Pulp-dentin regeneration: current approaches and challenges

Abstract

Regenerative endodontic procedures for immature permanent teeth with apical periodontitis confer biological advantages such as tooth homeostasis, enhanced immune defense system, and a functional pulp-dentin complex, in addition to clinical advantages such as the facilitation of root development. Currently, this procedure is recognized as a paradigm shift from restoration using materials to regenerate pulp-dentin tissues. Many studies have been conducted with regard to stem/progenitor cells, scaffolds, and biomolecules, associated with pulp tissue engineering. However, preclinical and clinical studies have evidently revealed several drawbacks in the current clinical approach to revascularization that may lead to unfavorable outcomes. Therefore, our review examines the challenges encountered under clinical conditions and summarizes current research findings in an attempt to provide direction for transition from basic research to clinical practice.

Physical Properties and Biofunctionalities of Bioactive Root Canal Sealers In Vitro

“…Root canal sealers are widely used dental materials for endodontic treatment. They are applied to fill the space between the core material (i.e., gutta-percha) and the root canal inner wall during the canal filling process to seal off the root canal system, trap the remaining microbes, and pack irregularities in the root canal [ 1 , 2 ]. Key characteristics of materials that are considered for use as root canal sealers include good sealing ability, small film thickness, dimensional stability, insolubility, short setting time, biocompatibility, and so on [ 3 , 4 ].…”

Berberine mediates root remodeling in an immature tooth with apical periodontitis by regulating stem cells from apical papilla differentiation

“…7 In several recent studies, the recurrence of periapical lesions, absence of continued root formation, and intracanal obliteration after revascularization have been reported. 8 Thus there is an unmet need for a more efficient method of saving immature teeth with AP.…”

Revascularization and vital pulp therapy in immature molars with necrotic pulp and irreversible pulpitis: A case report with two‐year follow‐up

“…Herein, a biodegradable scaffold serves as a temporary matrix for regenerating cells to attach, proliferate, and differentiate to mature and functional cells which produce pulp and dentin . It is now well‐established that mesenchymal stem cells which migrate from different sources such as apical papilla, periodontal ligament, and bone marrow play a significant role in pulp and dentin regeneration . In the present case, migrating stem cells are suggested to be responsible for pulp regeneration, dentin production, and root development.…”

“…18,19 It is now well-established that mesenchymal stem cells which migrate from different sources such as apical papilla, periodontal ligament, and bone marrow play a significant role in pulp and dentin regeneration. 20 In the present case, migrating stem cells are suggested to be responsible for pulp regeneration, dentin production, and root development. The capability of mesenchymal stem cells for differentiation into odontoblast-like cells has been demonstrated in several previous studies in vitro and in vivo.…”