Concentrated Growth Factors for Managing a Nonvital Maxillary Central Incisor With an Open Apex

Apexification procedure on a necrotic, infected tooth with an open apex is achievable if the canal is adequately disinfected. This case report aims to add an endodontic case to the body of knowledge currently available on the application of concentrated growth factor (CGF). A 24-year-old man with a history of a fall 15 years earlier developed apical periodontitis and pulpal necrosis in his maxillary central incisor with an open apex. Following the preparation of the access cavity, a solution containing 20 mL of sodium hypochlorite solution (5.25%) and 10 mL of 0.2% chlorhexidine was used to irrigate the canal successfully, and paper points were used to dry it. The canal was covered with a calcium hydroxide dressing for 10 days. The patient's right antecubital vein yielded 10 mL of whole blood, from which CGF was made. After the removal of the intracanal dressing, the CGF was placed into the canal to act as apical matrix to stabilize the mineral trioxide aggregate. The canal underwent composite restoration after being obturated. One year later, the clinical examination showed that the tests for palpation and percussion were negative. Both the electric and cold pulp tests yielded positive results for the tooth. Regression of the periapical lesion was seen on radiographic evaluation. Our case report's findings lead us to the conclusion that, in certain circumstances, complete canal disinfection can be used to treat necrotic, infected immature teeth, and that CGF might make an excellent scaffold matrix for treating open apex cases.