Pulpal necrosis in permanent teeth with immature roots leads to development of roots which are very short, thin walled and an inadequate crown-root ratio, which overshadows their survival prognosis. Traditionally, the apexication procedure has consisted of multiple and long-term applications of calcium hydroxide to create an apical barrier to aid the obturation. Recently, articial apical barriers such as those made with mineral trioxide aggregate (MTA) have been used in teeth with necrotic pulps and open apices. More recently, procedures referred to as regenerative endodontics have received much attention as an option for these teeth. This paper reviews the past, present and recent concepts used for apexication.
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