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.