Cone-beam computed tomographic evaluation of biodentine apexification for traumatized necrotic immature permanent incisors: One-year clinical study

Aim: The aim of this study was to assess the outcome of biodentine apexification for the management of traumatized immature teeth with necrotic pulp over a period of 12 months. Methods: Eighty-five human maxillary incisors with traumatized immature necrotic pulp in patients aged 10-50 years were selected for this study. Root canal treatment was initiated and the biodentine apexification procedure was performed in a single appointment for all teeth. Intraoral preoperative and postoperative periapical radiographs were used to assess periapical (PA) changes, changes in root length (RL), and radiographic root area (RRA). Preoperative and postoperative cone-beam computed tomography (CBCT) images were used to assess the three-dimensional (3D) volumetric changes. Patients were recalled at 12 months posttreatment for the evaluation of clinical symptom, percussion, and palpation examination. Descriptive statistics was computed for preoperative demographic, patient-centric data, and treatment success. Paired t-test was used to compare the preoperative and 12-month postoperative changes in RRA, RL, and 3D volumetric changes of the parameters. Results: Forty-eight out of the 49 teeth that completed the study were asymptomatic and functional. Comparing the preoperative and the 12-month review radiographs using the periapical index scores based on the size of the lesion, completely healed lesions were 79.16% while lesions in the process of healing were 20.83%. There was a significant (P < 0.05) increase in RL (14.17%), RRA (40.87%), and dentin volume (26.63%). Conclusion: 3D volumetric analysis suggests that biodentine apexification has the ability to deposit hard tissue 3-dimensionally, and it is an effective alternative to the conventional apexification materials.