One Step Apexification With Intracoronal Bleaching In Maxillary First Incisor With Open Apex And Periapical Lesion

Abstract

Apexification is a therapeutic approach employed for managing an open tooth apex. Among the available materials, Mineral Trioxide Aggregate (MTA) stands out as a highly promising choice due to its exceptional biocompatibility and reduced cytotoxicity. An open apex in a necrotic tooth often followed by external discoloration. This discoloration can pose a significant cosmetic concern, especially when it affects the anterior teeth. Therefore, considering intracoronal bleaching as a treatment option before the final restoration is imperative. A 19-year-old female patient presented at the Dental Hospital of Prof. Soedomo (RSGM Prof. Soedomo) with a complaint of anterior tooth discoloration. The patient had a history of swelling in the affected tooth, but at the time of her visit, she reported experiencing no pain. Radiographic examinations revealed an open apex in tooth 21 and a periapical lesion in tooth 11. Both tooth 11 and 21 underwent root canal treatment. Tooth 21 underwent apexification using MTA, followed by root canal obturation and intracoronal bleaching. The entire treatment process spanned approximately six weeks. The final radiograph showed an MTA apical plug in tooth 21 and a reduction in the size of the apical lesion in the same tooth.