Title: Radiographic appearance of apical closure in apexification: follow-up after 7-13 years
Abstract: Aim This was the radiographic evaluation of 15 maxillary incisors apexification treatment carried out on 7-9 years old patients with periapical pathology due to pulpal necrosis after dental trauma. Materials and Methods The treatment consisted of two phases. The aim of first phase was the formation of a calcified apical barrier through calcium hydroxide medications repeated twice with a three months interval. The aim of the second phase was the obturation of the root canal system once achieved a radiographic evidence of the formation of an apical barrier. The treated teeth were radiographed at six months and then periodically once a year for a period of 7 and 13 years. Results The radiographic analysis allowed to underline three different kinds of apical formation: a physiological development of the apical portion with a final root length equal to the controlateral tooth; the formation of a cap tissue and an apical development with the final root length slightly shorter than the controlateral tooth; or the formation of different layers of mineralised tissue that aggregate together trough the years. Conclusion Apexification isn’t a static phenomenon and the apexified area undergoes through the years to a conspicuous readjustment involving bone, apical root tissues and root filling material.