Outcome of Guided Pulpal Regeneration in Immature Molar Teeth with Chronic Apical Abscess: A Case Report and Mini-Review.

Q3 Dentistry

Frontiers in Dentistry Pub Date : 2026-03-14 eCollection Date: 2026-01-01 DOI:10.18502/fid.v23i13.21567

Mohammad Mahdi Kiafar, Farzaneh Afkhami, Sholeh Ghabraei, Ove A Peters, Chun Xu, Seyyed Ali Abaee

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Abstract

This case report describes guided pulpal regeneration (GPR) of two immature permanent molar teeth with chronic apical abscess, thin dentinal walls, and open apices. Both teeth were treated with an identical protocol in two sessions, with minimum instrumentation with hand files, irrigation with 1.5% sodium hypochlorite (NaOCl), and application of 1:1 mixture of ciprofloxacin and metronidazole as an intracanal medicament, blood clot as a scaffold, and mineral trioxide aggregate (MTA) as the capping material. At the one-year follow-up, both treated teeth were asymptomatic. However, the root development procedure was different even in different roots of the same tooth, varying from only an increased thickness of dentinal walls to complete closure of the apex along with an increase in root length and dentinal wall thickness. It is concluded that the outcome of GPR is not completely predictable, and may vary among teeth with similar initial conditions and treatment approaches.

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未成熟磨牙慢性根尖脓肿引导下牙髓再生1例报告及回顾。

这个病例报告描述了两颗未成熟恒磨牙的牙髓再生（GPR），慢性根尖脓肿，薄的牙本质壁，开放的根尖。两颗牙在两次治疗中采用相同的方案，使用最少的器械，用手锉，1.5%次氯酸钠（NaOCl）冲洗，环丙沙星和甲硝唑的1:1混合物作为管内药物，血凝块作为支架，三氧化二矿骨料（MTA）作为盖层材料。在一年的随访中，两颗治疗过的牙齿均无症状。然而，即使在同一牙齿的不同根中，根的发育过程也是不同的，随着根长和牙本质壁厚度的增加，从仅仅增加牙本质壁厚度到根尖完全闭合不等。结论：GPR的结果不能完全预测，并且在初始条件和治疗方法相似的牙齿之间可能会有所不同。

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