Endodontic management of immature permanent teeth is still a challenge for both clinicians and researchers. Open apex is an unusual wide apical foramen that arises due multiple reasons such as incomplete development, extensive apical resorption, caries leading to pulpal necrosis or trauma before complete root formation, root-end resection, or maybe due to over instrumentation. Traditionally, calcium hydroxide was used for inducing the formation of an apical barrier. Currently, mineral trioxide aggregate (MTA) has shown promising results for apexification procedures. Recently some authors have shown that non vital, infected immature teeth can be alternatively treated by pulp regenerative process. Regenerative endodontics has brought a revolutionizing tissue engineering concept in the field of endodontics for the treatment of immature permanent teeth. It’s been considered as a “paradigm shift” in the treatment modalities, as it fosters continued root maturation. Hence, this review of literature aims to discuss about various treatment modalities for management of open apex.

Immature tooth, Open apex, Apexification