Pulp and Bone Regenerative Therapy Using Biomaterials and Dual Rinse 1-Hydroxyethylidene-1,1-Diphosphonic Acid in a Single Visit: A Case Report

The use of platelet concentrates has become increasingly widespread in dentistry and regenerative medicine. Injectable platelet-rich fibrin (I-PRF) has gained attention in bone tissue engineering. Etidronic acid (HEDP), a mild chelator commercially available as "Dual Rinse® HEDP" (Medcem, Switzerland) has been introduced for endodontic use. However, to date, no reports exist on single-visit pulp and bone regenerative therapy using HEDP and I-PRF for immature permanent teeth with complete buccal bone loss following traumatic dental injury. This case report presents a successful single-visit regenerative endodontic procedure (REP) for an immature maxillary right central incisor following trauma one year earlier. A 9-yearold female was referred with severe pain in her maxillary central incisors. The extraoral examination was within normal limits. Intraorally, maxillary right central incisor showed a complicated crown fracture, an opened pulp chamber, and a sinus tract on the labial mucosa. Clinical and radiographic examinations revealed pulp necrosis, symptomatic apical periodontitis, a large periapical lesion, and complete loss of the buccal cortical plate. A single-visit REP was performed, the root canal was disinfected using HEDP mixed with NaOCl, and I-PRF was injected beyond the apex. At 12-month follow-up, the tooth was asymptomatic, responded to sensibility tests, and exhibited complete periapical healing with buccal bone regeneration. This case demonstrates that regenerative endodontic treatment can be successfully achieved in a single visit using HEDP and I-PRF. Keywords: Apical periodontitis, CBCT, Dual rinse, Injectable-PRF, Pulp regeneration