Vol. 11, Issue 3, Part B (2025)

The management of immature necrotic permanent teeth poses challenges due to thin dentinal walls and open apices, with traditional apexification failing to promote root development, thereby increasing fracture risk. Regenerative endodontic techniques offer a biological alternative by encouraging pulp-dentin regeneration and continued apex growth. This clinical investigation evaluated the effectiveness of Platelet-Rich Fibrin (PRF), Concentrated Growth Factor (CGF), and induced bleeding as scaffolds in treating such teeth, assessing radiographic outcomes like periapical healing, root lengthening, and dentinal wall thickening, along with clinical responses to sensitivity, percussion, and palpation tests. Three anterior teeth from patients aged 18–22 were treated with standard disinfection protocols followed by different scaffolds-CGF (Case 1), PRF (Case 2), and induced bleeding (Case 3)-then sealed with a 3mm layer of MTA or Biodentine and permanent composite restoration. Follow-ups with radiographic imaging at 3, 6, and 12 months revealed symptom resolution across all cases. CGF showed the most significant improvement with a PAI score reduction from 4 to 2, approximately 2mm root lengthening, and 1.5mm dentinal wall thickening. PRF yielded slightly lesser benefits with a PAI score drop from 3 to 2, 1.5mm root length gain, and 1mm wall thickening. The induced bleeding method, while clinically successful, showed the least radiographic improvement with a PAI decrease from 4 to 3, root elongation of 0.5mm, and minor dentinal wall thickening. Thus, although all three approaches were effective, CGF demonstrated superior regenerative potential, PRF served as a viable alternative, and induced bleeding remained a useful option where resources were limited.