Long term radiographic study of bilateral second premolars with immature root treated by apexogenesis and apexification.

A ten-year-old girl broke the central cusps of the mandibular second premolars. The mandibular right second premolar was treated with apexification and the left with apexogenesis. These methods were chosen in view of the presented clinical symptoms, radiographic findings, and outcome of bacterial cultures of root canal samples. At postoperative 2 years 8 months, disappearance of the focus, closure of the root canal, and formation of the root apex were observed in both mandibular premolars. The mandibular left second premolar demonstrated a nearly normal root formation and root apex morphology. Immediately beneath the extracted pulp, regular, uniform, and thick hard tissue was formed. Meanwhile, in the mandibular right second premolar, root growth was suspended, making the root short, and the contour was constructed in such a way that it encircled the distal apical area from the mesial side forming the root apex.