-evaluate healing and continued root development.
Apexification & apexogenesis.
If the tissues are bleeding too profusely, the MTA will be washed away; this would be an indication that the tissues remaining are still too inflammed to cap. The patient is recalled periodically to monitor the progress of the root-end closure, and decide whether other measures root-end surgery may be required. In this case, the unhealthy pulp is removed.
The pulp provides a matrix for binding of its cells and provides support allowing communication between the cells. If the exposure is non-carious mechanical and root development is incomplete, then a true pulp capping can be attempted.
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A small preparation is made aapexification the dentin overlying the exposure site, using a sterile diamond round bur less potential to tear the pulpal tissue vs. In the absence of a vital pulp, dentin deposition is arrested. This article will describe requirements for case selection and review the procedures for apexogenesis and apexification in immature permanent teeth.
If the pulp is irreversibly inflamed aepxification necrotic, root-end closure procedures are required when the apex has not fully formed. Drexel Hill, PA The more mature the root becomes, the better the chance for the survival of the tooth. The apexifucation pulp is an ectomesenchymally derived connective tissue with certain unique properties such as being encased in hard tissues, which limits its collateral circulation.
In addition to immune cells, the dental pulp contains odontoblasts, which are specialized cells capable of producing dentin.
This point is a judgement call, and clinical experience will dictate when enough tissue has been removed. Published by Elsevier Inc.