Radiological Assesment of Apex Formation following Use of Hydroxyapatite

The treatment of pulp in teeth with incomplete apex formation is still a clinical challenge. In addition to the most widely used medication for this purpose, calcium hydroxide, other materials have also been tested. Following the use of synthetic biomaterials for restoring bone tissue, and considering their recognized biocompatibility and bioconductivity, our intention was to explore the possibility of using synthetic biomaterials in the endodontic treatment of permanent teeth with incomplete apex formation. The aim of this study was to observe the effectiveness of hydroxyapatite in apexogenesis of young permanent teeth. In this study a 100 μm synthetic hydroxyapatite material, Beohap (HAP) powder, was applied to 24 teeth in 3 dogs of 5.5 months of age, after incomplete root development was established on radiographs. The treated teeth were radiographed monthly and the radiographs compared with those of the corresponding teeth on the other side of the jaw until completion of apex growth. The tested teeth were divided into three groups according to the method of treatment: the first was direct pulp capping, the second was amputation of the pulp at the enamelcement junction and the third was high amputation at the radiographically identified point of root growth. On the basis of radiographic analysis, apex formation was successful in all test groups, with no significant differences between the three groups and the controls (Fisher's and 2 test). Deformities of the root apex were observed in two teeth (25%) in the third group.