Regenerative Endodontic Revascularization of a Traumatized Immature Permanent Maxillary Central Incisor

Background/Objectives: Regenerative endodontic procedures have fundamentally changed the management of immature permanent teeth with pulpal necrosis by shifting the therapeutic focus from artificial apical barrier formation to biologically driven tissue regeneration. Unlike conventional apexification, revascularization aims to restore a functional intracanal environment that supports continued root maturation, dentinal wall thickening and apical closure. The present study describes the clinical application and long-term outcome of regenerative endodontic revascularization in a traumatically injured immature permanent maxillary central incisor. Methods: An 11-year-old patient presented with a traumatized immature permanent maxillary central incisor exhibiting pulpal necrosis and an open apex. Following clinical and radiographic assessment, a regenerative endodontic protocol was performed. Canal disinfection was achieved using 1.5% sodium hypochlorite irrigation and calcium hydroxide as the intracanal medicament. At the subsequent appointment, bleeding was intentionally induced beyond the apical foramen to establish an autologous blood clot scaffold. The canal was sealed coronally with a bioceramic material and restored with a definitive composite restoration. Clinical and radiographic follow-up, including cone-beam computed tomography, was performed over a three-year period. Results: Throughout the observation period, the treated tooth remained asymptomatic and functional, with no clinical or radiographic evidence of persistent apical pathology. Serial radiographs and CBCT examinations demonstrated progressive root maturation, increased dentinal wall thickness, continued root elongation and complete apical closure. Functional integrity and esthetic appearance were maintained during the entire follow-up period. Conclusions: This case demonstrates that regenerative endodontic revascularization is a predictable and biologically based treatment option for immature permanent teeth with pulpal necrosis following traumatic injury. When performed according to contemporary regenerative protocols, the procedure can facilitate continued root development and improve the long-term structural integrity of the tooth. Revascularization should be considered a valuable treatment option in appropriately selected immature permanent teeth, while long-term follow-up remains essential to evaluate healing and treatment stability.