REGENERATIVE ENDODONTICS IN YOUNG PERMANENT TEETH WITH PULP NECROSIS: A LITERATURE REVIEW

Abstract

The treatment of immature permanent teeth with pulp necrosis represents a challenge in Endodontics due to the interruption of root development, which results in roots with thin dentinal walls and greater structural fragility. This study aimed to analyze the scientific evidence on clinical management, comparing apexification with regenerative endodontic procedures regarding infection control, root development, and outcome predictability. An integrative literature review with a qualitative and descriptive approach was conducted, including studies published between 2016 and 2026 and identified in the PubMed, SciELO, and Google Scholar databases. The literature demonstrates that both approaches present favorable outcomes in infection control and resolution of clinical signs and symptoms. However, while apexification is associated with the formation of an apical barrier, regenerative endodontics has the potential to promote continued root development, with increases in root length and dentinal wall thickness. These outcomes vary among studies and have limited predictability. Histological evidence indicates that the newly formed tissues may exhibit repair characteristics and do not necessarily correspond to the regeneration of functional pulp tissue. Thus, regenerative endodontics demonstrates clinical potential, but its consolidation depends on protocol standardization and further long-term clinical evidence.