Gülşah Ünsal, Deniz Imamoglu, Donya Rahimi, Kamran Gulsahi
Turkish Endodontic Journal - 2026;11(1):118-124
Regenerative endodontic procedure (REP) is a treatment approach that aims to resume physiological root development and maintain apical closure in immature, necrotic permanent teeth. REP procedures are widely accepted treatment strategies, especially by American Association of Endodontics, European Society of Endodontics and European Academy of Paediatric Dentistry. Traumatic dental injuries to the permanent dentition occur frequently in 25% of children and 33% of adults, with most of the injuries taking place before 19 years of age. Trauma may induce pulp and periradicular pathosis, and in teeth with immature apices, this may lead to the disruption of the root development. REP contributes to the thickening of the dentin walls and normal maturation of the root, thus maintaining long-term tooth functionality. However, the desired outcome may not be achieved in every case, and post-treatment complications such as the development of periapical lesions could occur. According to recent systematic reviews, the clinical success rates of REPs are on par with those of traditional non-surgical endodontic treatments (NSETs). Variability in follow-up periods, however, seems to have an impact on these results. Specifically, short-term results might not accurately represent long-term clinical success, highlighting the significance of proper follow-up in assessing treatment effectiveness. Periapical healing is the most commonly attained outcome, and pooled clinical success rates exceeding 90% have been reported in recent quantitative meta-analyses In this case report, the treatment procedure and follow-up of a left maxillary central incisor that previously underwent a regenerative endodontic procedure is presented. After a thorough anamnesis, clinical and radiographical examination, a non-surgical endodontic retreatment was applied. Apexification treatment included intensive irrigation, Ca(OH)2 administration and finally, creating an apical plug with MTA. Follow-up radiographic and clinical examination showed healing of the periapical area and reduction of initial symptoms, keeping the tooth in function. As regenerative endodontic procedures can be recognized as the best option for permanent teeth with immature apices, there are always alternatives that can be implemented following failure.
