Spontaneous apical closure in a traumatized immature tooth: a case report

The purpose of this manuscript was to report the occurrence of an unusual spontaneous apical closure similar to that obtained in response to apexification, without any clinical intervention. An 11-year-old boy was referred by his dentist for endodontic evaluation of the maxillary right medial incisor. He had a traumatic incident 3 years previously. The tooth suffered a coronal fracture without pulp exposure and was restored with a resin-based esthetic material. During the period between the trauma and treatment, the tooth was asymptomatic. Incomplete root formation was observed radiographically with a wide canal, although the foramen appeared closed and a small radiolucency in the apical region was detected.The clinical diagnosis was pulp necrosis with asymptomatic apical periodontitis with an indication for endodontic treatment, which was performed during three sessions. The final filling of the root canal was done using a gutta-percha cone associated with a zinc oxide-based sealer, through the lateral condensation technique. The access opening was sealed with temporary cement and the patient was referred for a definitive restoration. Even without any specific treatment besides the esthetic restoration performed after crown fracture, the deposition of a hard tissue clinically andradiographically similar to that one formed in cases of apexification occurred in this case.