Present status and future directions: Apexification.

The success rate of apexification is primarily determined by multiple factors, including the material used, the size of the open apex compared to the length of the root, and the technique used in each case. The main objective of this review was to provide an update on the present management of open apex to identify factors and circumstances that may influence the success of apexification using different materials and techniques. Future research on apexification should focus on how to treat open apices with wide periapical lesions without surgery. Previously, the predictability of these parameters with non-surgical procedures was uncertain, but now, with the use of a dental operating microscope, it has become more predictable. Another reason could be that extra visits are no longer required due to major advances in the armamentarium and materials used for apexification.