OPEN APEX

OPEN APEX (Incomplete rhizogenesis) refers to the absence of sufficient root development to provide a conical taper to the canal. The anatomy of the apical foramen changes with age as root formation has yet to be completed when teeth erupt. The completion of root development and closure of the apex occurs up to three years after eruption. Patients who present with immature apical formation pose a challenge due to the presence of large open apices along with divergent and thin dentinal walls that are susceptible to fracture. An immature tooth with pulpal necrosis and periapical pathology imposes a great difficulty to the endodontist. Various causes of Open apices are like incomplete root development, extensive apical resorption, root end resection, over-instrumentation and pulp injury in teeth with developing roots. Every effort should be made to attain the genetically programmed closure of the foramen that remains open because of early pulp death.