Apexification and Corono-radicular Restoration of Teeth with Open Apices

Clinical management of permanent teeth where pulp necrosis occurs before the roots are fully formed represents a significant challenge because of widely open apices and relatively thin root walls. While the former preclude the effective application of conventional root filling methods, the latter is associated with an increased risk of cervical root fracture. Both limitations adversely affect the long-term prognosis of such immature permanent teeth.

The approach to apexification treatment in such teeth has evolved from the traditional multiple-session to one-session procedures using MTA apical plugs or, alternatively, to regenerative endodontic procedures. While one-session apical plug apexification is associated with predictably good outcomes, concerns of long setting time of MTA and occasional tooth structure discoloration have given rise to new calcium-silicate based cements expected to posses improved handling and esthetic outcomes.

This presentation will focus on one-session apexification technique protocol, the determinant factors to its expected outcome and clinical decisions to prevent discoloration. Biological basis for clinical performance of different calcium-silicate based cements will be highlighted.

Dr. João Miguel Marques dos Santos

  • Degree in Dentistry in 1995 (Faculty of Medicine, University of Coimbra).
  • MSD in Experimental Pathology in 2000, from the Faculty of Medicine, University of Coimbra – Portugal.
  • In 2001 he received a scholarship from the Calouste Gulbenkian Foundation to perform an internship at the Department of Endodontics, Faculty of Dentistry, University of Toronto – Canada.
  • In 2008 earned his PhD in Dentistry, specialty of Operative Dentistry and Endodontics with Summa Cum Laude.
  • Certified Member of the European Society of Endodontology since 2004.
  • Educator Member of the American Association of Endodontists.
  • Member of the International Association of Dental Traumatology.
  • Assistant Professor at the University of Coimbra.
  • Vice-President of the Portuguese Society of Endodontology.
  • Author of peer-reviewed publications (ORCID ID 0000-0002-2865-9698).
  • Private practice focused on Endodontics in Aveiro, Portugal.