Regenerative Endodontic Treatment

Regenerative endodontic treatment is a biologically based alternative to conventional root canal therapy used in immature permanent teeth with pulp necrosis, typically following infection or trauma in children, teenagers, and young adults. In a tooth where the root has not finished developing, conventional root canal treatment leaves the root with thin walls and an open apex, which weakens the long-term prognosis. The regenerative approach is designed to disinfect the canal and create conditions inside the tooth that allow the patient's own stem cells from the apical tissues to populate the canal space, supporting continued root development and thickening of the canal walls over time.

At Tri-City Endodontics, treatment is performed across two visits. At the first visit, the canal is accessed, gently disinfected with low-concentration irrigants chosen to preserve the viability of stem cells in the surrounding tissues, and medicated with an intracanal dressing for several weeks. At the second visit, bleeding is induced from the tissues at the root tip to form a scaffold within the canal, and a bioceramic material is placed over the scaffold to seal the coronal portion of the canal. The tooth is then restored to prevent bacterial contamination. Outcomes are monitored over months and years with follow-up imaging, since the goals of treatment include resolution of symptoms and signs of infection, continued root development, and thickening of the canal walls, and the degree of each varies from one case to the next.

Dr. Malhan and the Tri-City Endodontics team have practiced in Pasco for more than 25 years and receive referrals from general dentists and pediatric dentists throughout the Tri-Cities region for immature permanent teeth where preserving the potential for continued root development is a priority. Case selection is important, since regenerative treatment is best suited to specific clinical situations and is not a replacement for conventional root canal therapy in fully developed teeth. Patients and parents are informed of the realistic range of outcomes before treatment begins, including the possibility that additional treatment may be needed in the future, so decisions are made with a clear understanding of what regenerative endodontics can and cannot accomplish