Regenerative Endodontics: Regeneration or Repair?

Mansoura Journal of Dentistry, 2021

Journal of endodontics, 2016

The development of regenerative endodontic therapies offers exciting opportunities for future improvements in treatment outcomes. Advances in our understanding of regenerative events at the molecular and cellular levels are helping to underpin development of these therapies, although the various strategies differ in the translational challenges they pose. The identification of a variety of bioactive molecules, including growth factors, cytokines, chemokines, and matrix molecules, sequestered within dentin and dental pulp provides the opportunity to present key signaling molecules promoting reparative and regenerative events after injury. The protection of the biological activity of these molecules by mineral in dentin before their release allows a continuing supply of these molecules, while avoiding the short half-life and the non-human origin of exogenous molecules. The ready release of these bioactive molecules by the various tissue preparation agents, medicaments, and materials c...

Journal of biomedical materials research. Part B, Applied biomaterials, 2015

Trauma to the dental pulp, physical or microbiologic, can lead to inflammation of the pulp followed by necrosis. The current treatment modality for such cases is non-surgical root canal treatment. The damaged tissue is extirpated and the root canal system prepared. It is then obturated with an inert material such a gutta percha. In spite of advances in techniques and materials, 10%-15% of the cases may end in failure of treatment. Regenerative endodontics combines principles of endodontics, cell biology, and tissue engineering to provide an ideal treatment for inflamed and necrotic pulp. It utilizes mesenchymal stem cells, growth factors, and organ tissue culture to provide treatment. Potential treatment modalities include induction of blood clot for pulp revascularization, scaffold aided regeneration, and pulp implantation. Although in its infancy, successful treatment of damaged pulp tissue has been performed using principles of regenerative endodontics. This field is dynamic and ...

Journal of Indian Academy of Dental Specialist Researchers, 2017

The advancement of science and technology has huge positive impacts on the present day world. It has contributed immensely to every aspect of our lives, including the medical and dental care. The treatment concepts that were once perceived to be imaginative are today considered achievable. Even though millions of teeth are saved by root canal therapy every year, still, a significant number is rendered unrestorable and doomed to extraction. Thus, an alternative restorative therapy, which may substitute natural teeth, other than root canal therapy is needed. One biological approach to restore tooth structure is a regenerative endodontic procedure, where tissue engineering principles are applied. The field of tissue engineering has literally exploded during the past decade. The first is revascularization, where a new pulp tissue is expected to grow into the root canals from the remaining tissues exist apically in the root canal. The second includes tissue engineering where the replacement of the diseased pulp with a healthy tissue that is able to revitalize the tooth and restore dentin formation process.

2016

When maintenance of tooth in a vital condition is no longer possible, the traditional treatment philosophy advocates endodontic treatment to retain it in a functional state. A paradigm shift of this thinking occurred with revascularization/regenerative procedures. Dental pulp is a specialized tissue organized in an order spatial arrangement and regenerating it is somewhat exigent. With advancements in molecular science and tissue engineering, the approach is becoming being refined with higher success rates. This review article will detail some of the methods of regeneration and the challenges to achieve success in these procedures.

Journal of endodontics, 2017

Pulp regeneration and its clinical translation into regenerative endodontic procedures are receiving increasing research attention, leading to significant growth of the published scientific and clinical literature within these areas. Development of research strategies, which consider patient-, clinician-, and scientist-based outcomes, will allow greater focus on key research questions driving more rapid clinical translation. Three key areas of focus for these research questions should include cells, signaling, and infection/inflammation. A translational pathway is envisaged in which clinical approaches are increasingly refined to provide regenerative endodontic protocols that are based on a robust understanding of the physiological processes and events responsible for the normal secretion, structure, and biological behavior of pulpal tissue.

Transfusion Medicine and Hemotherapy, 2016

2015

The ultimate goal of endodontics therapy is the regeneration of tooth supporting tissues. This case study evaluated whether the transplantation of autologous dental pulp stem cells with chitosan scaffold into pulpless root canals could mediate pulp regeneration in human mature teeth. The dental pulp stem cells isolated from the patient`s pulp tissue. The cells were then seeded onto a chitosan scaffold and then transported into the root canal of the patient. After eight weeks the tooth was extracted and prepared for histological and immunohistochemical examination in purpose to identify the nature of tissues formed in the canal space. After endodontic regeneration procedures, pulplike tissue characterized by the presence of odontoblast-like cells aligning dentin-like hard tissue was observed. This is the first clinical and histological evidence in the dental literature that shows that pulp and dentin like tissue can be generated in a human tooth using dental pulp stem cells.

Endodontic Topics, 2013