Apexification is an endodontic treatment that’s administered alongside root canal therapy to save a tooth that’s been damaged by a traumatic dental injury. It’s usually only required for children who have damaged one of their permanent teeth before it has fully formed.
In this process, unhealthy pulp is removed from the tip of the tooth, then special medication is used to treat it and encourage hard tissue to form near the root tip. This closes the tooth and allows it to be treated with a traditional root canal.
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To understand why apexification is necessary, it’s important to know a bit about the anatomy of a tooth. A normal tooth has a cone-shaped root. This root widens at the crown, then narrows to a closed root “tip.”
However, permanent adult teeth that are not developed don’t always have a closed root tip. This is called an “open apex.” These teeth need to continue to grow and develop to gain strength. Normally, this isn’t an issue. As the mouth grows and develops, the tip of the tooth will close.
However, if an immature permanent tooth is damaged by a traumatic dental injury, the open apex may never close. This will cause problems during root canal therapy. A closed root canal is necessary so that the tooth can be cleaned, filled, and restored properly.
This is why apexification must be integrated into the treatment process. By creating a calcified barrier and closing the open apex, apexification “closes” the tooth root and allows the tooth to be treated with a root canal.
Basically, the difference between a pulpotomy and apexification has to do with the level of damage done to an immature adult tooth. Pulpotomies are used for teeth that are not fully developed and have inflamed pulp, but are still “vital,” and can still be saved.
Alongside a pulpotomy, a treatment called “apexogenesis” is typically used. This treatment is somewhat similar to apexification, but it’s intended to help the root of the tooth heal and continue to form properly. With a pulpotomy and apexogenesis, it’s often possible to save the tooth, and ensure that it grows properly and continues to develop.
In contrast, apexification is usually used alongside a root canal to treat a tooth that’s non-vital (dead), but still does not have fully formed roots. In apexification, a special procedure is used to close up the root of the tooth. Special materials are placed in the end of the tooth root to close and seal the “apex” of the root and protect the tooth from further damage.
Apexification is usually only needed alongside a root canal for seriously-damaged teeth that are non-vital, meaning that the pulp has been completely destroyed and cannot be saved. In addition, it’s typically only necessary for immature teeth that are not fully developed and do not have a “closed” root.
For example, if your child is 13 years old, and they develop a serious tooth decay and tooth infection in a rear molar that destroys the tooth pulp, they may need treatment with a root canal and apexification. This is because the roots of the teeth often are not fully formed until about three years after the teeth have erupted.
First, the team at ONE ENDO would clean the interior of the tooth to remove their damaged pulp. Then, if they find that the root of their tooth has not fully formed, our team will also recommend apexification. In this process, they will apply sealing materials such as calcium hydroxide or mineral trioxide aggregate to the apex of your child’s tooth root.
Over time, these substances form a hardened layer over the apex of the root, which is known as a “calcific” barrier. This preserves the root of their tooth, and helps keep it strong and intact after root canal therapy.
If your child has serious tooth decay or a tooth infection in one of their adult teeth, apexification may be necessary alongside root canal therapy from ONE ENDO to restore their tooth. Common signs of decay and infections include tooth sensitivity, tooth and/or gum discoloration, visible holes or pits in the tooth, and toothaches.
The only way to know for sure whether or not apexification is necessary for your child is to schedule an appointment with the team at ONE ENDO. So don’t wait. Schedule an appointment at one of our offices in Westchester, Norwalk, or Greenwich, today, and make sure your child gets the treatment they need to save their tooth.
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