Pulp Revascularization- It’s your Future Whether you Know it or Not?

Abstract

Pulpal regeneration after tooth injury is not easy to accomplish. In teeth with immature apices and exposed vital pulp tissue, partial or complete pulpotomy is indicated to preserve pulpal function and allow continued root development. In many cases, injury causes loss of pulp vitality and arrested root development leading to a tooth with poor crown root ratio, a root with very thin walls, an open blunderbuss apex and development of apical pathosis.

Clinical and radiographic evaluation of Biodentine and Mineral Trioxide Aggregate in revascularization of non‐vital immature permanent anterior teeth (randomized clinical study)

“…Revascularization has been proven to be effective only in teeth with disinfected root canal systems, so it was essential to obtain a bacteria‐tight coronal seal to prevent bacterial invasion into the pulp space before revascularization takes place …”

“…29 Revascularization has been proven to be effective only in teeth with disinfected root canal systems, so it was essential to obtain a bacteria-tight coronal seal to prevent bacterial invasion into the pulp space before revascularization takes place. 18 Also, compatibility of coronal plug material is vital to allow survival of stem cells and regeneration of new tissues which is sensitive to the conditions within the intra-canal environment. 6 MTA was considered the recommended material for regenerative procedures.…”

“…Alexandria, Egypt), teeth were isolated with a rubber dam (Flexi Dam, Coltene Roeko, Cuyahoga Falls, OH, USA), and caries was removed if present. A conventional access cavity was prepared, the diagnosis of pulp necrosis was confirmed by absence of bleeding, the working length was determined radiographically, and the canal was slowly flushed with 1.5% sodium hypochlorite (NaOCl; Clorox Co, 10th of Ramadan, Egypt) (20 mL/canal, 5 minutes) followed by saline (El Fath for Pharmaceutical & Cosmetics Industries [FIPCO], Alexandria, Egypt; 20 mL/canal, 5 minutes) where an irrigating needle placed 1 mm short of the apex.…”

Cytotoxicity and osteogenic potential of silicate calcium cements as potential protective materials for pulpal revascularization

“…Revascularization of immature necrotic dental pulps has been proposed as a biologically-based alternative treatment strategy to conventional root canal treatment [6-13]. The revascularization process consists of meticulous aspesis of the root canal space via the use of antibiotics or disinfecting irrigants, induction of bleeding to create a blood clot for homing of undifferentiated mesenchymal stem cells, insertion of a collagenous matrix over the blood clot for controlled placement of a biocompatible material to an optimal level to protect the blood clot, and placement of a leak-free restoration to serve as a coronal seal to prevent leakage and resulting reinfection [9,14-16]. …”

Modified revascularization in human teeth using an intracanal formation of treated dentin matrix: A report of two cases

“…Endodontic management of immature permanent teeth with necrotic pulps and open apices has been challenging due to insufficient dentinal walls and open apices. [ 1 2 ] Conventionally, such teeth have been treated by the apexification technique using calcium hydroxide or artificial apical barrier methods which involve multiple visits and cannot predictably stimulate root development. [ 3 4 5 ] More recently, revascularization/revitalization is a known alternative practical approach in endodontic treatment.…”