Apexification and its Indication
- Apexification is indicated for immature permanent teeth with non-vital pulp and incomplete root formation.
- The objective of apexification is to induce mineralised tissue formation and achieve root end closure.
- Apical closure can take various forms and may or may not be accompanied by continued root development.

Materials Used in Apexification
- Mineral trioxide aggregate (MTA), bioceramics, and biodentine are commonly used materials in apexification.
- MTA is composed of tricalcium silicate, aluminate, and oxide, and has superior properties in terms of sealing ability and biocompatibility.
- Bioceramics offer similar or better properties than MTA, including biocompatibility, antimicrobial activity, and dentin biomineralization enhancement.
- Biodentine is a tricalcium silicate-based material that acts as a bioactive dentin substitute and promotes the formation of tertiary dentin.

Mineral Trioxide Aggregate (MTA)
- MTA is primarily composed of tricalcium silicate, aluminate, and oxide.
- It sets in the presence of moisture and has been used as a root-end filling material.
- MTA shows good healing with minimal inflammation and has properties such as sealing ability, antimicrobial activity, and dentin biomineralization enhancement.
- Potential drawbacks of MTA include the release of hazardous substances, potential discoloration, and handling inconvenience.

Bioceramics
- Bioceramics are composed of zirconium oxide, calcium silicates, calcium phosphate, and other agents.
- They offer properties similar to or better than MTA, including biocompatibility, sealing ability, antimicrobial activity, and dentin biomineralization enhancement.
- Bioceramics have better bonding ability in high-humidity environments and superior color stability compared to MTA.

Biodentine
- Biodentine is a tricalcium silicate-based material used as a dentin substitute and cement.
- It allows good marginal sealing without the need for dentin surface conditioning.
- Biodentine forms tag-like structures that penetrate dentin tubules and can be bonded with different adhesives.
- It is clinically indicated for various procedures, including permanent dentin substitute, direct and indirect pulp capping, and apexification.