Open Apex Management Flashcards
What is Apexogenesis?
- Allows development and formation of root end
- Allows thickening of canal walls
- Vital pulp tissue required
What is Apexification?
- Allows development of apical barrier
- Root length and thickness will not increase
- Only the root end is affected
- Pulp is necrotic
What are indications for Apexogenesis?
- Immature root, vital pulp
- Traumatic Exposure
- Carious Exposure
- Asymtomatic
- Cvek Pulpotomy = 96% Success
- Give the pulp a chance!
What are the objectives of Apexogenesis?
- Maintains pulp vitality
- Development of root end
- Thickening of dentinal walls
What is the objective of Apexification?
Induce a Calcified Apical Barrier
What are indications for Apexification?
- Immature root
- Necrotic Pulp
What do Long and Short Term Treatment Times look like for Apexification with CaOH?
- Long Term CaOH: 6 - 24 months
- Short Term CaOH: 4 Hours - 4 weeks
How does success compare with Short Term and Long Term Apexification?
- Short Term Tx = Excellent
- Long Term Tx - Poor (weak root)
What is happening here with Apexification?
- Leaves fracture-prone root
- If pulp vitality in doubt…attempt apexogenesis
What is the Contemporary Approach to Apexification?
- Debride/clean canal
- Short-Term CaOH…1 - 4 weeks
- MTA Apical Barrier… 4 mm thick
What is Same-Day Apexification?
- Debride/clean canal
- MTA apical barrier sets in 4 hours
What can you do to strengthen roots of teeth with Apexification?
With walls still prone to fracture, you can strengthen root by filling with resin
What can be used as “Instant” Apexification?
MTA
What is a way to obturate a tooth needing Apexification?
- Access, WL, C & S
- CaOH
- Obturation
- MTA
- Master Apical Impression
- Thermoplasticized G-P
What is the goal of Regenerative Endodontics?
Revascularization
What are the different components of Regenerative Endodontics?
- SCAP = Stem Cells from Apical Papilla
Describe the process of Revascularization…
What is going on here?
Regenerative Endodontics - Revascularization
