Successful Regenerative Endodontic Therapy of an Immature Dens Evaginatus Mandibular Second Premolar with Apical Periodontitis Case Report

Authors

Jake Horowitz D.D.S., Attending dentist, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NYFollow
Prashant Sukhani D.M.D., Chief of endodontics, New York-Presbyterian Brooklyn Methodist Hospital,Brooklyn, NYFollow
Aaron Brandwein D.D.S., FAGD, FICD, Program director, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NYFollow
James Sconzo D.M.D., Chief of service, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NYFollow

Keywords

Dens evaginatus, Regenerative Endodontic Therapy, Stem cells, Cusps, Open Apex

Abstract

Background: Dens evaginatus cusps typically have pulpal tissue, and fracturing of the cusp leads to necrosis. Immature permanent teeth with pulp necrosis have traditionally been treated with apexification, which eliminates infection but does not promote root development.

Methods: Regenerative endodontics utilizes revascularization by infiltrating stem cells from the apical papilla and using them to treat an immature necrotic tooth with periapical infection.

Results: Periapical radiolucency completely resolved, root length and thickness increased, and vitality returned at the one-year follow-up.

Conclusion: Regenerative protocols promote root development, reducing fracture risk. This treatment offers improved outcomes with fewer appointments and shorter treatment duration.

Recommended Citation

Horowitz, Jake D.D.S.; Sukhani, Prashant D.M.D.; Brandwein, Aaron D.D.S., FAGD, FICD; and Sconzo, James D.M.D. (2026) "Successful Regenerative Endodontic Therapy of an Immature Dens Evaginatus Mandibular Second Premolar with Apical Periodontitis Case Report," The New York State Dental Journal: Vol. 92: No. 2, Article 3.
Available at: https://commons.ada.org/nysdj/vol92/iss2/3