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A case report is presented in which continuing root formation occurred in an immature mandibular second premolar after calcium hydroxide apexification treatment. An apical hard tissue barrier was accompanied by a separate disto-apically growing root 18 months posttreatment. Histologic evaluation of the root revealed immature hard tissue mixed with calcium hydroxide, connective tissue and bone, apically in the original root canal. In the separate new formed part of the root, pulp tissue, odontoblasts, predentin, cementum and an apical foreman could be identified.

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