Clinical efficacy and prognostic factors of regenerative endodontic procedure for immature permanent teeth with periapical periodontitis.
- 1Department of Pediatric Dentistry, Sichuan Hospital of Stomatology, Chengdu, Sichuan, China.
- 2Department of Dental, Sichuan Jinxin Xinan Women & Children Hospital, Chengdu, Sichuan, China.
- 3Department of Stomatology, The First Affiliated Hospital of Changsha Medical University, Changsha, Hunan, China.
Abstract
Objective
To investigate the clinical effects of regenerative endodontic procedures in the treatment of immature permanent teeth with periapical periodontitis and to analyze the factors influencing prognosis.Methods
Clinical data of 148 immature permanent teeth with periapical periodontitis treated at our hospital from January 2022 to December 2025 were retrospectively analyzed. The patients were equally divided into Group A (regenerative endodontic procedure, n = 74) and Group B (apexification, n = 74). Clinical efficacy, root development, periodontal parameters, gingival crevicular fluid VEGF levels, and complication rates were compared. All subjects underwent 6-month follow-up and were stratified into good and poor prognosis subgroups. Multivariate logistic regression was used to screen for prognostic factors.Results
After 6 months of therapy, Group A achieved a superior overall response rate, thicker root canal walls, longer root lengths, lower SBI, PLI, and PD, elevated gingival crevicular fluid bFGF and VEGF levels, and fewer complications (P < 0.05). All participants completed the 6-month follow-up and were categorized into poor-prognosis (n = 26) and good-prognosis (n = 122) cohorts. The poor-prognosis group had fewer regenerative endodontic procedure cases and larger apical lesion areas (P < 0.05). Multivariate logistic regression identified treatment modality and apical lesion size as independent risk factors for an unfavorable prognosis (P < 0.05).Conclusion
Regenerative endodontic procedures are associated with favorable short-term (6-month) outcomes in immature permanent teeth with apical periodontitis, including improved root development and repair, a more favorable periodontal microenvironment, increased levels of repair-related cytokines, and fewer complications. The treatment modality and extent of the apical lesion were associated with prognosis. Individualized treatment decisions should consider the apical lesion characteristics and clinical status of the affected tooth to optimize outcomes in pediatric patients.
Related
- Regenerative Endodontic Procedure in Mandibular First Molar: A Clinical Case Report
- Long‐Term Clinical and Radiographic Outcomes of Large Periapical Lesions Managed by Non‐Surgical and Surgical Endodontic Treatment: A Case Series
- Strategic Orthograde Biodentine Obturation and Regenerative Surgical Management of a Persistent Radicular Cyst Refractory to Nonsurgical Endodontic Therapy: A One-Year Follow-Up Case Report.
- Comparative evaluation of clinical and radiographic outcomes of three different scaffolds in regenerative endodontic treatment – A randomized clinical trial
- Bioactivity and Regenerative Potential of Calcium Silicate-Based Endodontic Sealers on Human Periodontal Ligament Stem Cells: A Systematic Review of In Vitro Cellular Mechanisms.
BibTeX
@article{jiang2026clinical,
title = {{Clinical efficacy and prognostic factors of regenerative endodontic procedure for immature permanent teeth with periapical periodontitis.}},
author = {Huan Jiang and Siyu Bai and Ping Chen},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1945140},
url = {https://europepmc.org/article/MED/42898202},
note = {CC BY},
}
RIS
TY - JOUR
TI - Clinical efficacy and prognostic factors of regenerative endodontic procedure for immature permanent teeth with periapical periodontitis.
AU - Huan Jiang
AU - Siyu Bai
AU - Ping Chen
PY - 2026
DA - 2026/10/05
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1945140
UR - https://europepmc.org/article/MED/42898202
AB - Objective To investigate the clinical effects of regenerative endodontic procedures in the treatment of immature permanent teeth with periapical periodontitis and to analyze the factors influencing prognosis.Methods Clinical data of 148 immature permanent teeth with periapical periodontitis treated at our hospital from January 2022 to December 2025 were retrospectively analyzed. The patients were equally divided into Group A (regenerative endodontic procedure, n = 74) and Group B (apexification, n = 74). Clinical efficacy, root development, periodontal parameters, gingival crevicular fluid VEGF levels, and complication rates were compared. All subjects underwent 6-month follow-up and were stratified into good and poor prognosis subgroups. Multivariate logistic regression was used to screen for prognostic factors.Results After 6 months of therapy, Group A achieved a superior overall response rate, thicker root canal walls, longer root lengths, lower SBI, PLI, and PD, elevated gingival crevicular fluid bFGF and VEGF levels, and fewer complications (P < 0.05). All participants completed the 6-month follow-up and were categorized into poor-prognosis (n = 26) and good-prognosis (n = 122) cohorts. The poor-prognosis group had fewer regenerative endodontic procedure cases and larger apical lesion areas (P < 0.05). Multivariate logistic regression identified treatment modality and apical lesion size as independent risk factors for an unfavorable prognosis (P < 0.05).Conclusion Regenerative endodontic procedures are associated with favorable short-term (6-month) outcomes in immature permanent teeth with apical periodontitis, including improved root development and repair, a more favorable periodontal microenvironment, increased levels of repair-related cytokines, and fewer complications. The treatment modality and extent of the apical lesion were associated with prognosis. Individualized treatment decisions should consider the apical lesion characteristics and clinical status of the affected tooth to optimize outcomes in pediatric patients.
SN - 2296-858X
ER -