Posts Tagged ‘apexification’


Apexification is the procedure needed when apexogenesis fails to restore the health of an injured, immature tooth.

The first part of the process includes removal of all tooth pulp tissue. A medication is placed in the apex to seal off the opening; the root is then filled back up with a hardening material and sealed off, and any damage to the crown is also restored. The pulp will never be restored, but the natural tooth is saved and light monitoring will ensure it stays healthy in your mouth.

Because the tooth is filled with synthetic material and has not yet been as strongly established as the other adult teeth will become, the tooth will be more susceptible to fractures later. But apexification treatment done properly and carefully will lessen this possibility.

Dr. Sperbeck, West Los Angeles



Apexowhat?! Yes, this is definitely quite a new word to wrap our heads around. What can I say? It’s a two-for-one deal: learning a little bit about dentistry while simultaneously sharpening your vocabulary skills. How convenient, right?

Anyway, in the previous post, I introduced the concepts of apexogenesis and apexification. Apexogenesis will be briefly discussed in this post.

Apexogenesis is a procedure performed after an injury that helps a young adult tooth root to continue growing and the the pulp to heal correctly. Medication is used on the surrounding soft tissues to prevent infection and ensure proper recovery. If the procedure is successful, the apex (remember, the root’s tip which has a slight opening) continues to close as the tooth grows, and the root canal walls thicken. A successful operation also relieves the patient of any further endodontic treatment, provided the pulp heals completely and the tooth’s life is fully preserved.

If, however, the apexogenesis therapy did not prove to be successful, apexification may be required. Details coming!

Dr. Sperbeck, West Los Angeles

Traumatic Dental Injuries: Children’s Cases

Dealing with injuries in children’s teeth is a little different than with grown adults; their incoming adult teeth have not fully come through and developed a strong, established root.

The apex, or tip of the root (way down/up in the gums), in a tooth that has not yet matured in a child’s mouth, has a far larger opening than a mature tooth. The reason why this opening is wider during the young stages is so that nutrients can more easily enter the tooth to help it develop strength and health as the child grows up. Compare it to an ice cream waffle cone, where the crown of the tooth is where the scoop of ice cream goes, and the apex is the pointy part at the bottom. If you were to bite a hole in the bottom of the cone, it would leave an opening… and ice cream would drip out.

Well, the anatomy of a tooth is similar. In a still-developing adult tooth, the hole is just much wider, and the walls of the root canal are thinner. As the child and his teeth mature, the apex opening grows smaller, the walls thicker, and the tooth becomes nice and sturdy.

If an injury were to occur to these young adult teeth, special care is needed if the health of the tooth is to be preserved to its full potential. One of two kinds of procedures may be needed: apexogenesis or apexification. I will cover these in future posts.

Dr. Sperbeck, West Los Angeles

Traumatic Dental Injuries: Other Injuries and Further Treatment

Besides fracturing immature adult teeth, the aforementioned dislodging or knocking out completely are some things that young people have to endure sometimes, unfortunately. However, modern dentistry has so much more to offer now than it ever did, thanks to science, technology and really, really smart people; so the level of treatment, restoration, or therapy only depends on the severity of damage done. The good news is that something can always be done.

If a young adult tooth were to be minorly dislodged (which means moved out of its natural position, remember?), extensive treatment may not even be necessary. The tooth may be only monitored over a period of time, possibly with minor adjustments made here and there, to ensure it continues to grow and develop normally. A tooth severely dislodged, surgery may have to be performed to restore stability and strength. In both of these cases, though, the tooth’s natural potential for strength will never be reached because of the injury, no matter what kind of treatment is performed.

If this immature tooth has been knocked out completely, if it can be put back into its socket and stabilized within one hour and watched closely by a dentist for a few weeks, chances are good that it can be saved. Changes in the tooth’s appearance and feeling will be monitored as well, and if any signs of decay or infection arise, then measures — particularly apexification — may have to be taken to keep it alive and well. If the tooth has been out for longer than an hour, it has probably dried out and must be filled with medication, put back into the socket, and re-stabilized as a “dead” tooth.

In either of those cases, the tooth is likely to not last as long as the others, in which case other options (say, an implant) will have to be discussed with the endodontist.

Dr. Sperbeck, West Los Angeles