Management of              Immature Apices

There are a variety of reasons for infection in the root of a tooth, in children, one of the most common is what is known as immature apices. In this situation, conventional root canal treatment usually is not an option because the outcomes when dealing with immature apices are not as predictable. Often, these patients have traumatized anterior teeth or carious exposures in the posterior. On occasion, dental anomalies such as dens evaginatus or dens invaginatus present a unique challenge. We specialize in treating and managing immature apices. The most common procedures we use in this treatment include: - Apexogenesis - Apexification - Revascularization What does “immature apices” mean? The apex of the tooth is the tip of the root. Your front teeth only have one apex at the end of the single root, while molars have multiple roots that form an apical foramen. So, when we refer to “apices” we are just referring to multiple (plural form) roots. To better understand the anatomy of the tooth we have included the diagram below. While teeth are maturing the apices are open. It is only after teeth are fully developed that the tooth apices close. So when we say immature apices we are talking about teeth that are not fully developed, which typically occurs in children or people under the age of 18. Treatment of Immature Apices As mentioned previously, conventional root canal treatment usually is not a recommended course of outcome for immature teeth because the outcome is not as predictable in mature teeth. This is why coming to see an endodontist can be so critical. Endodontists are experts in treating infected roots, and they have other treatment options that are better suited to deal with immature apices such as, apexogenesis or apexification. These treatment options help to improve the chance of saving the tooth.