25 June 2024
: Case report 
Regenerative Endodontic Procedure on an Immature Necrotic Molar: A Case Report with a 5-Year Review
Unusual or unexpected effect of treatment
Majed A. Almalki
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DOI: 10.12659/AJCR.944179
Am J Case Rep 2024; 25:e944179
Table 1. Checklist of the REP clinical steps performed to treat an immature mandibular molar with necrotic pulp and apical periodontitis.
| Visit number | Clinical step |
|---|---|
| First visit | 1. Clinical examination |
| 2. Preoperative periapical radiograph | |
| 3. Local anesthesia administration | |
| 4. Rubber dam isolation and disinfection of the operating field | |
| 5. Access cavity preparation | |
| 6. Working length determination | |
| 7. Minimal canal instrumentation | |
| 8. Gentle irrigation with low concentration NaOCl followed by saline and 17% EDTA | |
| 9. Dry with paper point | |
| 10. Application of bonding agent to coronal dentin | |
| 11. Intracanal application of triple antibiotic paste | |
| 12. Sealing the access cavity with a temporary filling | |
| Second visit (after 4 weeks) | 1. Administration of local anesthesia without vasoconstrictor |
| 2. Rubber dam isolation and disinfection of the operating field | |
| 3. Temporary filling removal | |
| 4. Removal of TAP by irrigation | |
| 5. Dry the canal | |
| 6. Induce intracanal bleeding to the level 3 mm below the orifices | |
| 7. Apply 3 mm of MTA over the clot | |
| 8. Periapical radiography to confirm proper application of MTA | |
| 9. Sealing access cavity with glass ionomer material | |
| Third visit (4 weeks after the second visit) | 1. Composite buildup |
| Follow-up visit (5 years after the initial visit) | 1. Clinical examination |
| 2. Periapical radiography |