Use of calcium hydroxide for apical barrier formation and healing in non-vital immature permanent teeth: a review.
OBJECTIVE
To review the use of calcium hydroxide for induction of apical barrier formation and healing in immature permanent teeth.


BACKGROUND
Pulp necrosis is a frequent complication of dental trauma in immature permanent teeth. Endodontic treatment of these teeth is often complicated. The walls of the root canals are frequently divergent and the apices immature, making debridement and obturation difficult. The aim of treatment is induction of apical healing which may be defined as apical closure through formation of mineralised tissue and repair of the periapical tissues. Calcium hydroxide is the material of choice for apical barrier formation and healing.


RESULTS
The use of calcium hydroxide for apical barrier formation is successful in 74-100% of cases irrespective of the proprietary brand used. The average length of time for apical barrier formation is approximately 5 to 20 months. Control of infection and adequate cleaning of the root canal are very important for apical healing.


CONCLUSIONS
While the success rate of apical barrier formation using calcium hydroxide is high, long-term follow-up of these teeth is necessary. Problems such as failure to control infection, recurrence of infection and cervical root fracture may occur. The latter is more frequent in immature luxated teeth with the least root development.
Sheehy
E C
EC
Department of Paediatric Dentistry & Orthodontics, UMDS, Guy's Dental Hospital, London.
Roberts
G J
GJ
D001424:Bacterial Infections / Q000517:prevention & control; D002126:Calcium Hydroxide / Q000627:therapeutic use*; D003790:Dental Pulp Necrosis / Q000209:etiology / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D010486:Periapical Tissue / Q000187:drug effects; D011670:Pulpectomy; D012008:Recurrence; D012387:Root Canal Filling Materials / Q000627:therapeutic use*; D012390:Root Canal Therapy; D013997:Time Factors; D019227:Tooth Apex / Q000187:drug effects* / Q000382:microbiology; D014074:Tooth Calcification / Q000187:drug effects; D019237:Tooth Cervix / Q000293:injuries; D014082:Tooth Fractures / Q000209:etiology; D018677:Tooth Injuries / Q000150:complications; D019553:Tooth, Nonvital / Q000382:microbiology / Q000628:therapy*; D016896:Treatment Outcome; D014945:Wound Healing
D012387:Root Canal Filling Materials; D002126:Calcium Hydroxide