Regenerative Endodontic Procedure of a Mature Anterior Tooth With Open Apex and Chronic Apical Abscess: A Case Report With 4-Years Follow-Up.

This case report describes the successful treatment of a mature anterior tooth with an open apex and chronic apical abscess using a regenerative endodontic procedure. A 36-year-old man with a history of trauma to tooth 11 at age 10 presented with incomplete root development and an asymptomatic chronic apical abscess. Cone beam tomography revealed a periradicular lesion with buccal bone plate loss. After biomechanical preparation using K-type files and irrigation with 1% sodium hypochlorite, calcium hydroxide was placed as intracanal medication for 14 days. Bleeding was induced by overinstrumenting the periapical tissues with a #25 K-file, and a bioceramic material was placed over the blood clot, followed by a composite resin coronal seal. At the 4-year follow-up, the patient was asymptomatic, with complete bone plate formation and no periradicular lesion or root resorption, although no hard tissue formation or changes in root canal morphology were observed.