Radiographic Changes Following Regenerative Endodontic Treatment in Immature Permanent Teeth with Traumatic or Carious Pulp Necrosis: A Retrospective Study.

Objective: To compare radiographic changes following regenerative endodontic procedures in immature permanent teeth with pulp necrosis of traumatic or carious origin. Methods: A retrospective study was conducted in 20 immature permanent teeth from 20 patients (10 traumatic and 10 carious cases) treated with a standardized regenerative endodontic protocol. Root length, dentinal wall thickness, periapical status, and type of repair were assessed using standardized periapical radiographs at baseline and 12 months. Radiographs were independently evaluated by two investigators blinded to etiology, and inter-examiner agreement for type of repair was assessed using Cohen's kappa. Results: No statistically significant differences were found in root-length change between the groups. A statistically significant greater increase in dentinal wall thickness was observed in the carious group compared with the traumatic group; however, the groups differed substantially in tooth type. No statistically significant differences were observed in Periapical Index scores after 12 months of follow-up, and periapical healing (PAI 1-2) was observed in all cases. Periodontal-associated repair was observed in all traumatic cases, whereas pulpal-associated repair was observed in all carious cases. Conclusions: Regenerative endodontic procedures were associated with favorable radiographic outcomes in immature permanent teeth with pulp necrosis of traumatic or carious origin. However, the small sample size, short follow-up, absence of a control group, and substantial differences in tooth type between etiological groups limit causal interpretation of the observed differences.