Management of dens evaginatus with an immature permanent tooth with apical periodontitis using platelet-rich fibrin in regenerative endodontics: case reports and literature review

The regenerative endodontic treatment (RET) of human immature permanent tooth with apical periodontitis using platelet-rich fibrin (PRF) has shown successful results in incisor. The purpose of this case series is to report four cases of the management of dens evaginatus in immature mandibular second premolars with apical periodontitis using PRF in regenerative endodontics. Four dens evaginatus with immature teeth with apical periodontitis were treated via RET using PRF as a scaffold. During the follow-up period, all teeth showed a resolution of periapical radiolucencies, and three teeth showed continuous root development and apical closure. Two teeth displayed a positive response to pulp sensibility tests. On the basis of the short-term results of the present case series, we can conclude that RET is an ideal treatment method for dens evaginatus with an immature permanent tooth with apical periodontitis. In addition, PRF is a potentially ideal scaffold material for RET, and the operation is easier with less risk. Therefore, PRF is recommended for use in DE or other cases in which it is difficult to induce bleeding.