{"title":"Clinical efficacy and prognostic factors of regenerative endodontic procedure for immature permanent teeth with periapical periodontitis.","authors":"Huan Jiang, Siyu Bai, Ping Chen","doi":"10.3389/fmed.2026.1945140","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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, <i>n</i> = 74) and Group B (apexification, <i>n</i> = 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.</p><p><strong>Results: </strong>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 (<i>P</i> < 0.05). All participants completed the 6-month follow-up and were categorized into poor-prognosis (<i>n</i> = 26) and good-prognosis (<i>n</i> = 122) cohorts. The poor-prognosis group had fewer regenerative endodontic procedure cases and larger apical lesion areas (<i>P</i> < 0.05). Multivariate logistic regression identified treatment modality and apical lesion size as independent risk factors for an unfavorable prognosis (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"13 ","pages":"1945140"},"PeriodicalIF":3.6000,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677467/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fmed.2026.1945140","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
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.
期刊介绍：
Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate
- the use of patient-reported outcomes under real world conditions
- the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines
- the scientific bases for guidelines and decisions from regulatory authorities
- access to medicinal products and medical devices worldwide
- addressing the grand health challenges around the world
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