Mechanisms Involved in Apice Closure of Pulpless Teeth – Literature Review

Alexandrino Pereira dos Santos Neto1, *, Sandra Maria Alves Sayão Maia2, Jair Carneiro Leão1, Iliana Lins Quidute2, Carolina dos Santos Guimarães2, Severino Alves Júnior3, Pamella Recco Álvares2, Maria Izabel Gomes Ribeiro1, Luciano Barreto Silva2
1 Department of Clinical and Preventive Dentistry, Health Sciences Center, Federal University of Pernambuco (UFPE), 1235 Prof. Moraes Rego Street, Recife, PE, 50670901 Brasil
2 Departament of Endodontics, University of Pernambuco (UPE), 1650 Gal Newton Cavalcanti Avenue, Camaragibe, PE, 54753-020 Brazil
3 Department of Fundamental Chemistry, Exact and Nature Sciences Center, Federal University of Pernambuco (UFPE), Prof. Luis Freire Street, Recife, PE, 50740-540 Brasil

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© 2021 dos Santos Neto. et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Clinical and Preventive Dentistry, Health Sciences Center, Federal University of Pernambuco (UFPE), 1235 Prof. MoraesRego Street, Recife, PE, 50670901 Brazil; Tel/Fax: +55-81-21268818; E-mail:



Unfinished root formation has always offered challenges in endodontics due to technical difficulties and weakened teeth resistance during the lifetime of an individual. Pulp revascularization therapy appeared as a solution for apical closure and root maturation. The existence of oral stem cells involved in the process associated with traditional resident cells requires adequate blood supply given by induced controlled injury deliberately accomplished into the periapical zone.


The aim of this work was to research, through literature review, the main mechanisms involved in the process of apical closure through the technique of pulp revascularization.


Apice closure in pulpless teeth seems to happen as a result of professional intervention and biological activity. The success rate depends on the role of traditional local immune cells and stem cells associated with adequate blood supply to finish root formation.

Keywords: Pulp revascularization, Apex closure, Endodontics, Oral stem cells, Apexogenesis, Angiogenesis.