Ballesio I, Marchetti E, Mummolo S, Marzo G
University of Rome Tor Vergata.
Eur J Paediatr Dent. 2006 Mar;7(1):29-34.
This was the radiographic evaluation of 15 maxillary incisors apexification treatment carried out on 7-9 years old patients with periapical pathology due to pulpal necrosis after dental trauma.
The treatment consisted of two phases. The aim of first phase was the formation of a calcified apical barrier through calcium hydroxide medications repeated twice with a three months interval. The aim of the second phase was the obturation of the root canal system once achieved a radiographic evidence of the formation of an apical barrier. The treated teeth were radiographed at six months and then periodically once a year for a period of 7 and 13 years.
The radiographic analysis allowed to underline three different kinds of apical formation: a physiological development of the apical portion with a final root length equal to the contralateral tooth; the formation of a cap tissue and an apical development with the final root length slightly shorter than the contralateral tooth; or the formation of different layers of mineralised tissue that aggregate together trough the years.
Apexification is not a static phenomenon and the apexified area undergoes through the years to a conspicuous readjustment involving bone, apical root tissues and root filling material.
本研究对7至9岁因牙外伤致牙髓坏死伴根尖周病变的患者的15颗上颌切牙进行根尖诱导成形术治疗，并进行影像学评估。
治疗分为两个阶段。第一阶段的目的是通过每隔三个月重复两次氢氧化钙药物治疗来形成钙化根尖屏障。第二阶段的目的是在根尖屏障形成的影像学证据出现后对根管系统进行充填。治疗后的牙齿在6个月时进行影像学检查，然后每年定期检查一次，持续7至13年。
影像学分析显示出三种不同类型的根尖形成：根尖部生理性发育，最终牙根长度与对侧牙齿相等；形成帽状组织且根尖发育，最终牙根长度略短于对侧牙齿；或多年来形成不同矿化组织层并聚集在一起。
根尖诱导成形术不是一种静态现象，多年来根尖形成区域会经历显著的重新调整，涉及骨组织、根尖根组织和根管充填材料。
