Pallabi Ghosh Saha, Gargi Das

ABSTRACT

A tooth with blunderbuss canal and open apex with periapical lesions can be an endodontic challenge because of difficulty in obtaining an apical seal, and existing thin radicular walls which are susceptible to fracture. To overcome the limitations of traditional long?term calcium hydroxide apexification procedures, nonsurgical one-step apexification using a calcium silicate based material such as MTA/ Biodentine has been suggested. The one-step apexification has been described as a non-surgical compaction of the biocompatible material at the apical end of the root canal, thus creating an apical stop and enabling an immediate filling of the root canal. However, adequate compaction of Biodentine in teeth with wide open apices can be an arduous task, and an internal matrix is required for controlled placement of Biodentine as a obturation material. So, initially the open apex is condensed with bone graft material(B-OSTIN) by non-surgical procedure(with the help of GP condenser).This material helps in osseoconduction and healing of the periapical lesions. This case report presents the endodontic management of immature permanent teeth with open apices using bone graft material and one step apical barrier placement of Biodentine.