The effectiveness of pulp revascularization in root formation of necrotic immature permanent teeth: A systematic review

Antunes, Leonardo Santos; Salles, Alessandro Guimarães; Gomes, Cinthya Cristina; Andrade, Thamara B; Delmindo, Manoela P

doi:10.3109/00016357.2015.1069394

Cited by 24 publications

(30 citation statements)

References 34 publications

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“…Since 2001, many clinical studies of RET on human immature permanent teeth with necrotic pulps have been published (Diogenes et al 2013, Antunes et al 2016.…”

Section: Clinical Outcomesmentioning

confidence: 99%

Regenerative endodontics: a comprehensive review

et al. 2018

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The European Society of Endodontology and the American Association for Endodontists have released position statements and clinical considerations for regenerative endodontics. There is increasing literature on this field since the initial reports of Iwaya et al. (Dental Traumatology, 17, 2001, 185) and Banchs & Trope (Journal of Endodontics, 30, 2004, 196). Endogenous stem cells from an induced periapical bleeding and scaffolds using blood clot, platelet rich plasma or platelet-rich fibrin have been utilized in regenerative endodontics. This approach has been described as a 'paradigm shift' and considered the first treatment option for immature teeth with pulp necrosis. There are three treatment outcomes of regenerative endodontics; (i) resolution of clinical signs and symptoms; (ii) further root maturation; and (iii) return of neurogenesis. It is known that results are variable for these objectives, and true regeneration of the pulp/dentine complex is not achieved. Repair derived primarily from the periodontal and osseous tissues has been shown histologically. It is hoped that with the concept of tissue engineering, namely stem cells, scaffolds and signalling molecules, that true pulp regeneration is an achievable goal. This review discusses current knowledge as well as future directions for regenerative endodontics. Patient-centred outcomes such as tooth discolouration and possibly more appointments with the potential for adverse effects needs to be discussed with patients and parents. Based on the classification of Cvek (Endodontics and Dental Traumatology, 8, 1992, 45), it is proposed that regenerative endodontics should be considered for teeth with incomplete root formation although teeth with near or complete root formation may be more suited for conventional endodontic therapy or MTA barrier techniques. However, much is still not known about clinical and biological aspects of regenerative endodontics.

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“…Since 2001, many clinical studies of RET on human immature permanent teeth with necrotic pulps have been published (Diogenes et al 2013, Antunes et al 2016.…”

Section: Clinical Outcomesmentioning

confidence: 99%

Regenerative endodontics: a comprehensive review

et al. 2018

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“…A large number of case reports, prospective and retrospective cohort studies, randomized clinical trials, and meta-analyses have been published on the clinical outcome of revitalization procedures under these clinical situations [22][23][24][25][26][27][28][29] . Clearly, a broad scientific basis exists for the assessment of revitalization treatments.…”

Section: Stimulation Of Bleeding and Coverage Of Thementioning

confidence: 99%

Clinical Perspectives of Pulp Regeneration

Schmalz

Widbiller

Galler

2020

Journal of Endodontics

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Introduction: A sound and vital pulp is an essential prerequisite for long-term tooth survival and preservation. However, current endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by a synthetic biomaterial. Recently, total or partial pulp regeneration has been proposed as an alternative treatment concept. The aim of this review was to evaluate the current options of pulp treatment and regenerative approaches, both for immature and mature teeth, in a clinical context. Methods: Clinical success rates of classic treatment options such as pulpotomy or root canal filling after pulpectomy or the removal of necrotic tissue are compared with recent reports on regenerative approaches like revitalization or partial and total pulp regeneration. Results: Revitalization in immature teeth with pulp necrosis is an additional treatment option besides placing an apical plug, leading to clinically acceptable outcomes, although with low predictability regarding the completion of root formation. Coronal regeneration of the amputated pulp in immature teeth constitutes a promising scientific approach, but data from clinical studies are missing. Mature teeth display a reduced potential for regeneration. Regenerative procedures using cell transplantation or cell homing are mainly in the experimental phase with only 2 clinical studies on cell transplantation. In parallel to the further development of regenerative therapies, the classification of pulp diseases should be revised, and the diagnostic tools need improvement. Conclusions: The rethinking of current concepts for biology-based treatments and improved diagnostic concepts might postpone the point of root canal filling depending on the clinical situation.

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“…Although several features still remain unrecognized like the type of tissue formed as well as no protocol defined, REPs promote root development with apical closure and thickening of root dentin [12][13][14]. The first treatment choice was REP because of the possibility to foment root development with a close apex and coarsen root dentin.…”

Section: Discussionmentioning

confidence: 99%

Management of an Unsuccessful Regenerative Endodontic Procedure after Tooth Fracture: A Case Report

et al. 2020

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Dental trauma is a very frequent occurrence in children and adolescents, which creates a great impact on the esthetics, functions, and phonetics. Traumatic dental injuries can range from simple enamel fractures to permanent tooth loss. This case report presents an eight-year-old patient with an uncomplicated crown fracture of tooth 21, and 30 days after trauma, it was diagnosed as necrotic pulp. The first treatment choice was a regenerative endodontic procedure (REP), however, the failure led to apexification with Mineral Trioxide Aggregate (MTA). The chosen rehabilitation was a composite veneer. Concerning the available literature and fracture enamel dentin, the treatment approach proposed for the case provided good functional and esthetic outcomes.

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The effectiveness of pulp revascularization in root formation of necrotic immature permanent teeth: A systematic review

Cited by 24 publications

References 34 publications

Regenerative endodontics: a comprehensive review

Regenerative endodontics: a comprehensive review

Clinical Perspectives of Pulp Regeneration

Management of an Unsuccessful Regenerative Endodontic Procedure after Tooth Fracture: A Case Report

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