Post-traumatic apexogenesis of immature non-vital permanent incisors

Injury to an immature permanent tooth may result in cessation of dentin deposition and root maturation leaving an open root apex and thin dentinal walls that are prone to fracture. Endodontic treatment is often complicated and protracted with an uncertain prognosis frequently resulting in pre-mature tooth loss. There are several advantages of promoting apexogenesis in immature teeth with open apices. It encourages a longer and thicker root to develop thus decreasing the propensity of long term root fracture. This case report highlights the role of Hertwig root sheath and dental papilla in continued root formation of immature permanent tooth, even diagnosed with necrotic pulp.