Long term radiographic study of bilateral second premolars with immature root treated by apexogenesis and apexification.

A ten-year-old girl broke the central cusps of the mandibular second premolars. The mandibular right second premolar was treated with apexification and the left with apexogenesis. These methods were chosen in view of the presented clinical symptoms, radiographic findings, and outcome of bacterial cultures of root canal samples. At postoperative 2 years 8 months, disappearance of the focus, closure of the root canal, and formation of the root apex were observed in both mandibular premolars. The mandibular left second premolar demonstrated a nearly normal root formation and root apex morphology. Immediately beneath the extracted pulp, regular, uniform, and thick hard tissue was formed. Meanwhile, in the mandibular right second premolar, root growth was suspended, making the root short, and the contour was constructed in such a way that it encircled the distal apical area from the mesial side forming the root apex.

Management of a root fracture in an immature permanent tooth.

A 9-year-old girl with trauma to the maxillary right permanent central incisor is reported. Clinically the tooth appeared extruded with one third of the root visible. The radiographic examination revealed a root fracture. The extruded tooth was repositioned and splinted with a heavy wire and adhesive resin, after which a resorbable collagen tissue was placed to cover the buccal region. Subsequent to the injury, swelling was observed and the patient complained of pressure pain in the periapical region of the tooth with no response to electric pulp testing. It was treated successfully with periodontal therapy and endodontic therapy with Vitapex.