Frank in 1966 was one of the first to describe the clinical methods using calcium hydroxide paste & camphorated monochlorophenol (CMCP),to stimulate root closure.
The procedure for Apexification is
The tooth is isolated with rubber dam, & access is gained into the pulp chamber.
Using large reamers & files, remove the debris from the coronal half of the pulp & establish the file length radiographically.
Clean the canal, irrigate it & then dry it with a paper point. Repeated gentle use of sodium hypochlorite assists debris removal.
Seal a pellet of CMCP in the pulp chamber with a provisional restorative material.
On recall, in 1 to 3 weeks, remove the restoration & clean the canal.
Take care to avoid any instrumentation of the walls of the dentin near the apex.
Mix a paste of calcium hydroxide & CMCP on a glass slab. Carry the paste to the canal & force it into the apex with a larger plugger or cone-shaped instrument. The objective is to fill the canal completely. Obtain a radiograph to check the accuracy of the root canal filling.
On a 6 month recall, you should see radiographic evidence of an apical closure.
When you have accomplished apical closure, the root canal filling is completed.
If apexification has not been completed, repeat the cleaning & insertion of a calcium hydroxide & CMCP paste
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