Although numerous studies have been conducted on apexification using mineral trioxide aggregate (MTA), direct observation of extracted human teeth after the procedure has been rarely reported. This case report describes a mandibular premolar treated 2.5 years ago and extracted recently for orthodontic treatment. The tubercle of the right mandibular premolar of a 12-year-old boy with dens evaginatus was fractured and the pulp was exposed. The tooth was diagnosed with pulp necrosis and asymptomatic periapical abscess. During the first visit, copious irrigation was performed with 2.5% sodium hypochlorite. Calcium hydroxide paste was placed as an intracanal medicament. The sinus tract had disappeared at the second visit after 3 weeks. MTA was applied on to the bleeding point as a 4-mm-thick layer, followed by a 3-mm-thick gutta-percha filling and resin core build-up. After 2.5 years, the tooth and three other premolars were extracted for orthodontic treatment. The right and left mandibular premolars were scanned with micro-computed tomography to determine the root shape and canal anatomy. Irregular root growth was observed and the root outline of the right mandibular premolar differed from that of the contralateral tooth. Apexification with MTA leads to the formation of roots with irregular morphology, without any pulpal space.

Caries remains prevalent throughout modern society and is the main disease in the field of dentistry. Although studies of this disease have used diverse methodology, recently, X-ray microtomography has gained popularity as a non-destructive, 3-dimensional (3D) analytical technique, and has several advantages over the conventional methods. According to X-ray source, it is classified as monochromatic or polychromatic with the latter being more widely used due to the high cost of the monochromatic source despite some advantages. The determination of mineral density profiles based on changes in X-ray attenuation is the principle of this method and calibration and image processing procedures are needed for the better image and reproducible measurements. Using this tool, 3D reconstruction is also possible and it enables to visualize the internal structures of dental caries. With the advances in the computer technology, more diverse applications are being studied, such automated caries assessment algorithms.