APMAdvances in Precision Medicine2424-85922424-9106WHIOCE PUBLISHING PTE. LTD.10.18063/APM.v11i5.2030ArticleComparison of Clinical Efficacy between Apexification and Revascularization for Immature Permanent Teethhttps://artdesignp.com/journal/APM/11/5/10.18063/APM.v11i5.2030ZhuYifei20261152026-05-26Objective: This study aimed to compare the clinical and radiographic efficacy of apexification and pulp revascularization for treating immature permanent teeth with pulp necrosis and periapical lesions, so as to provide evidence-based references for clinical treatment selection. Methods: A total of 80 patients aged 6–18 years with immature permanent teeth complicated by pulp necrosis or periapical periodontitis from January 2020 to December 2023 were enrolled and randomly divided into the control group (apexification treatment, n = 40) and observation group (pulp revascularization treatment, n = 40). Standardized surgical protocols were implemented for both groups. Clinical and radiographic follow-up evaluations were conducted at 6, 12, and 24 months postoperatively. The primary observation indicators included clinical success rate, radiographic root development parameters (root length, root canal wall thickness), periapical lesion healing status, and total treatment duration. Statistical analysis was performed via SPSS 26.0 software. Results: At 24 months of follow-up, the clinical success rate of the observation group was 90.0%, significantly higher than 80.0% of the control group (p < 0.05). Radiographically, the observation group achieved significant physiological root development, with the average root length increased by 1.52 ± 0.43 mm and root canal wall thickness increased by 0.45 ± 0.12 mm, while no obvious root growth was observed in the control group (p < 0.01). The average treatment duration of the observation group was 3.6 months, which was remarkably shorter than 12.5 months in the control group (p < 0.01). Conclusion: Pulp revascularization is superior to traditional apexification in the treatment of immature permanent teeth with periapical lesions. It can improve long-term clinical success rate, promote physiological root maturation, shorten the treatment cycle, and reduce clinical burden, which is worthy of being the first-line regenerative treatment for eligible patients.Immature permanent teeth,Apexification,Pulp revascularization,Pulp regeneration,Clinical efficacy,Root development,Periapical periodontitis

[1] Zhang Y, Liu Y, Zhao Y, 2021, Comparative Analysis of the Efficacy of Revascularization and Apexification in the Treatment of Periapical Periodontitis in Immature Permanent Teeth. Chinese Journal of Stomatology, 56(8): 756–761. [2] Wang L, Chen M, Zhou X, 2022, Advances in Clinical Research of Regenerative Endodontics: Application and Prospects Based on Revascularization Technology. West China Journal of Stomatology, 40(3): 245–251. [3] Li M, Guo Q, Yang Z, 2023, Clinical Evaluation of iRoot BP Plus as a Sealing Material in Revascularization of Immature Permanent Teeth. Journal of Practical Stomatology, 39(2): 210–214. [4] Pendse G, Madhusudhan K, Khijmatgar S, et al., 2025, Comparison of Revascularization and Apexification Using Mineral Trioxide Aggregate in Young Human Immature Nonvital Teeth: A Systematic Review and Meta-Analysis. Cureus, 17(7): e88732. [5] Dos Reis-Prado A, Benetti F, de Oliveira P, et al., 2025, Optimizing Methods for Regenerative Endodontics. Regenerative Medicine, 20(8): 339–351. [6] Wikström A, Brundin M, Mohmud A, et al., 2024, Outcomes of Apexification in Immature Traumatized Necrotic Teeth and Risk Factors for Premature Tooth Loss: A 20-Year Longitudinal Study. Dental Traumatology, 40(6): 658–671. [7] Kahler B, Lin L, 2024, Regenerative Endodontic Treatment and Traumatic Dental Injuries. Dental Traumatology, 40(6): 618–635. [8] Tewari N, Devi P, Sampath S, et al., 2025, Comparative Effectiveness of Regenerative Endodontic Treatment Versus Apexification for Necrotic Immature Permanent Teeth with or without Apical Periodontitis: An Umbrella Review. Dental Traumatology, 41(3): 263–282. [9] Sabeti M, Ghobrial D, Zanjir M, et al., 2024, Treatment Outcomes of Regenerative Endodontic Therapy in Immature Permanent Teeth with Pulpal Necrosis: A Systematic Review and Network Meta-Analysis. International Endodontic Journal, 57(3): 238–255. [10] Torabinejad M, Nosrat A, Verma P, et al., 2017, Regenerative Endodontic Treatment or Mineral Trioxide Aggregate Apical Plug in Teeth with Necrotic Pulps and Open Apices: A Systematic Review and Meta-Analysis. Journal of Endodontics, 43(11): 1806–1820.