Regenerative endodontic treatment of an immature permanent canine following infant oral mutilation

Extracting primary canine tooth buds is a ritual ceremony that prevails in some African countries. This procedure is considered infant oral mutilation (IOM) and may damage the permanent successor and adjacent primary and permanent teeth, resulting in dysplastic or deformed teeth. The purpose of this report was to describe regenerative endodontic treatment of a permanent mandibular canine with extensive coronal hypoplasia, immature root, and a periapical radiolucency following damage to the permanent canine that was probably a result of infant oral mutilation. Regenerative endodontic treatment was initiated by irrigating the root canal, followed by applying triple antibiotic paste dressing over three weeks and creating a blood clot scaffold covered with mineral trioxide aggregate. A 4-year clinical and radiographic follow-up demonstrated healing of the periapical radiolucency. This treatment may serve as a substitute for traditional apexification with calcium hydroxide or creation of an artificial apical barrier with mineral trioxide aggregate.