ReviewJournal of clinical and experimental dentistry2026
Microbial control and a simple regenerative endodontic protocol achieve durable apical healing and long-term root development: A 10-year case report.
Review in Journal of clinical and experimental dentistry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
4 authors.
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Abstract
Regenerative endodontics offers a biologically driven alternative to apexification for immature teeth with necrotic pulps and apical periodontitis. We report the management of an 11-year-old girl with a history of dentoalveolar trauma and an immature maxillary left central incisor (tooth 21) presenting with gray discoloration, negative sensibility, and a defined apical radiolucency (Nolla stage 9). Treatment followed a conservative, accessible protocol: disinfection with 5.25% sodium hypochlorite, placement of triple-antibiotic paste (ciprofloxacin, metronidazole, amoxicillin), and, at two weeks, irrigation with 17% EDTA, apical bleeding induction by controlled over-instrumentation, placement of a collagen matrix, and sealing with white mineral trioxide aggregate under a definitive composite restoration. A separate endodontic treatment was later performed on tooth 11 for mastication pain unrelated to the regenerative site. Long-term follow-up showed progressive and stable tissue regeneration. At 4 years, periapical radiography revealed early hard-tissue deposition in the middle and apical thirds and a slight increase in root length. At 8 years, marked root elongation and dentinal wall thickening were evident, improving structural prognosis. Cone-beam CT at 10 years confirmed complete apical closure, absence of periapical pathology, and substantial thickening of canal walls. Clinically, periodontal health remained intact and the tooth recovered a positive response to cold testing, consistent with true pulpal regeneration. This case demonstrates that meticulous microbial control combined with a simple, cost-conscious regenerative protocol may be associated with durable apical healing, continued root development, and functional recovery in an immature traumatized incisor. Although this is a single case and the findings are not generalizable, the sustained radiographic and clinical outcomes over a decade suggest that regenerative endodontics can be a feasible option in selected comparable cases when performed under appropriate clinical conditions.
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Registered trials
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