{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T11:49:37Z","timestamp":1777031377512,"version":"3.51.4"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Immature permanent teeth pose therapeutic challenges due to immature root development; primary approaches include apexification, vital pulpotomy and revascularization, with few systematic imaging studies on their efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study systematically compares the radiographic outcomes of apexification, vital pulpotomy, and pulp revascularization in managing immature permanent teeth, assessing root development and periapical healing to inform clinical decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort analysis employed propensity score matching (PSM) to evaluate treatments for immature permanent teeth. Patients treated between January 2022 and December 2024 were categorized into three groups: apexification (n = 51), vital pulpotomy (n = 50), and revascularization (n = 51) after 1:1 nearest-neighbor matching. Primary outcomes were resolution of clinical signs and symptoms and periapical lesion healing; secondary outcomes were root development (increase in root length and canal wall thickness) and apical closure. Outcomes were assessed radiographically using pre- and postoperative periapical radiographs and cone-beam computed tomography (CBCT) at 6- and 12-month follow-ups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After PSM, baseline characteristics were balanced (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;gt; 0.05). At the 12-month follow-up, the revascularization group demonstrated significantly greater increases in both root length (1.8 \u00b1 0.4\u00a0mm) and canal wall thickness (0.35 \u00b1 0.05\u00a0mm) compared to the other interventions (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05). While apical closure rates were comparable between revascularization (88.2%) and vital pulpotomy (82.0%), both significantly outperformed apexification (56.9%,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.01). Similarly, treatment success rates were higher in revascularization (88.5%) and vital pulpotomy (92.0%) than in apexification (76.5%,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05). Revascularization achieved superior periapical lesion healing (95.0%) versus both apexification (76.9%) and vital pulpotomy (72.0%) (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05). Complication rates showed no significant intergroup differences (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;gt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Revascularization demonstrated superior efficacy in promoting root maturation, followed by vital pulpotomy and apexification. It is recommended to choose a personalized treatment plan according to the condition of the affected teeth.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fbioe.2026.1792713","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T11:21:37Z","timestamp":1777029697000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal periapical radiographic evaluation of apexification, vital pulpotomy, and revascularization in immature permanent teeth: a retrospective comparative study"],"prefix":"10.3389","volume":"14","author":[{"given":"Xiaona","family":"Sun","sequence":"first","affiliation":[{"name":"Preventive Dentistry, Wuxi Stomatological Hospital","place":["Wuxi, Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kailing","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry 1, Wuxi Stomatological Hospital","place":["Wuxi, Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e70941","DOI":"10.1002\/ccr3.70941","article-title":"Regenerative endodontic treatment in an immature permanent tooth with necrotic pulp and periradicular lesion","volume":"13","author":"Adel","year":"2025","journal-title":"Clin. 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