Tissue Characteristics in Endodontic Regeneration: A Systematic Review

Abstract

The regenerative endodontic procedure (REP) represents a treatment option for immature necrotic teeth with a periapical lesion. Currently, this therapy has a wide field of pre-clinical and clinical applications, but no standardization exists regarding successful criteria. Thus, by analysis of animal and human studies, the aim of this systematic review was to highlight the main characteristics of the tissue generated by REP. A customized search of PubMed, EMBASE, Scopus, and Web of Science databases from January 2000 to January 2022 was conducted. Seventy-five human and forty-nine animal studies were selected. In humans, the evaluation criteria were clinical 2D and 3D radiographic examinations. Most of the studies identified a successful REP with an asymptomatic tooth, apical lesion healing, and increased root thickness and length. In animals, histological and radiological criteria were considered. Newly formed tissues in the canals were fibrous, cementum, or bone-like tissues along the dentine walls depending on the area of the root. REP assured tooth development and viability. However, further studies are needed to identify procedures to successfully reproduce the physiological structure and function of the dentin–pulp complex.

Deciduous pulp tissue implantation into the root canal of mandibular incisor resulted in pulp revascularization: a case report with a 5-year follow-up

“…The pulp tissues of the autologous tooth have been used in single-rooted mature premolars and single-rooted immature permanent incisors and proven as a feasible biologic scaffold for regenerative endodontic treatment [7,8]. Consistently, the results presented here further suggest that autologous pulp transplantation can achieve clinical outcomes and radiographic results that are similar to those using traditional revascularization techniques [7][8][9]. These include periapical inflammation healing, continued development of the root canal, augmentation of root length, and reduction of apical diameter.…”

Dental pulp mesenchymal stem cells-response to fibrin hydrogel reveals ITGA2 and MMPs expression

“…Better knowledge of the fibrin meshwork replacement could allow to adapt the treatment to various pathological conditions. Uncontrolled tissue regeneration mechanisms could lead to fibrotic scaring or mineralization resulting in inappropriate tissue formation [ [9] , [10] , [11] , [12] , [13] , [14] , 58 ]. The crucial role of a controlled cross-talk between cells and their extracellular environment for tissue integrity and functionality is notably illustrated by pathophysiological modifications occurring during aging.…”

Engineering the Future of Dental Health: Exploring Molecular Advancements in Dental Pulp Regeneration

“…To provide an overview of the possible outcomes of regenerative endodontic procedures and to highlight the inconsistency of criteria for the successful regeneration in both animal models and human studies, Minic et al conducted a systematic review [19]. The aim was to categorize the characteristics of the resulting tissues that could be evaluated in each study design.…”