Preservation of a Non-Vital Immature Maxillary Central Incisor Using MTA Apexification: Case Report with Long-Term Follow-Up: Case Report

Traumatic dental injuries in children commonly involve maxillary central incisors and may lead to pulpal necrosis in immature permanent teeth with open apices. Management of such teeth is challenging due to thin dentinal walls and the lack of an apical constriction. Apexification aims to create an apical barrier to enable proper obturation. Although calcium hydroxide has been traditionally used, it requires prolonged treatment and may increase the risk of root fracture. Mineral trioxide aggregate (MTA) offers a predictable alternative, allowing single-visit apexification with superior sealing ability. This case report presents the management of a 10-year-old girl with a chronic periapical abscess associated with an immature maxillary central incisor. After infection control, canal debridement, and interim calcium hydroxide dressing, an MTA apical barrier was placed, followed by obturation with gutta-percha and bioceramic sealer and composite restoration. At The two-year follow-up, periapical healing was observed. This case supports the clinical effectiveness of MTA apexification for long-term preservation of non-vital immature teeth.