Apexogenesis story – case report

Introduction: Apexogenesis iis the first choice of treatment for teeth with trauma or carious lesions with a vital pulp at the time of exposure and open the apex.
Aim: The goal of this paper was to demonstrate an effective treatment for permanent teeth with unfinished root growth and a deep caries lesion.
Methodology and material: A 9-year-old patient came in our office with severe spontaneous pain. During the clinical examination, a deep carious lesion on the upper first premolar 14 was discovered. A radiograph revealed incomplete root growth and an open apex (parallel walls).
Therapy: 1. Anesthesia and placement of rubber dam isolation; 2. Removal of the entire inflamed coronary pulp to the level of the radicular pulp (conventional pulpotomy); 3. Control bleeding by pressure with sterile saline-soaked cotton balls; 4. Flushing the exposed pulp with 2.5% sodium hypochlorite; 5. Application of MTA with MAP System on the amputated pulp; 6. Covering with glass ionomer cement; 7. Final restoration.
After follow up in 3-6-9 months, there were no clinical symptoms of any kind, and the periapical radiograph showed continuous apical root growth. (figure3,4and5)
Conclusion: Clinical use of MTA as a material for apexogenesis may be an appropriate and very efficient treatment option. This case report emphasizes the importance of regular follow-up after any procedure in young permanent dentition.