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However, there are fundamental differences in the microbiome and the microenvironment between a canal with a primary endodontic infection and a canal with a persistent endodontic infection. The aims of this report are to report a case where a previously treated tooth with an open apex and a large apical radiolucency was treated successfully using regenerative endodontic treatment (RET) and to review and critically appraise the literature on procedures and outcomes of RET that result in revitalization of canal(s) in previously treated teeth with open apices. A maxillary central incisor with poor\u2010quality root filling, a large apical radiolucency and an open apex was retreated using RET using platelet\u2010rich fibrin as the scaffold. After 24\u00a0months, there was complete healing of the periapical lesion and obvious radiographic signs of apical root closure. Electronic searches were performed in MEDLINE, Scopus and Embase, and the baseline, procedural and outcome data of qualified articles were collected. An assessment tool was developed to rate the quality of evidence reported in these case report\/series. Nine articles, three case series and six case reports, with a total of 17 teeth of all types, were included in the reports identified. The age of patients ranged from 7 to 48\u00a0years (mean: 19.4\u00a0years). The recall period ranged from 12 to 72\u00a0months (mean: 29\u00a0months). All 17 teeth survived and were functional with healing\/healed outcomes. \u201cApical closure\u201d was the most common radiographic finding regarding root development. The quality of evidence using the new assessment tool was rated \u201cExcellent\u201d in three case reports but only \u201cFair\u201d in the other six articles. The present case report, as well as the review of the literature, suggests that revitalizing the root canal system of teeth with open apices and post\u2010treatment disease using RET is a potentially valid treatment option. However, more clinical studies with higher levels of evidence and higher quality of evidence are required to confirm the viability of this treatment approach.<\/jats:p>","DOI":"10.1111\/iej.13570","type":"journal-article","created":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T08:55:20Z","timestamp":1621328120000},"page":"1782-1793","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Revitalizing previously treated teeth with open apices: A case report and a literature review"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4768-9717","authenticated-orcid":false,"given":"Ali","family":"Nosrat","sequence":"first","affiliation":[{"name":"Division of Endodontics Department of Advanced Oral Sciences and Therapeutics School of Dentistry University of Maryland Baltimore Maryland USA"},{"name":"Private Practice Centreville Endodontics Centreville Virginia 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