Regenerative Endodontic Therapy in a Necrotic Immature Tooth with Chronic Apical Abscess with Apical Placement of Calcium Hydroxide: A Clinical Case Report
Managing necrotic immature teeth is complex due to thin root walls and open apices. Regenerative endodontics has emerged to overcome these limitations. These biologically based approaches aim to restore pulp vitality and promote further root development by using dental stem cells and revascularization. A female patient aged 9 years and 4 months diagnosed with dens evaginatus, necrotic pulp, and a chronic apical abscess in an immature mandibular premolar underwent treatment with regenerative endodontic procedures (REPs). Calcium hydroxide (Ca(OH)2) medication was applied to the apical region of the root canal. Over a 22-month follow-up period, the tooth remained asymptomatic, and radiographic assessments revealed periapical healing, apical closure, root lengthening, and dentinal wall thickening. The favorable outcomes observed suggest that apical placement of Ca(OH)2 during REPs may be a promising approach for managing immature teeth with pulp necrosis and chronic apical abscess, supporting both disinfection and root maturation.
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