Management of open apex with regenerative endodontic therapy: case report

Trauma of developing teeth may lead to pulpal necrosis with subsequent arrestment of root development, making them more susceptible to fracture. Regenerative endodontic procedures induce maturogenesis in necrotic immature permanent teeth in order to promote continuation of root growth This case report describes the Revascularization of a Permanent Immature Maxillary left central incisor with Pulp Necrosis and asymptomatic apical periodontitis. Access opening was done & the canal was disinfected with copious irrigation using 5.25% NaOCl and triple antibiotic paste (Ciprofloxacin, Metronidazole, and Minocycline) as intracanal medicament. After the disinfection protocol is complete, it is followed by revascularization procedure. The apex was mechanically irritated to initiate bleeding into the canal to produce a blood clot to the level just below the level of cementoenamel junction. Mineral trioxide aggregate was placed over the blood clot followed by bonded resin restoration above it. The patient was recalled at follow-ups after seven days, three, six and nine months. No symptoms such as pain, inflammation, discomfort was observed during the review period and there was radiographic evidence of continuing thickness of dentinal walls.