Root Development Following Bioceramic Material Application in Immature Permanent Teeth: A Case Series With 24-Month Follow-Up.

Objective: Dental trauma frequently impacts children and adolescents, leading to functional and esthetic challenges. If not managed promptly and effectively, complications may ensue. Apexification with calcium silicate cement (CSC) has been proposed as a reliable treatment for necrotic immature teeth with thick dentinal walls and open apices. While CSC effectively eliminates periapical infection and improves tooth survival, its ability to promote root lengthening in immature teeth is not consistently proven. Materials and Methods: This case series highlights five instances in four children of traumatized anterior teeth with necrotic pulps treated using bioceramic putty and bioceramic sealer-a contemporary generation of CSC-in apexification procedures spanning two to three visits. Results: Radiographic follow-ups of 24 months demonstrated successful canal system sealing, periapical lesions healing, and notable root lengthening. Importantly, no posttreatment complications, such as pain or exacerbation, were observed, underscoring the efficacy and potential of these materials for managing necrotic immature permanent teeth. Conclusion: Bioceramic apical barrier is recognized as an effective treatment for managing traumatized anterior teeth. Moreover, it demonstrates promising results by facilitating the healing of necrotic immature teeth and potentially supporting root lengthening. Trial Registration: ClinicalTrials.gov identifier: NCT06119477.