The objective of this investigation was to evaluate the 12-month effectiveness of biodentine apexification for treating traumatized immature teeth presenting with necrotic pulps. A total of 85 human maxillary incisors with traumatized immature necrotic pulps, sourced from patients aged 10–50 years, were included in this study. Root canal therapy was initiated, and the Biodentine apexification protocol was performed in a single visit for each tooth. Intraoral periapical radiographs captured before and after treatment were utilized to evaluate periapical (PA) changes, shifts in root length (RL), and radiographic root area (RRA). Pre- and postoperative cone-beam computed tomography (CBCT) images were used to measure three-dimensional (3D) volumetric changes. Follow-up was conducted at 12 months posttreatment to examine clinical symptoms and responses to percussion and palpation. Descriptive statistics were generated for preoperative demographic information, patient-related data, and treatment success. A paired t-test was applied to assess the differences between preoperative and 12-month postoperative changes in RRA, RL, and 3D volumetric measurements of the studied parameters. Of the 49 teeth remaining at study completion, 48 were asymptomatic and functional. Upon comparing preoperative radiographs with those from the 12-month review using periapical index scores based on lesion dimensions, 79.16% of lesions were fully healed, while 20.83% were in the process of healing. Statistically significant (P < 0.05) gains were noted in RL (14.17%), RRA (40.87%), and dentin volume (26.63%). Findings from the 3D volumetric analysis indicate that biodentine apexification can facilitate 3D hard-tissue deposition, making it a viable alternative to traditional apexification materials.
