Histologic Outcomes of Uninfected Human Immature Teeth Treated with Regenerative Endodontics: 2 Case Reports

Histological assessment of regenerative endodontic treatment in animal studies with different scaffolds: A systematic review

“…47,48 However, the histological findings showed that the outcome of the treatment differed from normal dentin and pulp tissue. 24, 37 Zhu et al…”

“…49 Nosrat et al also reported that the stem cells in the BC might not differentiate into odontoblasts, as they may be mobilized into the root canal from different sources other than the apical papilla, including bone marrow. 24 Thus, different tissue engineering strategies have been suggested, such as using scaffolds impregnated with growth factors, 12 platelet-rich plasma, 19 and a combination of dental pulp stem cells, 13 in an attempt to regenerate true pulp tissue.…”

“…[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] The presence of a scaffold is considered to be an essential element for any regenerative treatment. Generally, a scaffold is a three-dimensional replica of the extracellular matrix which provides biological and mechanical support to the stem cells.…”

“…However, the number of reports on in vivo teeth that have undergone regenerative endodontics followed by histological analysis is scarce. Of those reported, four teeth were extracted due to orthodontic reasons and 24,[35][36][37] three fractured and were extracted, 23,38,39 and in the remaining studies, one tooth was extracted due to recurrence of infection after treatment, 40 another patient requested a root canal filling, 41 and one study evaluated mature teeth. 42 These reports may not be representative of the histological conditions in those cases where regenerative endodontics have been successful.…”

“…43 However, the review highlighted that all the studies that used MTA directly on BC or on other scaffolds showed intracanal calcification. [9][10][11][12][13][14][15][16][17][18][19]21,22 In fact, case reports have shown formation of hard tissue bridges under MTA, 24 and scattered calcification inside the canal, 39 when some portion of the MTA was pushed into the canal. It is worth noting that clinical success based on radiographic evidence of root lengthening, wall thickening, and root apex narrowing occurred through the deposition of cementum-and bone-like tissue and not dentin.…”