Apexification of an Endodontically Failed Permanent Tooth with Amniotic Membrane Matrix and MTA

Abstract Introduction The treatment of failure root canal treated traumatised immature tooth poses a significant challenge. The cessation of root development following trauma is a significant outcome of pulpal death. Traditional pulp space treatment will be impeded by the resultant slender, fragile dentinal walls, which will obstruct effective cleansing and adequate apical closure. The fundamental objective of regenerative dentistry is to reinvigorate the pulp-dentin architecture of immature tooth to effectively secure the incomplete apical end of the root and facilitate the completion of root development. Methodology Lower anterior tooth with an open apex underwent apexification as the standard treatment of care. Conventional endodontic treatment was proceeded under local anaesthesia followed by rubber dam isolation with respect to lower anterior tooth. Access cavity was prepared, retreatment was carried out using H files, apical gauging performed, biomechanical preparation performed upto size 45. Two rounds of intracanal dressing over a period of two weeks was given followed by 1.3% NaOCl irrigation. During the following session, after the elimination of the intracanal medicament and drying of canals with paper points, 1 mm × 1 mm size of amnion (Tata Memorial Hospital, Mumbai, India) was deposited at the apex with 5 mm BIO-C® Repair (Angelus, Londrina, Brazil) an MTA premixed CSBC was used for apical plug. The fag end of the pulp space was backfilled with thermoplasticized gutta percha. Post endodontic restoration with composite resin was done on later visits. Results Immature permanent tooth with open apex underwent apexification procedure with amniotic membrane and MTA. At one-year intervals, the tooth shown evidence of calcific barrier formation both clinically and radiographically. Conclusion Amniotic membrane with MTA plug has shown to form calcific barrier formation for the apexification. This combination is regarded as a feasible method for the apexification of juvenile teeth without any detrimental effects. Lay Summary This research highlights the need for regenerative endodontic therapy with the help of amniotic membrane. The need for regenerative technologies aims to achieve treatment success in a more conservative manner, which avoids the need for surgical intervention. Genesis of calcific bridge in blunderbuss canals with the help of viable healthy tissue without surgical approach is the key to good patient compliance and successful treatment outcomes.