Treatment of the young permanent tooth with a necrotic root canal system and an incompletely developed root is very difficult and challenging. Few acceptable results have been achieved through apexification but use of long-term calcium hydroxide might alter the mechanical properties of dentin. Thus, one alternative approach is to develop and restore a functional pulp-dentin complex. Procedures attempting to preserve the potentially remaining dental pulp stem cells and mesenchymal stem cells of the apical papilla can result in canal revascularization and the completion of root maturation. There are several advantages of promoting apexogenesis in immature teeth with open apices. It encourages a longer and thicker root to develop thus decreasing the propensity of long term root fracture. So, the present article reviews the recent approach of regeneration of pulp-dentin complex in immature permanent teeth. © Medicina Oral S. L.