Copyright (c) 2025 Dr. Dayanand Chole
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Regenerative Endodontics: Rising Ray of Dentistry- a Review
Corresponding Author(s) : Dr. Dayanand Chole
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 5 No. 1 (2017): 2017 Volume 5- Issue -1
Abstract
When pulp tissue becomes necrotic in immature teeth, the prognosis of the teeth is compromised. Disinfection of the root presents several challenges including difficulties in cleaning and shaping of large canals with open apices, obturation of canals with open apices, and potential root fractures caused by thin and/or weakened root walls. The regeneration of immature permanent teeth following trauma could be beneficial to reduce the risk of fracture and loss of millions of teeth each year. The purpose of this article is to review these biological procedures and the hurdles that must be overcome to develop regenerative endodontic procedures.
Keywords
Stem cells
Morphogenes
Scaffold,
Revasculrization
Various methods of regeneration technique
References
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Dayanand C et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-5(1) 2017 [094-108]
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References
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[5]. Herman BW. On the reaction of the dental pulp to vital amputation and calxyl capping. Dtsch Zahnarztl Z 7, 1952, 1446-7.
[6]. Langer R, Vacanti JP. Tissue engineering. Science 260, 1993, 920-6.
[7]. Nakashima M, Reddi AH. The application of bone morphogenetic proteins to dental tissue Engineering. Nat Biotechnol 21, 2003, 1025-1032
[8]. Buurma B, Gu K, Rutherford RB. Transplantation of human pulpal and gingival fibroblasts attached to synthetic scaffolds. Eur J Oral Sci 107, 1999, 282-289.
[9]. Kundabala M Malaysian Dental Journal: 31(2), 2010.
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[12]. Thomson JA, Itskovitz-Eldor J, Shapiro SS, et al. Embryonic stem cell lines derived from human blastocysts. Science 282, 1998, 1145–7.
Dayanand C et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-5(1) 2017 [094-108]
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[13]. Kerkis I, Caplan AI. Stem cells in dental pulp of deciduous teeth. Tissue Eng Part B Rev 18, 2012, 129–38.
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[15]. Crisan M, Yap S, Casteilla L, et al. A perivascular origin for mesenchymal stem cells in multiple human organs. Cell Stem Cell 3, 2008, 301–13.
[16]. Shi S, Gronthos S. Perivascular niche of postnatal mesenchymal stem cells in human bone marrow and dental pulp. J Bone Miner Res 18, 2003, 696–704.
[17]. Arthur A, Rychkov G, Shi S, et al. Adult human dental pulp stem cells differentiate toward functionally active neurons under appropriate environmental cues. Stem Cells 26, 2008, 1787–95.
[18]. Arthur A, Shi S, Zannettino AC, et al. Implanted adult human dental pulp stem Cells induce endogenous axon guidance. Stem Cells 27, 2009, 2229–37.
[19]. Gandia C, Arminan A, Garcia-Verdugo JM, et al. Human dental pulp stem cells improve left ventricular function, induce angiogenesis, and reduce infarct size in rats with acute myocardial infarction. Stem Cells 26, 2008, 638–45.
[20]. Christine M. Sedgley. Dental Stem Cells and Their Sources. Dent Clin N Am 56, 2012, 549–561.
[21]. Miura M, Gronthos S, Zhao M, Fisher LW, Robey PG, Shi S. SHED: stem cells from human exfoliated deciduous teeth. Proc Natl Acad Sci USA 100, 2003, 5807-12.
[22]. Ballini A, De Frenza G, Cantore S, Papa F, Grano M, Mastrangelo F, et al. In vitro stem cell cultures from human dental pulp and periodontal ligament: new prospects in dentistry. Int J Immunopathol Pharmacol 20, 2007, 9-16.
[23]. Sonoyama W, Liu Y, Yamaza T, Tuan RS, Wang S, Shi S, et al. Characterization of the apical papilla and its residing stem cells from human immature permanent teeth: a pilot study. J Endod 34, 2008, 166-71.
[24]. Huang AH, Chen YK, Lin LM, Shieh TY, Chan AW. Isolation and characterization of dental pulp stem cells from a supernumerary tooth. J Oral Pathol Med 39, 2008, 571-4.
[25]. Yang XC, Fan MW. Identification and isolation of human dental pulp stem cells. Zhonghua Kou Qiang Yi Xue Za Zhi 40, 2005, 244-7.
[26]. Huang GT, Gronthos S, Shi S. Mesenchymal stem cells derived from dental tissues vs those from other sources: Their biology and role in regenerative medicine. J Dent Res 88, 2009, 792-806.
[27]. Karaöz E, Do?an BN, Aksoy A, Gacar G, Akyüz S, Ayhan S, et al. Isolation and in vitro characterization of dental pulp stem cells from natal teeth. Histochem Cell Biol 133, 2010, 95-112.
[28]. Gronthos S, Mankani M, Brahim J, et al. Postnatal human dental pulp stem cells (DPSCs) in vitro and in vivo. Proc Natl Acad Sci U S A 97, 2000, 13625–30.
[29]. Shi S, Bartold PM, Miura M, et al. The efficacy of mesenchymal stem cells to regenerate and repair dental structures. Orthod Craniofac Res 8, 2005, 191–9.
[30]. Beyer Nardi N, da Silva Meirelles L. Mesenchymal stem cells: isolation, in vitro expansion and characterization. Handb Exp Pharmacol 174, 2006, 249–82
[31]. Yamagishi VT, Torneck CD, Friedman S, et al. Blockade of TLR2 inhibits Porphyromonas Gingivalis suppression of mineralized matrix formation by human dental pulp stem cells. J Endod 37, 2011, 812–8.
[32]. Rosa V, Botero TM, Nor JE. Regenerative endodontics in light of the stem cell paradigm. Int Dent J 61(1), 2011, 23–8.
[33]. Alongi DJ, Yamaza T, Song Y, et al. Stem/progenitor cells from inflamed human dental pulp retain tissue regeneration potential. Regen Med 5, 2010, 617–31
[34]. Leprince JG, Zeitlin BD, Tolar M, et al. Interactions between immune system and mesenchymal stem cells in dental pulp and periapical tissues. Int Endod J 2012
[35]. Sakai VT, Zhang Z, Dong Z, et al. SHED differentiate into functional odontoblasts and endothelium. J Dent Res 89, 2010, 791–6.
[36]. Nakamura S, Yamada Y, Katagiri W, et al. Stem cell proliferation pathways comparison between human exfoliated deciduous teeth and dental pulp stem cells by gene expression profile from promising dental pulp. J Endod 35, 2009, 1536–42.
[37]. 37.Sonoyama W, Liu Y, Fang D, et al. Mesenchymal stem cell-mediated functional tooth regeneration in swine. PLoS One 1, 2006, e79
Dayanand C et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-5(1) 2017 [094-108]
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[38]. Huang GT, Sonoyama W, Liu Y, et al. The hidden treasure in apical papilla: the potential role in pulp/dentin regeneration and bioroot engineering. J Endod 34, 2008, 645–51.
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[40]. Huang GT, Yamaza T, Shea LD, et al. Stem/progenitor cell-mediated de novo regeneration of dental pulp with newly deposited continuous layer of dentin in an in vivo model. Tissue Eng Part a 16, 2010, 605–15.
[41]. McCulloch CA. Progenitor cell populations in the periodontal ligament of mice. Anat Rec 211, 1985, 258–62.
[42]. Seo BM, Miura M, Gronthos S, et al. Investigation of multipotent postnatal stem cells from human periodontal ligament. Lancet 364, 2004, 149–55.
[43]. Gronthos S, Mrozik K, Shi S, et al. Ovine periodontal ligament stem cells: isolation, characterization, and differentiation potential. Calcif Tissue Int 79, 2006, 310–7
[44]. Gay IC, Chen S, MacDougall M. Isolation and characterization of multipotent human periodontal ligament stem cells. Orthod Craniofac Res 10, 2007, 149–60.
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[56]. Iwaya SI, Ikawa M, Kubota M. Revascularization of an immature permanent tooth with apical periodontitis and sinus tract. Dent Traumatol 17, 2001, 185–7.
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[69]. Kim JH, Kim Y, Shin SJ, et al. Tooth discoloration of immature permanent incisor associated with triple antibiotic therapy: a case report. J Endod 36, 2010, 1086–91.
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[71]. Thomson A, Mahler B. Regenerative endodontics–biologically-based treatment for immature permanent teeth: a case report and review of the literature. Aust Dent J 55, 2010, 446–52.
[72]. Cehreli ZC, Isbitiren B, Sara S, et al. Regenerative endodontic treatment (revascularization) of immature necrotic molars medicated with calcium hydroxide: a case series. J Endod 37, 2011, 1327–30.
[73]. Chen MY, Chen KL, Chen CA, et al. Responses of immature permanent teeth with infected necrotic pulp tissue and apical periodontitis/abscess to revascularization procedures. Int Endod J 45, 2011, 294–305.
[74]. Iwaya S, Ikawa M, Kubota M. Revascularization of an immature permanent tooth with periradicular abscess after luxation. Dent Traumatol 27, 2011, 55–8.
[75]. Nosrat A, Seifi A, Asgary S. Regenerative endodontic treatment (revascularization) for necrotic immature permanent molars: a review and report of two cases with a new biomaterial. J Endod 37, 2011, 562–7.
[76]. Torabinejad M, Turman M. Revitalization of tooth with necrotic pulp and open apex by using platelet-rich plasma: a case report. J Endod 37, 2011, 265–8.
[77]. Lenzi R, Trope M. Revitalization procedures in two traumatized incisors with different biological outcomes. J Endod 38, 2012, 411–4.
[78]. Nosrat A, Homayounfar N, Oloomi K. Drawbacks and unfavorable outcomes of regenerative endodontic treatments of necrotic immature teeth: a literature review and report of a case. J Endod 38, 2012, 1428–34.
[79]. Jeeruphan T, Jantarat J, Yanpiset K, et al. Mahidol study 1: Comparison of radiographic and survival outcomes of immature teeth treated with either regenerative endodontic or apexification methods: a retrospective study. J Endod 38, 2012, 1330–6.
[80]. Trope M. Treatment of the immature tooth with a non-vital pulp and apical periodontitis Dent Clin North Am 54, 2010, 313–24.
[81]. Huang GT, Lin LM. Letter to the editor: comments on the use of the term ‘‘revascularization’’ to describe root regeneration. J Endod 34, 2008, 511.
[82]. Trope M. Reply. J Endod 34, 2008, 511–2.
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[84]. Wang X, Thibodeau B, Trope M, et al. Histologic characterization of regenerated tissues in canal space after the revitalization/revascularization procedure of immature dog teeth with apical periodontitis. J Endod 36, 2010, 56–63
[85]. Thibodeau B, Trope M. Pulp revascularization of a necrotic infected immature permanent tooth: case report and review of the literature. Pediatr Dent 29, 2007, 47–50.
[86]. Ronald Wigler, Revascularization: A Treatment for Permanent Teeth with Necrotic Pulp and Incomplete Root Development JOE —39(3), 2013
[87]. Kling M, Cvek M, Mejare I. Rate and predictability of pulp revascularization in therapeutically reimplanted permanent incisors. Endod Dent Traumatol 2, 1986, 83–89.
[88]. Cvek M. Prognosis of luxated non-vital maxillary incisors treated with calcium hydroxide and filled with gutta-percha: a retrospective clinical study. Endod Dent Traumatol 8, 1992, 45–55.
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[91]. Essner MD, Javed A, Eleazer PD. Effect of sodium hypochlorite on human pulp cells: an in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 112, 2011, 662–6.
[92]. Trevino EG, Patwardhan AN, Henry MA, et al. Effect of irrigants on the survival of human stem cells of the apical papilla in a platelet-rich plasma scaffold in human root tips. J Endod 37, 2011, 1109–15.
[93]. Bose R, Nummikoski P, Hargreaves K. A retrospective evaluation of radiographic outcomes in immature teeth with necrotic root canal systems treated with regenerative endodontic procedures. J Endod 35, 2009, 1343–9.
[94]. Hoshino E, Kurihara-Ando N, Sato I, et al. In-vitro antibacterial susceptibility of bacteria taken from infected root dentine to a mixture of ciprofloxacin, metronidazole and minocycline. Int Endod J 29, 1996, 125–30.
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