Regenerative endodontic procedures: a review of the literature and a case report of an immature central incisor

Platelet Power: Revitalizing Endodontics With Scaffolds

This article provides an overview of a biologically based method for restoring damaged tooth structures and pulp tissues known as regenerative endodontics. It explores the concept of regenerative endodontics, its tissue engineering approach, and its application in maintaining vitality. The article discusses the significance of the factors affecting growth, scaffolds, and stem cells being the three tissue engineering components involved in the regeneration of pulp tissues. It also delves into the classification of scaffolds and the role of platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) as biological scaffolds. The methodology section details the search process for relevant studies, and the review section presents research findings associated with PRF and its application in regeneration and repair of tissue. The article concludes by highlighting the potential of advanced PRF and injectable PRF in regenerative endodontics, with a focus on their impact on tissue regeneration and healing.

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

OBJECTIVE

To asses clinically and radiographically the effect of using two types of coronal plug materials in revascularization of non-vital immature teeth.

METHODS

A total of 26 necrotic immature permanent anterior teeth were enrolled for pulp revascularization using a double antibiotic mix for root canal disinfection. They were randomly divided into the following based on coronal plug materials used: Biodentine (Group I) and white Mineral Trioxide Aggregate (Group II; n = 13). Clinical and radiographic assessments were performed after 3, 6, 9, and 12 months.

RESULTS

When comparing the overall clinical successes and percentage of increase in root length between the two groups, there was no statistically significant difference (P > 0.05). There was a significant difference in the distribution of discoloration between the two groups. One case was reported in Group I, and seven cases were reported in Group II (P = 0.01).

CONCLUSIONS

Both Biodentine and Mineral Trioxide Aggregate were successful clinically regarding the resolution of signs and symptoms associated with the necrotic teeth.

Regenerative Endodontic Procedures Using Contemporary Endodontic Materials

Calcium hydroxide apexification and Mineral Trioxide Aggregate (MTA) apexification are classical treatments for necrotic immature permanent teeth. The first tend to fail for lack of compliance given the high number of sessions needed; the second has technical difficulties such as material manipulation and overfilling. With both techniques, the root development is interrupted leaving the tooth with a fragile root structure, a poor crown-to-root ratio, periodontal breakdown, and high risk of fracture, compromising long-term prognosis of the tooth. New scientific literature has described a procedure that allows complete root development of these specific teeth. This regenerative endodontic procedure (REP) proposes the use of a combination of antimicrobials and irrigants, no canal walls instrumentation, induced apical bleeding to form a blood clot and a tight seal into the root canal to promote healing. MTA is the most used material to perform this seal, but updated guidelines advise the use of other bioactive endodontic cements that incorporate calcium and silicate in their compositions. They share most of their characteristics with MTA but claim to have fewer drawbacks with regards to manipulation and aesthetics. The purpose of the present article is to review pertinent literature and to describe the clinical procedures protocol with its variations, and their clinical application.