Chauhan R, Chauhan S, Bhasin P, Sood A, Kumar H, Gupta A, Bhasin M. Precision at the apex: Apexification under magnification: A case report. World J Methodol 2025; 15(4): 104655 [DOI: 10.5662/wjm.v15.i4.104655]
Corresponding Author of This Article
Sachin Chauhan, Assistant Professor, Department of Conservative Dentistry and Endodontics, Sudha Rustagi College of Dental Sciences and Research, Sector 89, Kheri More, Faridabad 121002, Haryāna, India. drsachinchauhan13@gmail.com
Research Domain of This Article
Dentistry, Oral Surgery & Medicine
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Radha Chauhan, Ajay Gupta, Department of Prosthodontics and Crown and Bridge, Mahatma Gandhi Dental College and Hospital, Jaipur 302022, Rājasthān, India
Sachin Chauhan, Prashant Bhasin, Ashima Sood, Hemanshi Kumar, Department of Conservative Dentistry and Endodontics, Sudha Rustagi College of Dental Sciences and Research, Faridabad 121002, Haryāna, India
Meenu Bhasin, Department of Periodontics, Sudha Rustagi College of Dental Sciences and Research, Faridabad 121002, Haryāna, India
Author contributions: Gupta A and Bhasin P were responsible for conception and supervision; Chauhan R and Chauhan S were responsible for conception design, literature review and critical review; Chauhan R was responsible for conception data collection; Chauhan R, Gupta A and Chauhan S were responsible for conception analysis and interpretation; Sood A and Kumar H was responsible for conception write.
Informed consent statement: It is taken from the patient.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sachin Chauhan, Assistant Professor, Department of Conservative Dentistry and Endodontics, Sudha Rustagi College of Dental Sciences and Research, Sector 89, Kheri More, Faridabad 121002, Haryāna, India. drsachinchauhan13@gmail.com
Received: December 28, 2024 Revised: March 5, 2025 Accepted: March 20, 2025 Published online: December 20, 2025 Processing time: 220 Days and 22.5 Hours
Abstract
BACKGROUND
Advanced materials and techniques are used to successfully manage the apexification of immature teeth with open apices. The use of mineral trioxide aggregate (MTA), bioceramic sealers, and sodium hypochlorite (NaOCl), combined with internal heating and ultrasonic activation, ensures that canals are cleaned, disinfected, and sealed properly. Magnification devices, such as dental operating microscopes (DOM), provide precise visualization for accurate material placement, while the micro apical placement system ensures void-free MTA delivery. This modern approach improves procedural outcomes, lowers iatrogenic errors, and increases long-term success in apexification, making it a dependable and predictable treatment option for immature teeth.
CASE SUMMARY
Apexification is a regenerative endodontic procedure that involves creating a calcified barrier at the apex of a nonvital tooth with an open apex. This technique is commonly used in immature teeth with necrotic pulps to ensure proper root canal sealing. Traditionally, calcium hydroxide was the preferred material, but advances have introduced bioceramic cements like MTA or Biodentine, which provide superior results with less treatment time. Apexification not only helps to maintain the tooth's structural integrity but also prevents further complications, making it an important procedure in such cases.
CONCLUSION
This case demonstrates the effectiveness of integrating advanced materials, precise irrigation protocols, and magnification tools in the apexification of immature teeth with open apices. The use of MTA created a stable apical barrier, while bioceramic sealers enhanced the seal and promoted long-term healing. NaOCl with internal heating, ultrasonic activation, and double-sided vented needles ensured thorough irrigation and disinfection, especially in complex canal anatomy.
Core Tip: Advanced materials and techniques are used to successfully manage the apexification of immature teeth with open apices. The use of mineral trioxide aggregate (MTA), bioceramic sealers, and sodium hypochlorite, combined with internal heating activation, ensures that canals are cleaned, disinfected, and sealed properly. Magnification devices, such as dental operating microscopes, provide precise visualization for accurate material placement, while the micro apical placement system ensures void-free MTA delivery. This modern approach improves procedural outcomes, lowers iatrogenic errors, and increases long-term success in apexification, making it a dependable and predictable treatment option for immature teeth.
