A 2-Year Follow-Up of Trauma-Induced Open Apex Mandibular Central Teeth: A Case Report

Abstract

This case report presents the clinical and radiographic follow-up of a 10-year-old male patient diagnosed with post-traumatic necrotic pulp and open apex-associated apical periodontitis. The patient presented to our clinic complaining of pain and swelling following dental trauma approximately 3 months ago. Clinical and radiographic evaluation revealed open apices, periapical radiolucent lesions, and loss of pulpal vitality in permanent incisors no 31 and 41.

As part of the treatment protocol, both teeth underwent apexification using a non-surgical apical barrier technique using mineral trioxide aggregate (MTA). Initial disinfection was achieved with calcium hydroxide medicament, followed by the creation of a 4-mm-thick apical barrier with MTA. One week later, after confirming the hardening of the MTA, the remaining canal space was filled using the lateral condensation method, and the restoration was completed.

No symptoms were observed at the patient's 3, 6, 12, and 24-month follow-ups. Radiographs showed; the apical lesions were observed to have regressed and periapical healing was achieved. This case demonstrates the long-term success of the apical barrier technique using MTA in necrotic permanent teeth with open apices.