Discussion
tooth type
APICAL PERIODONTITIS, PULP CANAL OBLITERATION, PULP NECROSIS
The null hypothesis was rejected since the present results showed that adding metformin to DAP significantly increased the root height and the rate of apical closure compared to the DAP per se. All cases in both groups showed periapical healing and 77% of cases showed signs of apical closure; 50% complete apical closure and 22% incomplete apical closure.REPs stand among one of the best strategies to treat immature permanent teeth with pulp necrosis [In contrast with the present study, Ding et al. [The present study showed complete clinical and radiographic resolution of apical periodontitis in all cases. Palma et al. [Various factors can affect REPs outcomes, for instance, tooth type and etiology. Lin et al. [Meanwhile, radiographic evidence of pulp canal obliteration or hard tissue deposition was observed in 15% of cases in the present study (Hard tissue deposition in the canal wall was also reported in other studies [Another study showed that the use of 200 µmol/L of metformin in the root canals of 20 rat teeth with periapical lesions diminished the size of periapical lesions through inhibition of hypoxia-enhanced mitochondrial superoxide production in osteoblast [Pradeep et al. [One of the primary strengths of the present study is the randomized clinical trial design. Our study addresses an important clinical question in the field of regenerative endodontics. We acknowledge that one of the limitations of our study is the relatively small sample size. In addition, we recognize that our sample size calculation may not have been fully accounted for. Additionally, the incorporation of a wide spectrum of periapical conditions and variables within our study is recognized as a limitation due to clinical intricacies. Given the limitations of our current study, further histopathologic and clinical studies with more samples and longer follow-up periods are suggested to investigate the influence of certain factors, such as periapical conditions, on the success of treatment and prove the desired effects of metformin in regeneration.