GRADUATE ENDODONTOLOGY
CLASSIC LITERATURE REVIEW SEMINAR
APEXIFICATION/APEXOGENESIS
FALL, 2006

The purpose of this seminar is to introduce the student to the principles and procedures of apexification and apexogenesis from a historical perspective.  The student will learn to differentiate between the two procedures and when to appropriately use each technique clinically.

SPECIFIC LEARNING OBJECTIVES:  Upon completion of this seminar the student will be able to:

1. Distinguish a completely developed from an incompletely developed root and determine which types of cases require treatment.
2. Discuss the treatment alternatives and the impact a vital pulp or non-vital pulp has on the treatment plan.
3. Discuss the different treatment options available for the incompletely developed root before the advent of the calcium hydroxide apexification procedure and their drawbacks.
4. Describe the historical evolution of the apexification and apexogenesis procedures and recognize authors that have made significant literature contributions to each procedure.
5. Describe alternative medications and procedures that have been tried for                       apexification and their clinical success.
6. Describe a step-by-step clinical procedure for apexification and apexogenesis techniques, including recognition of treatment completion or failure.
7. Discuss the possible morphologic and histologic features of both the apexification and apexogenesis procedures.

TEXT REFERENCES:. TEXT REFERENCES: Trope M, Blanco L, Chivian N, Sigrurdsson A. Pathways of the Pulp; Cohen S, Hargraves KM eds. Mosby Elsevier, 2006. 9th Ed. Chapter #16.

            1966
            *Frank AL. Therapy for the divergent pulpless tooth by continued apical
            formation. JADA 72:87-93. 1966.

            1970
            *Heithersay GS. Stimulation of root formation in incompletely developed                                   pulpless teeth. Oral Surg 29:620-630. 1970.

            1971
            *Steiner JC, Van Hassel HJ. Experimental root apexification in primates. Oral Surg 31:409-415. 1971.

            1972
            Cvek, M. Treatment of non-vital permanent incisors with calcium hydroxide. I. Follow-up of periapical repair and apical closure of immature roots. Odont Revy 23:27. 1972.

            1973   
            *Torneck CD, Smith J S. Biologic effects of endodontic procedures on developing incisor teeth. IV. Effect of debridement procedures and calcium hydroxide. Oral Surg 35:541-554. 1973.

            Binnie, WH and Rowe, AHR.  A histologic study of the periapical tissues of incompletely formed pulpless teeth filled with calcium hydroxide. J Dent Res 52:1110-1116. 1973.

            1975
            *Roberts SC, Brilliant, J.D. Tricalcium phosphate as an adjunct to apical closure in pulpless permanent teeth. J Endodon 1:263-269. 1975.

            1977
            *Krakow AA, Berk H, Gron P. Therapeutic induction of root formation in                                the exposed incompletely formed tooth with vital pulp. Oral Surg 43:755-765.                      1977.

            1981
            *Guttman JL, Heaton JF.  Management of the open immature apex. 1. Vital teeth. Int Endo J 14:166-172. 1981.

            Guttman, JL Heaton, JF. Management of the open immature apex. 2. Non-vital teeth. Int Endo J 14:173-178. 1981.

            *Webber RT, Schwiebert KA, Cathey GM.  A technique for placement of calcium hydroxide in the root canal system.  JADA 103:417-421. 1981.

            1982
            *Cvek M, Cleaton-Jones PE, Austin JC, Andreasen JO. Pulp reactions to exposure after experimental crown fractures or grinding in adult monkeys. J Endodon 8:391-397. 1982.

            1984
            Smith JW, Leeb IJ, Torney DL. A comparison of calcium hydroxide and barium                        hydroxide as agents for inducing apical closure. J Endodon 10:64-70. 1984.

            1985
            Krell KV, Madison S. The use of the Messing gun in placing calcium hydroxide                         powder. J Endodon 11:233-234. 1985.

            1991
            Morfis AS, Siskos G. Apexificatioon with the use of calcium hydroxide: A clinical study. J Clinical Ped Dent 16:13-19. January 1991.

            1998
            Katebzadeh N, Dalton BC, Trope M. Strengthening immature teeth during and              after apexification. J Endodon 24:256-259. 1998.

            1999
            Shabahang S, Torabinejad M, Boyne PP, Abedi H, McMillan P. A comparative                       study of root-end induction using osteogenic Protein-1, calcium hydroxide, and     Mineral Trioxide Aggregate in dogs. J Endodon 25:1-5. 1999.

            2002
            Hachmeister D, Schindler W, Walker W, Thomas D. The sealing ability and retention characteristics of mineral trioxide aggregate in a model of apexification. J Endon 28:386. May, 2002.
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OPTIONAL PAPERS:

Zander, HA. Reaction of the pulp to calcium hydroxide. J Dent Res 18:373. 1939.

Cooke C, & Rowbotham TC.  Root canal therapy in non-vital teeth with open apices. Brit Dent J 108:147-150. 1960.

Ostby, BN. Debate: the role of the blood clot in endodontic therapy-- an experimental  histologic study. Acta Odontol Scand 19:323. 1961.

Frank, AL. Endodontic therapy of wide open apex. DCNA:688. 1967.

Friend, LA. The treatment of immature teeth with non-vital pulps. Brit Endod Soc 1:28-33. 1967.

Gloudeman, EA. Endodontic management of the wide-open apex. J Wis State Dent Soc 44:49. 1968.

Steiner, JC, Dow, PR and Cathey, GM. Inducing root end closure of nonvital permanent teeth.  J Dent Child 35:47-54. 1968.

Torneck, CD and Smith, J. Biologic effects of endodontic procedures on developing incisor teeth. I.  Effect of partial and total pulp remoaval. Oral Surg 30:258-266. 1970.

Dylewski, JJ. Apical closure of nonvital teeth.  Oral Surg 32:82-89. 1971.

Hannah, DR. Gluteraldehyde and calcium hydrroxide, a pulp dressing material. Brit Dent J:227-231. 1972.
Ham J, Patterson SS et al. Induced apical closure of immature pulpless teeth in monkeys. Oral Surg 33:438. 1972.

*Torneck CD, Smith JS et al. Biologic dffects of endodontic procedures on developing incisor teeth. II. Effect of pulp injury and oral contamination. Oral Surg 35:378. 1973.

*Torneck CD, Smith JS et al. Biologic dffects of endodontic procedures on developing incisor teeth. III. Effect of debridement and disinfection procedures  in the treatment of experimentally induced pulp and periapical disease. Oral Surg 35:532. 1973.

Goldman, M. Root end closure techniques including apexification. DCNA 18:297-308. 1974.

*Klein SH & Levy BA. Histologic evaluation of induced apical closure of a human pulpless tooth. Oral Surg 38:954-959. 1974.

Cvek M. Treatment of non-vital permanent incisors with calcium hydroxide. IV. periodontal healing and closure of the root canal in the coronal fragment of  teeth with intra-alveolar fracture and vital apical fragment. Odont Revy 25:239-246. 1974.

Stewart, GG. Calcium hydroxide induced root healing.  JADA 90:793-800. 1975.

Heithersay, GS. Calcium hydroxide in the treatment of pulpless teeth with associated pathologhy. J Brit Endo Soc 8:74. 1975.

Barker BCW, Mayne JR. Some unusual cases of apexification subsequant to trauma. Oral Surg 39:144-150. 1975.

Cvek ML,  Hollender L et al. Treatment of non-vital permanent incisors with calcium  hydroxide. VI. A clinical, microbiological, and radiological evaluation of treatment in one sitting of teeth with mature or immature root. Odont Revy 27:97.1976.

Piekoff, MD and Trott, JR. Apexification: report of a case. J Endodon 2:182-185. 1976.

England, MC and Best, E.  Noninduced apical closure in immature roots of dogs’ teeth.
J Endodon 3:411-17. 1977.

Cvek, M. (1978). "A clinical report on partial pulpotomy and capping with calcium hydroxide in permanent incisors with complicated crown fractures." J Endodon 4(8): 232 - 237.

Dimashkieh, MR. The problem of the open apex--a new approach. J Brit Endo Soc 11. 1978.

Nevins, A et al.  Induction of hard tissue into pulpless open apex teeth using collagen-calcium phosphate gel.  J Endodon 4:76-81. 1978.
Donnelly, C. C. and F. J. Harty (1979). "An 'in-vitro' investigation of 6--9' in endodontics." JBES 12(1): 25 - 31.

Holland RV, deSouza V et al. A histologic study of the effect of calcium hydroxide in the treatment of pulpless teeth of dogs. J Brit Endo Soc 12:15-23. 1979.

Citrome GP, Kaminski EJ, Heuer MA.  A comparative study of tooth apexification in the dog.  J Endodon 5:290-297. 1979.

O'Riordan, M. (1980). "Apexification of deciduous incisor." Journal of Endodontics 6(6): 607 - 609.

West, NM. A possible impediment to biologic root end closure. J Endodon 6:11. 1980.

Biesterfield, RC and Taintor, JF. Root end closure in adults: report of cases. J Endodon
6:691-695. 1980.

Chawla HS, Tewari A et al. A study of apexification without a catalyst paste. J Dent Child:431-434. 1980.

Das, S. Apexification in a non-vital tooth by control of infection. JADA 100:880-881. 1980.

Ferguson, F. S., S. Friedman, et al. (1980). "Successful apexification technique in an immature tooth with dens in dente." Oral Surg 49(4): 356-359.

Andreasen, J. O. and L. Kristerson (1981). "The effect of extra-alveolar root filling with calcium hydroxide on periodontal healing after replantation of permanent incisors in monkeys." J  Endodon 7(8): 349-354.

Cvek, M. and M. Lundberg (1983). "Histological appearance of pulps after exposure by a crown fracture, partial pulpotomy, and clinical diagnosis of healing." J Endodon 9(1): 8 - 11.

Smith, G. N. and S. Woods (1983). "Organic iodine: a substitute for BaSO4 in apexification procedures." Journal of Endodontics 9(2): 153 - 155.

DiFiore, P. M., D. D. Peters, et al. (1983). "The antibacterial effects of calcium hydroxide apexification pastes on streptococcus sanguis." Oral Surg 55(1): 91.

Pomeranz, H. H. (1983). "A very active case of idiopathic external root resorption." Oral Surg 55(5): 521-523.

*Lieberman J, Trowbridge H.  Apical closure of nonvital permanent incisor teeth where no treatment was performed.  J Endodon 9:257-260. 1983.

Schlindler, WG and Walker, WW. Continued root development after apexification of an immature tooth with dens invaginatus. J Endodon 9(10). 1983.

Friedman S. Apical closure. Report of two cases. Oral Surg 58:94. 1984.

Webber, RT. Apexogenesis versus Apexification. DCNA 28:669-697. 1984.

Feiglin, B. Differences in apex formation during apexification with calcium hydroxide.  Endo Dent Traumatol 1:195-199. 1985.

Dumsha, TC and Guttman, JL. Clinical techniques for the placement of calcium hydroxide. Comp Cont Educ Dent 6:482-89. 1985.

*Heide, S and Kerekes, K. Delayed partial pulpotomy in permanent incisors of monkeys. Int Endo J 19:78-89. 1986.

Chawla, HS. Apical closure in a nonvital permanent tooth using one calcium hydroxide dressing. J Dent Child Jan/Feb 1986.

Anthony, D. R. (1986). "Apexification during active orthodontic movement." Journal of Endodontics 12(9): 419 - 421.

Ghose, L. J., V. S. Baghdady, et al. (1987). "Apexification of immature apices of pulpless permanent anterior teeth with calcium hydroxide." Journal of Endodontics 13(6): 285 - 290.

*Yates JA. Barrier formation time in non-vital teeth with open apices. Int Endo J  21:313-319. 1988.

Morse DR, O’Larnie JO and Yesiloy C. Apexification: review of the literature. Quint Int 21:589-598. 1990.

Yang, S. F., Z.-P. Yang, et al. (1990). "Continuing root formation following apexification treatment." Endod Dent Traumatol 6(5): 232.
Harbert, H. (1996). "One-step apexification without calcium hydroxide." J Endodon 22(12): 690-692.

*Klier DJ, Barr ES. A study of endodontically apexified teeth. Endod Dent Traumatol 7:112-117. 1991.

Guttman JL and Fava LRG. Periradicular healing and apical closure of a non-vital tooth in the presence of bacterial contamination. Int Endo J 25:307-3111. 1992.

*Schumacher JW, Rutledge RE. An alternative to apexification. J Endodon 19:529-31. 1993.
Bhambhani, SM. Root-End induction: apexification and apexogenesis. Clark’s Clinical Dentistry 4:Chapter 3;1-14.1993.

Leonardo M, de Silva L et al. Histological evaluation of therapy using a calcium hydroxide dressing for teeth with incompletely formed apices and periapical lesions. J Endodon 19:348-352. 1993.

Mackie I, Hill F et al. Comparison of two calcium hydroide pastes used for endodontic treatment of non-vital immature incisor teeth. Endo Dent Traum 10:88-90. 1994.

Wiscovitch J, and Wiscovitch G. Surgical apical repair with super-EBA cement: a one-visit alternative to apexification. J Endodon 21:43-46. 1995.

Caliskan, M. Periapical repair and apical closure of a pulpless tooth using calcium hydroxide. Oral Surg 84:683-687. 1997.

Chosack A, Sela J et al. A histological and quantitative histomorphic study of apexification  of nonvital permanent incisors of veret monkeys after repeated root filling with a calcium hydroxide paste. Endo Dent Traum 13:211-217. 1997.

Das S, Das AK et al. Experimental apexogenesis in baboons. Endo Dent Traum 13:31-35.
 1997.

Goodell, G. G., O. M. Thomas, et al. (1997). "Linear dye penetration of a calcium phosphate cement apical barrier." J Endodon 23(3): 174-177.

Nevins A and Crespi P. A clinical study using the collagen gel zyplast in endodontic treatment. J Endodon 24:610. 1998.

Capurro  M, Zmner O. Delayed apical healing after apexification treatment of non-vital immature tooth: a case report. Endo Dent Traumatol 15:244. 1999.

Finucane D, Kinirons M. Non-vital immature permanent incisors factors that may influence  treatment outcome. Endo Dent Traumatol 15:273. 1999.

Calt S, Serper A, Ozcelik B, Dalat M. pH changes and calcium ion diffusion from calcium hydroxide dressing materials through root dentin. J Endodon 25:329. 1999.

Shabahang S, Toribinejad M. treatment of teeth with open apices using mineral trioxide
aggregate. Pract Periodontics Aesthet Dent 12:315. 2000.

Koh E, Pitt Ford T Kariyawasam S, Chen N, Torabinejad M. Prophylatic treatment of dens evaginatus using mineral trioxide aggregate. J Endodon 27:540. August, 2001.

Seldon H. Apexification : An interesting case. J Endodon 28:44. January 2002.

Weisleder, R and Benitez, C. Mataurogenesis: Is it a new concept? J Endodon 29:776. November, 2003.

Lawley, G. R., W. G. Schindler, et al. (2004). "Evaluation of ultrasonically placed MTA and frature resistane with intracanal composite resin in a model of apexification." J Endodon 30(3): 167-172.

Ham, K. A., D. E. Witherspoon, et al. (2005). "Preliminary evaluation of BMP-2 expression and histological characteristics during apexification with calcium hydroxide and mineral trioxide aggregate." J Endodon 31(4): 275-279.

Fridland, M. and R. Rosado (2005). "MTA solubility: a long term study." J Endodon 31(5): 376-379.