Abstract
An immature tooth with pulpal necrosis and periapical pathology imposes a great difficulty to the endodontists. Endodontic treatment options for such teeth consist of conventional apexification procedure with and without apical barrier. An open apex tooth with pulpal necrosis and periapical pathology is a challenge for restoration as it is loaded with too much of bacteria. The complete elimination of debris and achievement of a sterile root canal system is very challenging in open apex cases because of the complexity of the root canal system. The use of lasers in the field of endodontology represents an innovative and new approach to match these requirements. In general, dental lasers provide greater and safer accessibility of formerly unreachable parts of the tubular network, due to their better penetration into dentinal tissues. This article describes the successful management of an open apex tooth with large periapical pathology using Er,Cr:YSGG AS an adjunct to conventional root canal preparation that resulted in remarkable and faster healing of the periradicular lesion in one year follow up. Conclusion: Single-visit apexification with biodentine following Er,Cr:YSGG laser disinfection for management of open apex cases having a very poor prognosis can be considered a predictable treatment.
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