Importance of diagnosis and case management in teeth with periapical pathology and presence of open apex

Abstract

The complete formation of a permanent tooth occurs 3 years after its eruption in the mouth. The formation can be altered for various reasons, preventing a complete maturation. Therefore, it is critical for the patient to receive an accurate diagnosis as soon as possible. The presence of open apex is a challenge for the clinician. Therapeutic options include apexification, inducing the formation of an artificial barrier by placing a biocompatible material. We are dealing with a patient who came for an appointment due to inflammation in the upper anterior region. After diagnostic tests, we found involvement in several teeth; tooth 12: Pulp necrosis with symptomatic apical periodontitis; tooth 11: Pulp necrosis with symptomatic apical periodontitis and tooth 21: previously treated with symptomatic apical periodontitis. As they presented different apical diameter, root canal treatment was chosen for tooth 12, and apexification for tooth 11 and 21.