Biologically Based Treatment of Immature Permanent Teeth with Pulpal Necrosis: A Case Series

Il Young Jung, Seung Jong Lee, Kenneth M. Hargreaves

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241 Scopus citations


This case series reports the outcomes of 8 patients (ages 9-14 years) who presented with 9 immature permanent teeth with pulpal necrosis and apical periodontitis. During treatment, 5 of the teeth were found to have at least some residual vital tissue remaining in the root canal systems. After NaOCl irrigation and medication with ciprofloxacin, metronidazole, and minocycline, these teeth were sealed with mineral trioxide aggregate and restored. The other group of 4 teeth had no evidence of any residual vital pulp tissue. This second group of teeth was treated with NaOCl irrigation and medicated with ciprofloxacin, metronidazole, and minocycline followed by a revascularization procedure adopted from the trauma literature (bleeding evoked to form an intracanal blood clot). In both groups of patients, there was evidence of satisfactory postoperative clinical outcomes (1-5 years); the patients were asymptomatic, no sinus tracts were evident, apical periodontitis was resolved, and there was radiographic evidence of continuing thickness of dentinal walls, apical closure, or increased root length.

Original languageEnglish (US)
Pages (from-to)876-887
Number of pages12
JournalJournal of endodontics
Issue number7
StatePublished - Jul 2008


  • Endodontics
  • immature permanent tooth
  • open apex
  • regenerative
  • revascularization
  • stem cell

ASJC Scopus subject areas

  • General Dentistry


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