Burns L E, Gencerliler N, Terlizzi K, Solis-Roman C, Sigurdsson A, Gold H T. Apexification Outcomes in the United States: A Retrospective Cohort Study. J Endod 2023; 49: 1269-1275.

Retention of immature permanent teeth keeps future options open.

Treatment options for necrotic immature permanent teeth include apexification - the creation of a calcific barrier at the apex to facilitate obturation - or regenerative endodontic procedures (REP) to increase root length and root wall thickness.

Using insurance claims data from the US states of Massachusetts (2013-2019) and New York (2006-2019), 636 cases of apexification treatments were identified which fitted the coding inclusion criteria. Median patient age was 11 years (range 5-82) and anterior teeth (46%) were the most commonly treated followed by molars (39%) and premolars (15%). Mean duration of treatment where it could be identified was 255 days. Over a mean follow-up period of 64 + 39 months, the overall survival rate was 86%. Failure was more likely in premolar and molar teeth. Failure was significantly less likely if a permanent restoration (composite, core build up, crown or amalgam) was placed after treatment.