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Al Ansary MAD et al. - Based on two included studies, there is weak evidence supporting the use of either calcium hydroxide or tricalcium phosphate for apical barrier formation in necrotic immature anterior teeth employing multi-visit apexification techniques. The evidence is insufficient to provide guidelines for practice. There was no reliable evidence on adverse events or long-term effects after the use of calcium hydroxide or tricalcium phosphate justifying caution in their use in apical barrier formation techniques.

Exclusive Author Commentary
Mohammad A D Al Ansary, 07/18/09

This systematic review of randomized controlled trials attempted to evaluate the relative effectiveness of apexification techniques,apical plug techniques, and root strengthening procedures in treating traumatized necrotic immature permanent teeth. We also evaluated immediate and/or long-term side effects reported in the literature. There is weak unreliable evidence supporting the use of either calcium hydroxide or tricalcium phosphate in multi-visit apexification in traumatized necrotic immature anterior teeth. There was no reliable evidence found for the use of other materials or techniques described in the literature. No firm conclusions can be made as to the optimum treatment or technique for apical barrier formation in immature anterior teeth due to the lack of reliable scientific research in this field.

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