{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:18:29Z","timestamp":1760059109007,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical significance: Apical fenestration is a rarely reported clinical finding that may be associated with apical periodontitis. However, its diagnosis can often be complicated by overlapping clinical and radiographic features. While management traditionally involves a combination of endodontic and surgical interventions, there is limited documentation regarding successful outcomes achieved through non-surgical treatment alone. Therefore, further reporting and investigation of such cases are warranted to enhance clinical understanding and inform decision-making. Case Presentation: This case report describes the non-surgical management of a 20-year-old patient presenting with symptomatic apical periodontitis and a labial apical fenestration in a previously treated maxillary left central incisor (tooth #21) exhibiting an open apex. Diagnosis was confirmed using cone-beam computed tomography (CBCT), which revealed a bone defect in the facial cortical plate. The treatment protocol involved conservative canal debridement, intracanal placement of calcium hydroxide, and final obturation using an apical plug of calcium silicate-based hydraulic cement (CSBHC) and the monoblock technique. Over a follow-up period of two years and eight months, clinical and radiographic assessments demonstrated resolution of symptoms, healing of the sinus tract, and complete regeneration of the buccal cortical bone. Conclusions: This case highlights the potential for complete healing of apical fenestration associated with apical periodontitis in an open apex tooth through non-surgical endodontic treatment alone.<\/jats:p>","DOI":"10.3390\/reports8020076","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T08:49:57Z","timestamp":1747903797000},"page":"76","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Non-Surgical Management of Apical Fenestration Associated with Apical Periodontitis in a Tooth with an Open Apex: A Case Report"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2124-9772","authenticated-orcid":false,"given":"Alexander","family":"Bonchev","sequence":"first","affiliation":[{"name":"Department of Conservative Dentistry, Faculty of Dental Medicine, Medical University, 1431 Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"ref_1","unstructured":"Blake, A., Tuttle, T., and McKinney, R. 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