Management of Failed Regenerative Endodontic Treatment of a Necrotic Immature Molar: A Case Report With 12-Month Follow Up

Abstract

Introduction: Management of necrotic immature permanent teeth has always posed a challenge to clinicians. Regenerative endodontic procedures (REPs) have been proposed as an alternative to apexification to treat necrotic immature teeth. However, few failed cases of REPs have been presented in the literature with different successful retreatment approaches. Case presentation: An eight-year-old boy reported spontaneous pain in the right permanent mandibular first molar. Regenerative endodontic treatment using platelet-rich fibrin (PRF) was the treatment method due to the open apices. At the 9-month follow-up, there was a periapical lesion around the distal root. Hence, apexification with Mineral trioxide aggregate (MTA) was carried out. In the twelve-month follow-up, the periapical lesion healed radiographically. Conclusions: MTA and bioceramic-based root canal sealers yielded satisfactory outcomes in lesion healing. Little is known about the biological and clinical aspects of regenerative endodontic treatment. Moreover, there are still unknown factors that govern the success of REPs.