Catherine Marcia Irawan*, Ovy Damara Prima*, Margareta Rinastiti**, Yulita Kristanti**
Background: Previously initiated therapy with symptomatic apical periodontitis in an open apex in anterior teeth with a shortened root presents challenges in achieving both functional and aesthetic outcomes. In these conditions, especially teeth with limited height, can be addresed using a composite splinter jacket crown accompanied by a post that specifically designed to provide stability. Objective: To highlights the use of a splinter jacket crown as a solution for restoring a shortened anterior tooth after apexification. Case Report: A 23-year-old female presented with tooth 21, diagnosed with previously treated and symptomatic apical periodontitis on the maxillary left central incisor. Clinical and radiographic examinations revealed an open apex, apical radiolucency, with a history of trauma at age 11. The treatment carried out is apexification using Biodentine as an apical plug, conventional root canal preparation, placement of a laboratory composite resin post, and final restoration with a composite splinter jacket crown. Follow-up evaluations at 1 and 3 months showed favorable clinical and radiographic outcomes, including resolution of symptoms and periapical healing. Discussion: The combination of Biodentine for apexification, laboratory post, and laboratory composite resin crowns as a splinter is an efficient solution for managing complex cases that needs root canal treatment in anterior teeth with open apex and shortened roots. Conclusion: Composite splinter jacket crown as a final restoration accompanied by laboratory post after apexification with Biodentine is an effective strategy for managing teeth with an open apex. Composite splinter jacket crown enhanced retention, making it practical for shortened teeth.
Keywords: Apexification, Biodentine, Composite post, Previously Initiated Therapy