Amniotic membrane scaffold in conjunction with Biodentine for apexification: a clinical study on immature permanent teeth

TL;DR

This clinical study explores using amniotic membrane and Biodentin for apexification in non-vital immature permanent teeth, showing promising results for apical closure.

Contribution

The study introduces a novel combination of amniotic membrane and Biodentin for regenerative endodontic treatment in immature teeth.

Findings

Amniotic membrane contributed to apical closure within two weeks in non-vital immature teeth.

Clinical and radiographic evaluations showed satisfactory healing with no adverse effects.

The combination of amniotic membrane and Biodentin appears promising for apexification.

Abstract

In Endodontics, the primary objective of regenerative treatment is to revitalize the pulpo-dentinal complex of immature permanent teeth, promote continued root development, and achieve complete closure of the open apical terminus. Traditionally, apexification has been performed using conventional pulp space therapy for all non-vital immature permanent teeth. In this study, after rubber dam isolation and local anesthesia, routine endodontic procedures were initiated. Access cavity preparation was followed by biomechanical preparation using ProTaper hand files (size F3). Irrigation was carried out with 3% sodium hypochlorite, and two rounds of intracanal calcium hydroxide dressing were placed. At subsequent visits, the dressing was removed, the canals were dried with absorbent points, and an amniotic membrane scaffold (Tata Memorial Hospital, Mumbai, India) was positioned at the apex for two weeks. The entire pulp space was then obturated with Biodentin, and composite resin was used for post-endodontic restoration.

Apexification protocols were followed in ten adult non-vital permanent teeth with open apices. Clinical and radiographic evaluations demonstrated satisfactory healing. The amniotic membrane appeared to contribute to apical closure within two weeks and showed no adverse effects. It may represent a promising scaffold material for apexification in developing non-vital permanent teeth.

Trial registration number: Current Controlled Trials CTRI/2025/11/097852 [Registered on 21/11/2025].

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