The treatment of nonvital immature teeth with calcium hydroxide-sterile water paste: two case reports

Death of the dental pulp before completion of root development results in a tooth with an open apex. During endodontic treatment, the open apex makes obturation difficult, because there is no apical stop against which the filling can be packed and condensed. For many years, open apices have been treated by root canal fillings or by periapical surgery with or without a reverse seal. Currently, the conservative approach is preferred over surgical management, to avoid the physical and psychological trauma of surgery to a young patient. Two patients were treated by calcium hydroxide-sterile water paste to promote the apexification of the nonvital teeth with an incompletely formed apex. Normal endodontic preparation of the canal had been carried out in the immature tooth. Radiologic examination after 6 to 9 months showed that the apex of the maxillary incisors was completed by newly formed tissue.