A matured and fully formed tooth, has a rounded conical-shaped root. In the x-ray, you can appreciate the round conical shape of the root as shown in the x-ray picture below.

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Sometimes, a tooth ​may present with apex that is not fully formed, and this phenomenon is known as open apex. This could happen if that particular tooth was injured when it is forming. Usually, this kind of open apex tooth will tend to be a dead tooth and there will be infection in the whole root canal system and around the tooth. The following radiograph shows a tooth with an open apex.

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​Apexification is a root canal treatment procedure that helps to form the apex of the tooth. First, laser-assisted root canal treatment will be performed because laser cleans and disinfects the best in this kind of case when compared to traditional root canal treatment. Then, a material known as mineral trioxide aggregate (MTA) will be placed to seal up the open apex. The mother nature, which is our human body will then deposit tooth structure known as cementum around MTA and forming a closed apex. Below is the radiograph after apexification was done.

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The following image shows 6 months follow up. The shadow indicating infection at the root tip has reduced in size and root structure has started to form.