Apexogenesis Procedure, Indications, Steps | Apexogenesis vs Apexification

When it comes to the person’s health, oral health is of foremost importance. Oral health refers to the practice where an individual keeps his mouth clean and thus free from exposure to any disease. 

The benefits of practicing good oral hygiene habits are numerous. It reduces gums and cavities, strengthens bones, prevents cancers, etc. 

However, if a person cannot take care of his oral health, he may be subjected to several inflammations. One of those kinds of inflammation is the inflammation of the pulp. The pulp is the most inner layer of the human tooth consisting of nerves and blood vessels. Layers of enamel and dentin protect the pulp. 

The pulp becomes susceptible to infections due to decay or any injury. The procedure of apexogenesis is available to treat an unhealthy tooth pulp. Apexogenesis refers to treat the flaws associated with the capping of an inflamed dental pulp of a tooth, partially developed. 

Apexogenesis Procedure

The procedure of apexogenesis is a dental procedure in which the technique applies in such a way, that the vital tissue present inside the teeth sustains the growth of the immature root. 

In apexogenesis, the affected inflamed region of the pulp is detached and removed. The affected portion of the pulp is then infused with a material bioceramic in nature, that is, materials capable of producing a regenerative response in the body. The function of this bioceramic material is to aid the teeth in maintaining the vitality within the roots. 

Following that, the fit and healthy tissue bring about the continuation of the root development. Once the root development completes, a traditional root canal needs to be performed.

Apexogenesis Procedure, Indications, Steps | Apexogenesis vs Apexification

Apexogenesis Indication

Depending upon the severity of the inflammation, pulp capping, shallow pulpotomy or conventional pulpotomy may be suggested. However, the first indication of apexogenesis to be performed is the inflammation of pulp to the deeper levels of the coronal pulp. Another indication of apexogenesis is the traumatic exposure after a duration of 72 hours or a carious exposure of a young tooth present where the apex is partially developed. These are the two examples when the treatment through apexogenesis is suggested. When it is desirable to maintain the teeth primarily for space and function and there are no contraindications to the pulpal therapy, pulpotomy is indicated.

Apexogenesis Steps

There are three types of methods used to ensure pulp health mentioned above. Those methods include pulpotomy, direct and indirect pulp capping. Let’s discuss each of them one by one.

Pulpotomy or a baby root canal is a method of saving decayed teeth with infected pulp. Local anesthesia is administered first; a rubber dam applies afterward. It then uses sterile numbers 4 or 8 to remove all carious dentin before the exposure of pulp horns.

After that, the placement of a 330 bur takes place at a fast speed and access to the pulp chamber is also carried out using type 1 cavity preparation. Finally, remove all overhanging enamel. 

Now, what about the pulp capping? The only difference between the two methods is that protective dressing gets placed directly over an exposed pulp in the direct method. However, in the indirect method, a thin layer of moistened dentin gets placed in between. 

Apexogenesis vs Apexification

The first point of difference between these two terms is that apexogenesis refers to the vital pulp’s treatment via capping to aid the growth of the root and closure of the open apex. While on the contrary, apexification refers to the method of induction of the development of the root apex of pulpless immature teeth; it proceeds via the formation of a bone-like tissue.

The final distinguishing point among the two is that apexogenesis lacks the presence of pulpal necrosis, while apexification does not. 

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