International Arab Journal of Dentistry


This case report describes the treatment of a necrotic immature permanent central incisor with symptomatic apical periodontitis, which was not treated with conventional apexification techniques. Instead, a regenerative approach based on the literature’s methods for regeneration was provided. The root canal was gently debrided of necrotic tissue with a large diameter file, irrigated with 5,25% NaOCl and then medicated with 2% chlorhexidine. After 21 days, the tooth was asymptomatic. The canal was accessed and irrigated with saline solution and a tissue scaffold was created with PRF (Platelet-Rich Fibrin) prepared using centrifugation. The final restoration was completed immediately with MM-MTA and a composite resin. The tooth was controlled every three months over a period of 2 years and has remained symptom free. Radiographic examination shows healing of the apical radiolucency suggesting that appropriate biologic responses can occur with this type of treatment of the necrotic immature permanent tooth.