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Periapical health is the primary goal of endodontic treatment in mature and immature teeth. In addition, the goals of treatment of immature teeth with arrested root development include root growth to length and maturation of the apex, as well as thickening of the canal wall. These goals are valid for immature teeth that have been subjected to trauma and dental caries or that are the result of developmental anomalies that expose the tooth to the risk of pulp necrosis and consequently result in the cessation of root maturation. Regenerative endodontic procedures (REPs) have been described as a "paradigm shift" in the treatment of immature teeth with pulp necrosis and underdeveloped roots, as there is the potential for further root maturation and return of vitality. Treatment with REPs is advocated as the treatment of choice for immature teeth with pulp necrosis. REP protocols involve the use of alkaline biomaterials, primarily sodium hypochlorite, calcium hydroxide, mineral trioxide aggregates and Biodentine, and are the essential components of a successful treatment regimen.

Pulp necrosis is the most common complication following dental trauma and is often associated with apical periodontitis. The management of these teeth is challenging in terms of large root canals, open apices, thin dentinal walls, and short roots. Over decades the conventional treatment for these teeth was calcium hydroxide apexification, a time‐consuming procedure despite high success rates. Subsequently after the introduction of mineral trioxide aggregate and hydraulic calcium silicate materials single visit apical plug procedures became increasingly practiced with comparable success rates to the conventional apexification. The search continued afterward for a clinical procedure that may stimulate further root development and apical closure to avoid the long‐term complication of root fracture after apexification. Regenerative procedures using stem cells derived from the apical papilla and blood clots as scaffolds were then introduced for the management of immature teeth, with variable protocols and success rates. This review will cover the evidence available and current position of regenerative endodontic procedures in traumatized immature teeth with apical periodontitis, in terms of clinical protocols, outcome, and potential prognostic factors. [ABSTRACT FROM AUTHOR]

Regenerative endodontic treatment (RET) has been described as a 'paradigm shift' in the treatment of immature teeth with pulp necrosis. It has been suggested that RET should be the first option for treating immature teeth when the roots are not yet fully developed. The European Society of Endodontology and the American Association of Endodontists have released position statements and clinical considerations for RET. Treatment modalities rely on the tissue engineering concept components stem cells, scaffolds and signalling molecules. Clinically, the treatment involves disinfection of, and often the introduction of a blood clot into, the root canal space. RET has three goals: 1) resolution of clinical signs and symptoms; 2) further root maturation; and 3) restoration of neurogenesis. To date, RET has been unable to establish a real regeneration of the pulp tissue and dentine space. Histologically, healing is achieved with repair from tissues derived primarily for the periodontal and osseous tissues such as bone-like tissue and cementum, rather than pulp tissue and odontoblasts. This review aims to present a clinical focus on RET and to provide a current view on this emerging clinical technique. [ABSTRACT FROM AUTHOR]