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Dr. Akanksha R. Rao* and Dr. B.S. Keshava Prasad


Immature permanent teeth with necrotic pulp/apical periodontitis are traditionally treated with apexification procedure using either calcium hydroxide to induce apical hard tissue barrier formation or apical MTA plug before root canal filling (Frank 1966, Heithersay 1975, Rafter 2005). Apexification procedure with calcium hydroxide usually takes multiple treatment visits over an extended period of time (Rafter 2005). The immature permanent teeth when exposed to prolonged calcium hydroxide dressing, show increased risk of root fracture (Andreasen et al. 2002). An apical MTA plug shortens the treatment time (Rafter 2005). The treatment outcome of calcium hydroxide apexification and apical MTA plug appears to be similar (Rafter 2005, Chala et al. 2011). However, an apexification procedure does not have potential to restore the vitality of damaged tissue in the canal space and promote root maturation of immature permanent teeth with necrotic pulp. A new treatment option termed „revascularization‟ was introduced in endodontics in the year 2001 to manage an immature permanent tooth with apical periodontitis and sinus tract (Iwaya et al. 2001).

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