Pulp Revascularization In 11 Immature Molars With Apical Periodontitis

To prospectively evaluate the clinical efficacy of pulp revascularization (REPs) in treating chronic apical periodontitis (CAP) in immature permanent molars. Eleven immature permanent molars with caries-induced chronic apical periodontitis (apical radiolucency <8 mm) treated with REPs between 2020-2024 were included, with follow-up periods of 5-15 months. Surgical procedures strictly adhered to the American Association of Endodontists (AAE) guidelines. Therapeutic outcomes were assessed using AAE’s three-tier criteria.Primary goal: Resolution of signs and symptoms and radiographic evidence of bony healing.Secondary goal: Increased root wall thickness and/or increased root length.Tertiary goal: Positive response to vitality testing.Cone-beam computed tomography (CBCT) was used for quantitative analysis of root canal length, wall thickness, and apical foramen diameter changes. The analysis revealed no significant influence of gender, age, tooth position, or periapical radiolucency size on treatment outcomes.The treatment failure rate was 45.45% (5/11 cases), consisting of 2 cases with persistent clinical symptoms and 3 cases demonstrating radiographic progression of periapical lesions.Among all cases, 63.64% (7/11) achieved the primary outcome, 81.82% (9/11) attained the secondary outcome, while none of the cases met the tertiary outcome criteria. REPs demonstrates potential for promoting root development in immature permanent molars with chronic apical periodontitis, representing a viable treatment option. A staged treatment approach is recommended, with REPs as the primary intervention and conventional root canal therapy considered if revascularization fails.