Regenerative Endodontic Therapy in the Management of Nonvital Immature Permanent Teeth: A Systematic Review—Outcome Evaluation and Meta-analysis

Tong, Huei Jinn; Rajan, Sadna; Bhujel, Nabina; Kang, Jing; Duggal, M. S.; Nazzal, Hani

doi:10.1016/j.joen.2017.04.018

Cited by 87 publications

(80 citation statements)

References 22 publications

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“…, Tong et al . ). It was believed that RET was capable of regenerating the pulp–dentine complex to restore the vitality of tissue damaged in the canal space and increase thickness of the canal walls to strengthen the fragile immature permanent teeth (Iwaya et al .…”

Section: Discussionmentioning

confidence: 97%

“…Two recent systematic reviews (Tong et al . , Torabinejad et al . ) demonstrated that the primary goal of RET could be reliably achieved with high probabilities (91–94% of periapical healing).…”

Section: Discussionmentioning

confidence: 99%

“…, Tong et al . ). Most recently, using cone beam computed tomography to evaluate root maturation after revitalization of immature permanent teeth with nonvital pulps also showed that root maturation was unpredictable (Linsuwanont et al .…”

Section: Is Root Maturation Predictable After Ret?mentioning

confidence: 97%

“…Recent systematic reviews showed that the success rate for resolution of periapical pathosis was reliably achieved (91%) with RET (Tong et al . , Torabinejad et al . ).…”

Section: Is Ret Successful?mentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Is Root Maturation Predictable After Ret?mentioning

confidence: 97%

“…Recent systematic reviews showed that the success rate for resolution of periapical pathosis was reliably achieved (91%) with RET (Tong et al . , Torabinejad et al . ).…”

Section: Is Ret Successful?mentioning

confidence: 99%

See 2 more Smart Citations

Regenerative endodontics: a comprehensive review

et al. 2018

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“…Recently published systematic review and meta‐analysis have shown that current published evidence is unable to provide definitive conclusions on the predictability of this technique (Tong et al . ). Indeed prospective studies have failed to predictably demonstrate any significant hard tissue gain in the root canal system (Nazzal et al .…”

Section: Discussionmentioning

confidence: 97%