Continued root-end growth and apexification using a calcium hydroxide and iodoform paste (metapex®): Three case reports

Aim: The aim of these case reports is to present a treatment to promote root-end growth and apexification in nonvital immature permanent teeth in children. Methods and Materials: Three cases were presented where the calcium hydroxide and iodoform paste Metapex® was placed in the root canals of immature permanent teeth using disposable plastic tips. The teeth involved were evaluated radiographically at regular intervals for the first 12 months after placement of the paste. At the end of 12 months all the cases showed continued root growth and apical closure (apexification) with no evidence of periapical pathology. Conventional endodontic treatment was then performed. Results: In all three of the clinical cases presented, a combination of calcium hydroxide and iodoform paste (Metapex®) was used and showed promising results in inducing root-end growth and closure after 12 months. Conclusion: In these three clinical cases, the calcium hydroxide and iodoform paste Metapex® (Meta Biomed Co. Ltd., South Korea) was found to induce apical closure when assessed radiographically. Over a period of 12 months all the cases showed continued root growth. Clinical Significance: The calcium hydroxide and iodoform paste Metapex® promoted continued root-end growth with apexification in the nonvital immature permanent teeth treated.