Regenerative Endodontic Procedure in Mandibular First Molar: A Clinical Case Report

Regenerative endodontic procedures (REPs) have emerged as a biologically based treatment modality for managing immature permanent teeth with necrotic pulp, offering the potential for continued root development and periapical healing. This case report describes the regenerative endodontic treatment of a necrotic, immature mandibular first molar in a 9-year-old female patient. The treatment protocol involved canal disinfection using double antibiotic paste (DAP), induction of intracanal bleeding to form a natural scaffold, and coronal sealing with mineral trioxide aggregate (MTA). A 12-month follow-up demonstrated successful resolution of the periapical lesion, continued root maturation with increased root length and wall thickness, and clinical absence of symptoms. The extraoral sinus tract also healed completely within this period. This case highlights the clinical viability of REPs in immature multirooted teeth, emphasizing the importance of appropriate case selection, careful scaffold induction, and long-term monitoring. Although short-term outcomes were favorable, extended follow-up is necessary to fully validate the durability of regenerative success.