Current overview on challenges in regenerative endodontics

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 Dental Health and Oral Research, 2024

Regenerative endodontics is an innovative field within dentistry that aims to restore damaged dental pulp using stem cells, tissue engineering techniques and biocompatible materials. This article provides an overview of the current trends in regenerative endodontics, highlighting recent research findings. Stem cells obtained from different sources like dental pulp, bone marrow and adipose tissue possess the ability to differentiate into cells similar to dental pulp and facilitate the regeneration of tissues. The use of biocompatible substances, such as Mineral Trioxide Aggregate (MTA) biodentine, offers an ideal setting for tissue growth and healing. Dental scaffolds, made from biodegradable materials, support the development of new blood vessels, nerve fibers and dental pulp-like tissues. Growth factors, like PDGF and TGF-β, are incredibly important in stimulating cell growth and specialization. Researchers and clinical trials are currently working on improving regenerative endodontic procedures, with promising results seen in terms of pulp regeneration and root development. By embracing these trends, dental professionals can offer innovative solutions for restoring damaged dental pulp and preserving natural teeth. The present article, is an overview of regenerative endodontics, exploring the current trends that are shaping the future of this field.

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.

International Dental & Medical Journal of Advanced Research - VOLUME 2015

Regenerative medicine, aims to restore or establish the normal function of lost, diseased, damaged or aging cells, tissues and organs using a range of approaches; including cellbased and gene-based therapies, tissue engineering, and biomedical engineering. The future scope of regenerative endodontics may be increased to include the replacement of periapical tissues, periodontal ligaments, gingiva, and even tooth in-toto. The aim of this article is to review the prospects of endodontic regeneration.Future clinical research would likely focus on translating basic research findings into improved regenerative procedures, such as formation of cementum-like material on the dentinal walls that might lead to studies evaluating benefits of revascularization procedures for overall tooth resistance to fracture. Controlled differentiation into odontoblasts is an important area of research and amenable to tissue engineering concepts. The development of the delivery systems might permit structural reinforcement of the cervical area that might provide clinical opportunities to regenerate lost tooth structure, thereby permitting natural teeth to be retained. Clinical significance: Expanding the scope of regenerative medicine, researchers have also developed and applied regenerative procedures in oral soft and hard tissues.

International Journal of Stem cell Research & Therapy, 2015

Journal of endodontics

Recent advances in biotechnology and translational research have made it possible to provide treatment modalities that protect the vital pulp, allow manipulation of reactionary and reparative dentinogenesis, and, more recently, permit revascularization of an infected root canal space. These approaches are referred to as regenerative procedures. The method currently used to determine the origin of the tissue secreted during the repair/regeneration process is largely based on the identification of cellular markers (usually proteins) left by cells that were responsible for this tissue production. The presence of these proteins in conjunction with other indicators of cellular behavior (especially biomineralization) and analysis of the structure of the newly generated tissue allow conclusions to be made of how it was formed. Thus far, it has not been possible to truly establish the biological mechanism controlling tertiary dentinogenesis. This article considers current therapeutic techni...

Transfusion Medicine and Hemotherapy, 2016

IP Indian Journal of Conservative and Endodontics, 2021

Till last few decades, a necrosed tooth with immature apex was an indication for apexogenesis. With advances in dentistry such as improved irrigation protocols, better visibility to the operating site and increased skills of endodontists, regenerative endodontic procedures have come into the limelight. The alongside research in tissue engineering also have been beneficial for researchers and endodontists to open new horizons in regenerative endodontics. This review paper involves the triad of tissue engineering, concepts of regenerative endodontics applied in past, current protocols according to American Association of Endodontists and future concepts of tooth tissue regenerations which are being researched.

Journal of Endodontics, 2007

Millions of teeth are saved each year by root canal therapy. Although current treatment modalities offer high levels of success for many conditions, an ideal form of therapy might consist of regenerative approaches in which diseased or necrotic pulp tissues are removed and replaced with healthy pulp tissue to revitalize teeth. Researchers are working toward this objective. Regenerative endodontics is the creation and delivery of tissues to replace diseased, missing, and traumatized pulp. This review provides an overview of regenerative endodontics and its goals, and describes possible techniques that will allow regenerative endodontics to become a reality. These potential approaches include root-canal revascularization, postnatal (adult) stem cell therapy, pulp implant, scaffold implant, three-dimensional cell printing, injectable scaffolds, and gene therapy. These regenerative endodontic techniques will possibly involve some combination of disinfection or debridement of infected root canal systems with apical enlargement to permit revascularization and use of adult stem cells, scaffolds, and growth factors. Although the challenges of introducing endodontic tissue engineering therapies are substantial, the potential benefits to patients and the profession are equally ground breaking. Patient demand is staggering both in scope and cost, because tissue engineering therapy offers the possibility of restoring natural function instead of surgical placement of an artificial prosthesis. By providing an overview of the methodological issues required to develop potential regenerative endodontic therapies, we hope to present a call for action to develop these therapies for clinical use. (J Endod 2007;33:377-390)