Regenerative endodontics: a comprehensive review

S. G. Kim, M. Malek, Asgeir Sigurdsson, Louis Lin, B. Kahler

Research output: Contribution to journalReview article

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1367-1388
Number of pages22
JournalInternational Endodontic Journal
Volume51
Issue number12
DOIs
StatePublished - Dec 1 2018

Fingerprint

Endodontics
Tooth
Traumatology
Pemetrexed
Regeneration
Tooth Discoloration
Dental Pulp Necrosis
Stem Cells
Blood Platelets
Platelet-Rich Plasma
Neurogenesis
Dentin
Tissue Engineering
Fibrin
Signs and Symptoms
Appointments and Schedules
Thrombosis
Parents
Hemorrhage

Keywords

  • current perspectives
  • future prospectives
  • immature permanent teeth
  • regenerative endodontics
  • treatment outcomes

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Regenerative endodontics : a comprehensive review. / Kim, S. G.; Malek, M.; Sigurdsson, Asgeir; Lin, Louis; Kahler, B.

In: International Endodontic Journal, Vol. 51, No. 12, 01.12.2018, p. 1367-1388.

Research output: Contribution to journalReview article

Kim, S. G. ; Malek, M. ; Sigurdsson, Asgeir ; Lin, Louis ; Kahler, B. / Regenerative endodontics : a comprehensive review. In: International Endodontic Journal. 2018 ; Vol. 51, No. 12. pp. 1367-1388.
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