Apical Barrier Technique In Maxillary Second Premolar: A Case Report

This case report presents the management of a 23-year-old female with chronic apical periodontitis in the maxillary right second premolar (tooth 15), characterized by recurrent gingival swelling. The case highlights the application of the apical barrier technique, a minimally invasive approach for teeth with open apices, emphasizing its clinical relevance in modern endodontics. The patient reported no prior treatment. Clinical examination revealed a sinus tract, negative response to cold testing, and radiographically confirmed an open apex with periapical radiolucency. Under microscope guidance, root canal disinfection was performed using 3% NaOCl and 17% EDTA. After calcium hydroxide interim dressing, iRoot SP paste (Innovative BioCeramix) was placed at the apex, followed by iRoot BP (Innovative BioCeramix) and thermoplasticized gutta-percha obturation. Postoperative radiographs confirmed adequate filling. The apical barrier technique avoids traditional apexification, reducing treatment duration and enhancing predictability. The use of bioceramic materials (iRoot SP/BP) promoted apical sealing and biocompatibility. This aligns with current literature advocating bioactive materials for improved outcomes in immature teeth. The successful 6-month follow-up underscores the efficacy of the apical barrier technique with bioceramics in managing open-apex cases. This approach offers a viable alternative in endodontics, emphasizing minimally invasive protocols and bioactive material applications, with direct implications for clinical practice in dental specialties.