A paradigm shift is happening in treating immature, necrotic permanent teeth - from traditional apexification to regenerative endodontic procedures (REPs). While conventional root canal therapy yields high success in mature teeth, immature teeth pose greater challenges. REPs, leveraging tissue engineering and the regenerative potential of Hertwig’s Epithelial Root Sheath (HERS) and Stem Cells of the Apical Papilla (SCAP), offer a biological approach that promotes continued root development and functional restoration. This case report presents a successful REP in an immature necrotic tooth, with clinical and radiographic outcomes over 30 months.












