Treatment of a Partially Necrotic Molar Tooth by Applying Apexogenesis Principles

Abstract

The most suitable endodontic treatments for immature teeth vary depending on the case selection criteria, the dental pulp’s status, the root’s maturity, and the prognosis. This report describes the case of an immature first lower molar tooth with necrotic pulp that was to be treated with the apexification method. During the endodontic procedure, the pulp sensitivity in the apical third of the canal was evaluated as positive. Therefore, the treatment was changed from apexification to modified apexogenesis. The working length was measured until the pulp sensitivity response, and the canals were chemo-mechanically prepared at that length. Then, endodontic treatment using calcium hydroxide short term therapy and a 3-mm mineral trioxide aggregate plug in the present working length was applied. Periapical healing and apical closure were achieved during the follow-up period, and root length increased.