Nonsurgical Endodontic Management of an Immature Non-vital Maxillary Left Central Incisor Using a Regenerative Endodontic Procedure: A Case Report

The clinical management of immature teeth with open apex is arduous because of the lack of an apical barrier, thin dentinal walls, and the higher susceptibility to root fracture.This case report highlights a regenerative endodontic approach to manage immature permanent teeth, aiming to preserve tooth structure.A 19-year-old female reported with discoloration of the upper left central incisor (#21) and reported a history of dental trauma approximately 10 years ago.Clinical examination revealed that the tooth did not respond to cold or electric pulp vitality tests.Radiographic evaluation demonstrated a periapical radiolucent lesion along with an open apex.Based on these findings, a diagnosis of pulpal necrosis associated with asymptomatic apical periodontitis was established.After discussing the available treatment options, regenerative endodontic therapy was selected.The procedure involved induction of bleeding into the canal space, followed by placement of platelet-rich fibrin (PRF) and Biodentine™.The patient remained asymptomatic, with radiographic evidence of reduced periapical radiolucency, progression toward apical closure, and a positive response to pulp vitality testing after 12-month follow-up.