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Adhikari, Bhawana, Sanjeeb Chaudhary, Bibek Khanal, Nisha Acharya, and Jwolan Khadka. "Knowledge, Attitude and Practice on Regenerative Endodontics among Endodontists of Nepal." MedS Alliance Journal of Medicine and Medical Sciences 2, no. 3 (2022): 18–23. http://dx.doi.org/10.3126/mjmms.v2i3.47656.
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INTRODUCTION: Regenerative Endodontics is one of the most fascinating development in modern dentistry. Since Endodontists are the first providers of this type of dental treatment, it is essential to learn their knowledge, attitude and practice of these procedures. Aim: This online questionnaire-based study was conducted amongst Endodontists practicing in Nepal with the aim to learn their knowledge, attitude and practice of regenerative endodontic procedures. MATERIALS AND METHODS: A cross-sectional study was conducted among Endodontists in Nepal. In total 65 Endodontists participated in this study. The questionnaire was distributed to the participants using the available electronic measures. Descriptive statistical analyses were performed on the responses given by Endodontists using SPSS Statistical Software package (version 21.0). RESULTS: A total of 20 questions were included in this study. Out of the responses analyzed, 100% (n=65) had come across the term regenerative endodontics. Respondents had good knowledge about the sources of dental stem cells (87.3%, n=55). A high percentage (98.4%, n=62) of respondents strongly recommended regenerative therapy to be incorporated into dentistry. Among the participants of this study, 87.1% (n=54) had a belief that regenerative endodontic treatment could serve as the alternative treatment option to dental implant. CONCLUSIONS: The Endodontists practicing in Nepal had sound knowledge about regenerative endodontic procedures. They were enthusiastic in practicing regenerative endodontics and interested in stem cell therapy. It’s a high time to uplift the regenerative endodontic procedure from simple revascularization via blood clotting to more advanced procedure.
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Thanglienzo, Grace, Shipra Jaidka, Rani Somani, et al. "REGENERATIVE ENDODONTICS." International Journal of Advanced Research 10, no. 02 (2022): 306–18. http://dx.doi.org/10.21474/ijar01/14209.
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Regenerative endodontics has been defined as biologically based procedures designed to replace damaged structures, including dentin and root structures, as well as cells of the pulp-dentin complex. Presently, two concepts exist in regenerative endodontics to treat non-vital infected teeth - one is the active pursuit of pulp-dentine regeneration to implant or regrow pulp (tissue engineering technology), and the other in which new living tissue is expected to form from the tissue present in the teeth itself, allowing continued root development(revascularisation). Regenerative endodontic procedures (REPs) have evolved in the past decade, being incorporated into endodontic practice and becoming a viable treatment alternative for immature teeth. The authors have summarized the status of regenerative endodontics on the basis of the available published studies and provide insight into the different levels of clinical outcomes expected from these procedures.
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Patil, Pranjali Naresh, M. Robert Justin, Aditi Subhashchandra Sarda, Lalit Dattu Darade, Supriya Ramchandra Zanjad, and Rupesh Bowlekar. "Review on regenerative endodontics: Past concepts, current protocols and future strategies." IP Indian Journal of Conservative and Endodontics 6, no. 4 (2021): 205–11. http://dx.doi.org/10.18231/j.ijce.2021.045.
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Till last few decades, a necrosed tooth with immature apex was an indication for apexogenesis. With advances in dentistry such as improved irrigation protocols, better visibility to the operating site and increased skills of endodontists, regenerative endodontic procedures have come into the limelight. The alongside research in tissue engineering also have been beneficial for researchers and endodontists to open new horizons in regenerative endodontics. This review paper involves the triad of tissue engineering, concepts of regenerative endodontics applied in past, current protocols according to American Association of Endodontists and future concepts of tooth tissue regenerations which are being researched.
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Patel, Jalak, Tejal Sheth, Dhwanit Thakore, and Dharmesh Dhamat. "Biomimetics in Endodontics: A Review of the Changing Trends in Endodontics." Journal of Advanced Oral Research 9, no. 1-2 (2018): 11–14. http://dx.doi.org/10.1177/2320206818816186.
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Newer scientific technological advancement in dentistry provides an array of projects such as molecular biology, cell culturing, tissue grafting, and tissue engineering. Conventional root canal treatment, apexification with biomaterials, and extractions are the procedures of choice to treat a nonvital tooth. These treatment options do not give predictable outcomes in the regeneration of the pulp tissue. This can be easily achieved by regenerative endodontics wherein the diseased or a nonvital tooth is replaced by a healthy and functional pulp-dentin complex. The rationale for regenerative endodontics follows tissue engineering techniques. This article reviews the shift in regenerative endodontic techniques.
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Junaid, Muhammad, Saif Alyami, Fawaz Saad Alkayraan, et al. "Advancements in Regenerative Endodontics: A Systematic Literature Review of Stem Cell-Based Therapies, In Vitro and In Vivo Evidence, Clinical Relevance, and Future Prospects." Journal of Pioneering Medical Sciences 14, Special Issue 1 (2025): 218–24. https://doi.org/10.47310/jpms202514s0128.
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Objectives: By emphasizing the regeneration of compromised or diseased pulp tissue rather than relying solely on conventional root canal treatments, regenerative endodontics marks a significant advancement in dental care. Primarily relying on stem cell-based treatments, this method aims to restore normal tooth function, repair pulp tissue, and preserve the native tooth structure. With their remarkable capacity to differentiate into multiple cell types, stem cells hold great potential for regenerating pulp and periapical tissues. Stem cell-based regenerative endodontics has excellent potential, but its practical use is hampered in several ways. Methods: The efficacy, challenges, and prospects of stem cell-based therapies in regenerative endodontics were evaluated through a systematic literature review. With an eye toward peer-reviewed preclinical and clinical research from 2013 to 2023, a thorough search was conducted across critical databases including PubMed, Web of Science, and the Cochrane Library. Studies were selected based on their relevance to regenerative endodontic treatments, pulp regeneration, and stem cell-based tissue engineering. Emphasizing stem cell types, techniques, results, and obstacles found, data from qualified studies were gathered, analyzed, and synthesized. Results: Particularly with dental pulp stem cells (DPSCs), stem cells from the apical papilla (SCAP), and induced pluripotent stem cells (iPSCs), stem cell-based therapies for regenerative endodontics have shown promise in regenerating pulp and restoring tooth vitality. Because they can differentiate into odontoblast-like cells and encourage dentin development, DPSCs are known for their particular properties. Particularly in young teeth, SCAPs have shown outstanding regeneration potential; iPSCs offer an alternative but still require further development. Improvements in growth factors and scaffold materials have further enhanced the regenerative capabilities of stem cell treatments. Challenges such as immunological response, stem cell differentiation, and long-term safety still exist, despite favorable preclinical and clinical data. Discussion: Although stem cells from various sources show great promise for regenerative endodontics, their clinical applications are still in their early stages, and further study is required to optimize techniques and enhance results. Effective pulp regeneration depends critically on biomaterial scaffolds, growth factors, and the regulation of stem cell differentiation. Despite significant advancements, the sector still struggles with the long-term viability of regeneration treatments and the standardization of treatment strategies. Conclusion: Mainly stem cell-based treatments, regenerative endodontics has significant promise to transform dental care by repairing damaged pulp tissue and preserving tooth health. Although DPSCs, SCAPs, and iPSCs have made tremendous progress, further study and development are necessary to address clinical issues and enhance the long-term effectiveness of these treatments. The future of regenerative endodontics will be shaped by ongoing research into stem cell technologies and biomaterials, resulting in more biologically oriented and successful therapies for pulp and periapical diseases.
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Feigin, Kristina, and Bonnie Shope. "Regenerative Endodontics." Journal of Veterinary Dentistry 34, no. 3 (2017): 161–78. http://dx.doi.org/10.1177/0898756417722022.
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Regenerative endodontics has been defined as “biologically based procedure designed to replace damaged structures, including dentin and root structures, as well as cells of the pulp–dentin complex.” This is an exciting and rapidly evolving field of human endodontics for the treatment of immature permanent teeth with infected root canal systems. These procedures have shown to be able not only to resolve pain and apical periodontitis but continued root development, thus increasing the thickness and strength of the previously thin and fracture-prone roots. In the last decade, over 80 case reports, numerous animal studies, and series of regenerative endodontic cases have been published. However, even with multiple successful case reports, there are still some remaining questions regarding terminology, patient selection, and procedural details. Regenerative endodontics provides the hope of converting a nonvital tooth into vital one once again.
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Krupińska, Anna M., Katarzyna Skośkiewicz-Malinowska, and Tomasz Staniowski. "Different Approaches to the Regeneration of Dental Tissues in Regenerative Endodontics." Applied Sciences 11, no. 4 (2021): 1699. http://dx.doi.org/10.3390/app11041699.
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(1) Background: The regenerative procedure has established a new approach to root canal therapy, to preserve the vital pulp of the tooth. This present review aimed to describe and sum up the different approaches to regenerative endodontic treatment conducted in the last 10 years; (2) Methods: A literature search was performed in the PubMed and Cochrane Library electronic databases, supplemented by a manual search. The search strategy included the following terms: “regenerative endodontic protocol”, “regenerative endodontic treatment”, and “regenerative endodontics” combined with “pulp revascularization”. Only studies on humans, published in the last 10 years and written in English were included; (3) Results: Three hundred and eighty-six potentially significant articles were identified. After exclusion of duplicates, and meticulous analysis, 36 case reports were selected; (4) Conclusions: The pulp revascularization procedure may bring a favorable outcome, however, the prognosis of regenerative endodontics (RET) is unpredictable. Permanent immature teeth showed greater potential for positive outcomes after the regenerative procedure. Further controlled clinical studies are required to fully understand the process of the dentin–pulp complex regeneration, and the predictability of the procedure.
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Almoharib, Bander Khalid, Reem Saleh Alonazi, Mohammed Ali Alanazi, et al. "Innovative approaches in regenerative endodontics." International journal of health sciences 8, S1 (2024): 999–1015. http://dx.doi.org/10.53730/ijhs.v8ns1.15031.
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Background: Biomimicry or biomimetics refers to developing materials and techniques inspired by natural systems. In dentistry, this approach aims to replicate natural tooth structures and functions, addressing limitations of conventional materials and techniques. Regenerative endodontics, including cell homing and revascularization, represents significant advancements in this field, focusing on pulp-dentin regeneration and tooth vitality restoration. Aim: This review explores innovative biomimetic approaches in regenerative endodontics, including the latest techniques and their clinical implications. It aims to assess the effectiveness and future prospects of these methods in enhancing tooth repair and regeneration. Methods: The review synthesizes current literature on regenerative endodontic procedures, including cell homing, revascularization, scaffold implantation, and gene therapy. It examines experimental studies, clinical trials, and advancements in biomimetic materials and techniques, highlighting their applications and outcomes. Results: The review finds that regenerative endodontics has evolved from traditional apexification to advanced techniques such as cell homing and revascularization. Cell homing, which leverages the body’s natural healing processes without cell transplantation, shows promise in generating pulp-dentin tissue. Revascularization, involving the induction of a blood clot and stem cell recruitment, has demonstrated potential in restoring vitality to necrotic teeth.
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Etezadkeyhan, Pardis. "Recent Advances in Regenerative Endodontics: Clinical Applications and Challenges." Journal of Oral and Dental Health Nexus 1, no. 1 (2024): 29–42. https://doi.org/10.61838/kman.jodhn.1.1.3.
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This study aims to examine recent advances in regenerative endodontics, focusing on its clinical applications, challenges, and future prospects in modern dental practice. A descriptive narrative review was conducted, analyzing peer-reviewed literature published between 2019 and 2024. Studies were selected from major databases, including PubMed, Scopus, and Web of Science, using keywords related to regenerative endodontics, stem cell therapy, biomaterials, and clinical applications. The review synthesized findings on the biological principles of pulp regeneration, recent technological advancements, and the clinical effectiveness of regenerative endodontic procedures. Emphasis was placed on the role of stem cells, scaffolds, growth factors, and biomaterials in tissue engineering. Additionally, challenges such as biological variability, technical limitations, and ethical considerations were explored to provide a comprehensive perspective on the feasibility of regenerative therapies in standard endodontic practice. The analysis revealed that regenerative endodontics has significantly evolved through innovations in stem cell-based therapies, biomaterial scaffolds, and growth factor delivery systems. Clinical studies demonstrated successful pulp revascularization and continued root development in necrotic immature teeth, offering a biologically superior alternative to conventional apexification. The integration of platelet-rich fibrin, hydrogels, and nanomaterials has improved scaffold functionality, while gene therapy and 3D bioprinting show promise for future applications. However, challenges such as inconsistent treatment outcomes, immune responses, and the lack of standardized protocols remain obstacles to widespread clinical adoption. Economic barriers and ethical concerns regarding stem cell sourcing further complicate the translation of regenerative therapies into routine dental practice. Regenerative endodontics represents a paradigm shift in modern dentistry, providing an alternative to traditional root canal therapy by restoring pulp vitality and promoting natural tooth development. Despite ongoing challenges, advancements in biomaterials, stem cell technology, and molecular signaling offer promising avenues for enhancing treatment predictability and accessibility. Further research, clinical trials, and regulatory frameworks are essential to establish regenerative endodontics as a mainstream treatment modality.
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Sandra, Ferry, Andri Sutanto, Widya Wulandari, et al. "Crucial Triad in Pulp-Dentin Complex Regeneration: Dental Stem Cells, Scaffolds, and Signaling Molecules." Indonesian Biomedical Journal 15, no. 1 (2023): 25–46. http://dx.doi.org/10.18585/inabj.v15i1.2265.
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BACKGROUND: Pulp damage can lead to dentinogenesis impairment, irreversible pulpitis, or pulp necrosis. Despite being the most used endodontic procedure to treat damaged pulp, root canal therapy only results in nonvital teeth which are prone to fractures and secondary infection. Pulp-dentin regeneration has a potential to regenerate structure similar to normal pulp-dentin complex, and can be achieved by combining dental stem cells, scaffold, and signaling molecules. This article reviews the role of various types of dental stem cells, scaffolds, signaling molecules, and their combinations in regenerating pulp-dentin complex.CONTENT: Dental pulp stem cell (DPSC), stem cell from human exfoliated deciduous teeth (SHED), and dental follicle stem cell (DFSC) were reported to regenerate pulp-dentin complex in situ. SHED might be more promising than DPSCs and DFSCs for regenerating pulp-dentin complex, since SHED have a higher proliferation potential and higher expression levels of signaling molecules. Scaffolds have characteristics resembling extracellular matrix, thus providing a suitable microenvironment for transplanted dental stem cells. To accelerate the regeneration process, exogenous signaling molecules are often delivered together with dental stem cells. Scaffolds and signaling molecules have different regenerative potential, including induction of cell proliferation and migration, formation of pulp- and/or dentin-like tissue, as well as angiogenesis and neurogenesis promotion.SUMMARY: Combinations of dental stem cells, scaffold, and signaling molecules are important to achieve the functional pulp-dentin complex formation. Current trends and future directions on regenerative endodontics should be explored. The right combination of dental stem cells, scaffold, and signaling molecules could be determined based on the patients’ characteristics. Incomplete pulp-dentin regeneration could be overcome by applying dental stem cells, scaffold, and/or signaling molecules in multiple visits.KEYWORDS: pulp-dentin regeneration, regenerative endodontics, dental stem cells, scaffold, signaling molecules
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Kajol Relan, Manoj Chandak, Pooja Chandak, Madhulika Chandak, Chanchal Rathi, and Shruti Mishra. "Antibiotics: A changing scenario in Regenerative Endodontics." International Journal of Research in Pharmaceutical Sciences 11, SPL4 (2020): 1453–57. http://dx.doi.org/10.26452/ijrps.v11ispl4.4321.
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The main aim of Endodontics is to either prevent the endodontic disease or to treat it. This is achieved by maintaining the pulp health in cases of pulp inflammation. If there is pulp necrosis, pulp health can be maintained by regenerating the healthy pulp tissue. Hence various researches and the clinical studies tried to regenerate the healthy functioning pulp-dentin complex. Regenerative dentistry aims to biologically replace the dental tissues along with their supporting structures. Regenerative Endodontics can be defined as “ biologically based procedures designed to replace damaged structures such as dentin, root structures, and cells of the pulp-dentin complex.” Root canal anatomy is complex, hence even after mechanical instrumentation, there exists some portions of the root canal that remain untouched. Only instrumentation cannot completely eliminate the microbes existing into the root canal. Hence there is need to additionally irrigate the canals and also using medicaments is required to disinfect the root canal and promote healing. This article aims at focussing on various antibiotics used and role of these materials to disinfect the canals during revascularization treatment.
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Assiry, Ali A., Mohmed Isaqali Karobari, Niher Tabassum Snigdha, Roshan Noor Mohamed, Syed Nahid Basheer, and Mohammed Zameer. "Evaluation of Attitude and Knowledge of Endodontic, Pedodontic and SBARD Residents in Saudi Arabia toward Regenerative Endodontics—A National Survey." Medicina 58, no. 4 (2022): 545. http://dx.doi.org/10.3390/medicina58040545.
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Background and Objectives: There are no guidelines on the regenerative endodontic procedures that should be followed in dental treatment. Thus, it is essential to learn the knowledge, attitudes, and opinions about regenerative endodontics among dental practitioners, particularly endodontists, as they are the first providers of this type of dental treatment. Aim: This study aimed to assess the knowledge and attitudes among residents of the Saudi Board of Advanced Restorative Dentistry (SBARD) in Saudi Arabia. Methods & Materials: A questionnaire-based survey was conducted among 128 residents of endodontics, pedodontics, and the SBARD in Saudi Arabia. The questionnaire was distributed to participants using the available electronic measures such as emails and social media. The questionnaire was made by Google Forms, and responses were received directly in the excel sheet in the email. The data were exported as an excel file, coded, and analyzed, and the p-value < 0.05 was set as significant. Results: More than 50% (74 dentists) of the participants reported receiving continuing education in regenerative treatment, with a significant difference found among specialty (p = 0.023). No significant association was found between knowledge, gender, and type of postgraduate study. The vast majority (89.1%) of the participants believed regenerative endodontics should be incorporated into dentistry curricula. About two-thirds (78.2%) of the participants declared their ability to attend future training courses in a regenerative endodontic, whereas 10.9% did not, and 10.9% were unsure. Conclusions: The dental practitioners were enthusiastic and interested in regenerative and stem cell treatment. The results also suggested incorporating regenerative treatment into the dental curriculum and signaled the need for more continued training courses.
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Fiegler-Rudol, Jakub, Wojciech Niemczyk, Katarzyna Janik, Anna Zawilska, Małgorzata Kępa, and Marta Tanasiewicz. "How to Deal with Pulpitis: An Overview of New Approaches." Dentistry Journal 13, no. 1 (2025): 25. https://doi.org/10.3390/dj13010025.
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Background: Traditional root canal therapy (RCT) effectively removes diseased or necrotic pulp tissue and replaces it with inorganic materials. Regenerative endodontics is an alternative to conventional RCT by using biologically based approaches to restore the pulp–dentin complex. This review explores emerging techniques, including autogenic and allogenic pulp transplantation, platelet-rich fibrin, human amniotic membrane scaffolds, specialized pro-resolving mediators, nanofibrous and bioceramic scaffolds, injectable hydrogels, dentin matrix proteins, and cell-homing strategies. These methods utilize stem cells, growth factors, and biomaterials to regenerate vascularized, functional pulp tissue. Methods: A narrative review was conducted using PubMed, Scopus, and Embase to identify studies published between 2010 and 2023. In vitro, animal, and clinical studies focusing on innovative regenerative endodontic techniques were analyzed. Conclusions: Although regenerative endodontics demonstrates great potential, challenges remain in standardizing protocols, addressing biological variability, and achieving consistent clinical outcomes. Future research must focus on refining these techniques to ensure their safety, efficacy, and accessibility in routine practice. By addressing current limitations, regenerative endodontics could redefine the management of pulpitis, offering biologically based treatments that enhance tooth vitality, structural integrity, and long-term prognosis.
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Simon, Stéphane R. J., Phillip L. Tomson, and Ariane Berdal. "Regenerative Endodontics: Regeneration or Repair?" Journal of Endodontics 40, no. 4 (2014): S70—S75. http://dx.doi.org/10.1016/j.joen.2014.01.024.
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Jain, Vaibhav, Sonam Suyog Ghodke, Kapadia Junaid, Nazia Anwer, and Asad Yusuf. "Regenerative Endodontics." International Journal of Oral Care & Research 5, no. 3 (2017): 238–40. http://dx.doi.org/10.5005/jp-journals-10051-0105.
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Sachdeva, Surinder, RajnishK Singhal, Jyotsna Goyal, Swantika Chaudhry, Abha Sood, and Nishu Vakil. "Regenerative endodontics." Saint's International Dental Journal 1, no. 2 (2015): 82. http://dx.doi.org/10.4103/2454-3160.177927.
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Mohamed, Nadia. "Regenerative endodontics." Dentistry and Medical Research 5, no. 1 (2017): 1. http://dx.doi.org/10.4103/2348-1471.198781.
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Simon, S., and A. J. Smith. "Regenerative endodontics." British Dental Journal 216, no. 6 (2014): E13. http://dx.doi.org/10.1038/sj.bdj.2014.243.
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Mao, Jeremy J., Sahng G. Kim, Jian Zhou, et al. "Regenerative Endodontics." Dental Clinics of North America 56, no. 3 (2012): 639–49. http://dx.doi.org/10.1016/j.cden.2012.05.005.
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Diogenes, Anibal, Nikita B. Ruparel, Yoav Shiloah, and Kenneth M. Hargreaves. "Regenerative endodontics." Journal of the American Dental Association 147, no. 5 (2016): 372–80. http://dx.doi.org/10.1016/j.adaj.2016.01.009.
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Li, Fang-Chi, and Anil Kishen. "3D Organoids for Regenerative Endodontics." Biomolecules 13, no. 6 (2023): 900. http://dx.doi.org/10.3390/biom13060900.
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Apical periodontitis is the inflammation and destruction of periradicular tissues, mediated by microbial factors originating from the infected pulp space. This bacteria-mediated inflammatory disease is known to interfere with root development in immature permanent teeth. Current research on interventions in immature teeth has been dedicated to facilitating the continuation of root development as well as regenerating the dentin–pulp complex, but the fundamental knowledge on the cellular interactions and the role of periapical mediators in apical periodontitis in immature roots that govern the disease process and post-treatment healing is limited. The limitations in 2D monolayer cell culture have a substantial role in the existing limitations of understanding cell-to-cell interactions in the pulpal and periapical tissues. Three-dimensional (3D) tissue constructs with two or more different cell populations are a better physiological representation of in vivo environment. These systems allow the high-throughput testing of multi-cell interactions and can be applied to study the interactions between stem cells and immune cells, including the role of mediators/cytokines in simulated environments. Well-designed 3D models are critical for understanding cellular functions and interactions in disease and healing processes for future therapeutic optimization in regenerative endodontics. This narrative review covers the fundamentals of (1) the disease process of apical periodontitis; (2) the influence and challenges of regeneration in immature roots; (3) the introduction of and crosstalk between mesenchymal stem cells and macrophages; (4) 3D cell culture techniques and their applications for studying cellular interactions in the pulpal and periapical tissues; (5) current investigations on cellular interactions in regenerative endodontics; and, lastly, (6) the dental–pulp organoid developed for regenerative endodontics.
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Mitronin, A. V., K. A. Archakov, D. A. Ostanina, Yu A. Mitronin, and T. V. Khizrieva. "Current Aspects of Regenerative Endodontics: A Systematic Review." Endodontics Today 21, no. 4 (2024): 287–92. http://dx.doi.org/10.36377/1683-2981-2023-21-4-287-292.
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Relevance. The modern concept of endodontic treatment in most clinical cases involves extirpation of the pulp with the loss of its plastic, trophic, sensory, and protective functions. In this regard, the search for ways to recreate lost cells and the main substance of the pulp and periodontium to replace the intraradicular space with “vital” tissue. Regenerative endodontics based on the principles of tissue engineering and offers techniques for restoring damaged tissues of the pulp-dentin complex based on the use of stem cells, growth factors, and an organic matrix. Aim. Systematize information presented in scientific articles about research conducted, opportunities and development prospects in the field of regenerative endodontics. Materials and methods. A search of literature sources was carried out in the PubMed, dissercat.com, elibrary database.ru, cyberleninka.ru, by keywords, “regenerative endodontics”, “stem cells”, “growth factors”, “pulp-dentin complex” with a choice of article types “Clinical Trial”, “Meta-Analysis”, “Review”, "Systematic Review". Results. After analyzing the literature review, an idea was obtained about the current stage of development of regenerative endodontics, preclinical and clinical studies on the restoration of the pulp-dentin complex. Clinical cases based on the triad of regenerative endodontics are presented, as well as an algorithm for performing these therapeutic procedures. Conclusions. Regenerative endodontics is a rapidly developing discipline whose clinical advances are primarily related to the treatment of immature tooth roots, which results in continued root development. Subsequent scientific research is aimed at obtaining significant results in the treatment of a fully formed permanent tooth, which will ensure a unique restoration of the immunological, sensory and protective properties of the pulp-dentine complex.
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Iliescu, Alexandru Andrei, Gabriel Tulus, Paula Perlea, Irina Maria Gheorghiu, Mihaela Georgiana Iliescu, and Horia Octavian Manolea. "Bioceramics and Endodontics: Present and Expectations in Clinical Use." Defect and Diffusion Forum 376 (July 2017): 29–38. http://dx.doi.org/10.4028/www.scientific.net/ddf.376.29.
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Currently bioceramics are preferentially used in various endodontic treatments such as pulp capping, pulp amputation, apexification, root-end fillings, perforation repair, and pulp regeneration. Additionally, bioceramics started to replace traditional materials still used in root canal fillings. The promising clinical results achieved during last 20 years by mineral trioxide aggregate (MTA) promoted in root canal treatments other MTA-like innovative endodontic materials, some of them produced by nanotechnology. Though the newcomers claim to have at least the same efficacy as MTA only rigorous long-term clinical studies might confirm the expectations. Probably the most spectacular effect of using bioceramics in endodontics is mirrored in regenerative treatments. However, are still required proper treatment protocols able to optimize the signaling environment of bioactive molecules for achieving the most efficient pulp regeneration. Pivotal is also the balance between clinical and histological outcomes. As compared to conventional materials used in endodontic treatments bioceramic cements are not only biocompatible but also bioactive as they proved to be involved in controlling the tissue healing and pulp regeneration. MTA or MTA-like cements are already the material of choice in regenerative endodontics, conservative vital pulp therapy and periradicular surgery due to their clinical success rate that spectacularly upraised in recent years. Based on in progress technology of fabrication it is expected that the newcomers belonging to bioceramic cements will overcome some potential clinical and histological downsides. MTA-based endodontic sealers are also promising promoters of improved interfacial bond between the filling material and the dentinal walls of root canal as a guarantee against microinfiltration.
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Padmawar, Neeta Surendra, Viddyasagar Prabhakar Mopagar, Vinay Hanumantrao Vadvadgi, Sourabh Ramesh Joshi, and Meghna J. Padubidri. "Immature to Mature - A Predictable Outcome of Two Immature Incisors with 36 Months Follow-Up!" Journal of Evolution of Medical and Dental Sciences 10, no. 18 (2021): 1356–60. http://dx.doi.org/10.14260/jemds/2021/286.
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Management of non-vital immature anterior permanent teeth in children remains a challenge in paediatric dentistry and endodontics. Once the tooth becomes non-vital, root development ceases, rendering the tooth weak, and unable to withstand physiological forces of mastication. This results in a high rate of root fracture with poor prognosis in the medium to long term. Despite being endodontically treated, over 50 % of such teeth will be lost in the first 10 years following trauma. Traditional endodontic treatment does not contribute to any quantitative or qualitative increase in root dimensions resulting in life-long oral disability. The advancement in the science of Endodontics - Regenerative Endodontics has revolutionized current treatment strategies in treating the immature non-vital permanent tooth which has overcome the drawbacks of traditional treatment approaches. This report provides an insight view on successful maturogenesis of immature non-vital permanent incisors by induction of intracanal bleeding along with complications endured during the process. Regenerative endodontics is defined as “biologically based procedures designed to replace damaged structures, including dentin and root structures, as well as cells of the pulp - dentin complex”.1 Continued root development and reestablishment of pulp - dentine complex can be achieved by these procedures. Two major concepts in the regenerative endodontics are guided tissue regeneration (GTR) and tissue engineering. The base of these procedures is stem cells which can differentiate into the desired tissue component, growth factors or other tissue - inducing mediators and scaffold.2 Regenerative endodontic procedure (REP) includes induction of intracanal bleeding, placement of platelet rich fibrin (PRF), and platelet rich plasma (PRP). The goals of these procedures were elimination of signs and symptoms, continued root development, apical healing, and positive response to vitality testing. But preparation of PRP and PRF requires withdrawal of blood and sight of syringe can add emotional stress to young patients. Revascularization may be defined as the invagination of undifferentiated periodontal cells from the apical region in immature teeth.3,4 The nature of tissue formed after revascularization is not certain and can be confirmed by histological evaluation. Presence of blood supply is reliable. Revascularization considers only one facet - nature of newly formed tissue thus making term revascularization inaccurate and thus many authors disagreed with this term.5
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L, Hammouda. "A Comparative Evaluation of Biological Scaffold in Regenerative Endodontic Treatment of Immature Non-Vital Permanent Teeth." Advances in Pharmacology and Clinical Trials 8, no. 4 (2023): 1–3. http://dx.doi.org/10.23880/apct-16000224.
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Endodontic treatments techniques for immature necrotic teeth include: surgical endodontics, apexification, and singlevisit MTA plug. Regenerative endodontic therapy (RET) is a newer concept that involves restoring the pulp-dentin complex in an infected tooth with an open apex. The aims of this paper were to evaluate RET of immature permanent teeth using biological scaffold and the distinctions between them, with a focus on their ease of manipulation and regenerative potential.
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Wadhwa, Deepti, MukeshKumar Hasija, Babita Meena, and Dipanshu Kumar. "Pediatric regenerative endodontics." Journal of the International Clinical Dental Research Organization 13, no. 1 (2021): 73. http://dx.doi.org/10.4103/jicdro.jicdro_47_19.
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Samiei, Mohammad, Martin Conrad Harmsen, Elaheh Dalir Abdolahinia, Jaleh Barar, and Xenos Petridis. "Scaffold-Free Strategies in Dental Pulp/Dentine Tissue Engineering: Current Status and Implications for Regenerative Biological Processes." Bioengineering 12, no. 2 (2025): 198. https://doi.org/10.3390/bioengineering12020198.
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Conventionally, root canal treatment is performed when the dental pulp is severely damaged or lost due to dental trauma or bacterial endodontic infections. This treatment involves removing the compromised or infected pulp tissue, disinfecting the root canal system, and sealing it with inert, non-degradable materials. However, contemporary endodontic treatment has shifted from merely obturating the root canal system with inert materials to guiding endodontic tissue regeneration through biological approaches. The ultimate goal of regenerative endodontics is to restore dental pulp tissue with structural organization and functional characteristics akin to the native pulp, leveraging advancements in tissue engineering and biomaterial sciences. Dental pulp tissue engineering commonly employs scaffold-based strategies, utilizing biomaterials as initial platforms for cell and growth factor delivery, which subsequently act as scaffolds for cell proliferation, differentiation and maturation. However, cells possess an intrinsic capacity for self-organization into spheroids and can generate their own extracellular matrix, eliminating the need for external scaffolds. This self-assembling property presents a promising alternative for scaffold-free dental pulp engineering, addressing limitations associated with biomaterial-based approaches. This review provides a comprehensive overview of cell-based, self-assembling and scaffold-free approaches in dental pulp tissue engineering, highlighting their potential advantages and challenges in advancing regenerative endodontics.
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Ahrari, Farzaneh, Salehe Akhondian, Reza Shakiba, et al. "Laser Applications in Regenerative Endodontics: A Review." Journal of Lasers in Medical Sciences 15 (February 4, 2024): e1. http://dx.doi.org/10.34172/jlms.2024.01.
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Introduction: Developing regenerative endodontic treatment (RET) is an exciting approach to managing immature permanent teeth with pulp necrosis. RET is usually performed in two clinical steps: disinfection (first step) and tissue engineering (second step). Recently, laser therapy has entered the field of RET. This study aimed to provide an overview of the literature that employed laser therapy for root regeneration. Methods: A comprehensive search was performed on four databases, including PubMed, Web of Science, Scopus, and Google Scholar. The searched keywords were laser, regenerative endodontics, immature permanent teeth, and dental pulp necrosis, and related English-published articles were included up to October 2023. Results: Thirteen studies utilized a laser for RET. In the first step of RET, both high-power and low-level lasers (through photodynamic therapy [PDT]) may be applied for canal disinfection. In contrast, regenerative procedures in the second step of RET are just accelerated by low-power lasers (biostimulation). The literature does not support the benefit of laser-assisted irrigation in improving the clinical success of RET. There is some evidence that laser-assisted disinfection with a diode laser may provide comparable results to triple antibiotic paste in reducing bacterial counts in root canals while providing slightly better clinical and radiographic outcomes. PDT may be an effective and suitable adjunct to conventional disinfection methods in immature, necrotic teeth. Conclusion: Low-power lasers may be beneficial tools for improving the results of regenerative endodontics through chemical disinfection in the first step (PDT) or by biostimulation in the second step of RET.
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Abdel Hafiz Abdel Rahim, Al-Shaimaa, Fatma Abdelgawad, Ahmed M. Abd Alsamed, Dalia Mohamed Moheb, and Norhan Abdel Wahab El-Dokky. "Case Report: Photo-activated oral disinfection in regenerative endodontics." F1000Research 8 (August 28, 2019): 1519. http://dx.doi.org/10.12688/f1000research.20118.1.
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Background: Root canal disinfection is considered critical for achieving successful regenerative endodontic procedures. Photo-activated oral disinfection is a novel disinfection method that can help to achieve the goal of regenerative endodontics. This article reports the clinical and radiographic results after single visit regenerative endodontics using photo-activated oral disinfection. Methods: An 8.5-year-old girl complained of fractured upper right central incisor. Pulp necrosis was diagnosed on the basis of clinical findings. The root canal was irrigated with sodium hypochlorite solution (1.5%) followed by saline. Then, the canal was dried with paper points. A combination of a photosensitizer solution and low power laser light were applied. EDTA solution was used as a final irrigant. Bleeding was induced, followed by placement of collagen resorbable matrix and white mineral trioxide aggregate. Two days later, the tooth was sealed and restored with permanent filling. Results: Clinical findings revealed no pain on percussion or palpation tests. Radiographic examination revealed an increase in root length, an increase of apical root thickness and apical closure at the 12-month follow-up period. Conclusion: Regenerative endodontics using photo-activated oral disinfection achieved successful outcomes in the necrotic immature permanent tooth.
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Abdel Hafiz Abdel Rahim, Al-Shaimaa, Fatma Abdelgawad, Ahmed M. Abd Alsamed, Dalia Mohamed Moheb, and Norhan Abdel Wahab El-Dokky. "Case Report: Single visit photo-activated disinfection in regenerative endodontics." F1000Research 8 (June 3, 2020): 1519. http://dx.doi.org/10.12688/f1000research.20118.2.
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Background: Root canal disinfection is considered critical for achieving successful regenerative endodontic procedures. Photo-activated disinfection is a novel disinfection method that can help to achieve the goal of regenerative endodontics. This article reports the clinical and radiographic results after single visit regenerative endodontics using photo-activated disinfection. Methods: An 8.5-year-old girl complained of fractured upper right central incisor. Pulp necrosis was diagnosed on the basis of clinical findings. The root canal was irrigated with sodium hypochlorite solution (1.5%) followed by saline. Then, the canal was dried with paper points. A combination of a photosensitizer solution and low power laser light were applied. EDTA solution was used as a final irrigant. Bleeding was induced, followed by placement of collagen resorbable matrix and white mineral trioxide aggregate. Two days later, the tooth was sealed and restored with permanent filling. Results: Clinical findings revealed no pain on percussion or palpation tests. Radiographic examination revealed an increase in root length, an increase of apical root thickness and apical closure at the 12-month follow-up period. Conclusion: Regenerative endodontics using photo-activated disinfection achieved successful outcomes in the necrotic immature permanent tooth.
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Mishra, Preeti, Vineeta Nikhil, and Shalya Raj. "Effects of Irrigants on Pulp Stem Cells: A Systematic Review." International Journal of Research and Review 10, no. 10 (2023): 477–83. http://dx.doi.org/10.52403/ijrr.20231060.
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Endodontic intervention in necrotic immature permanent teeth is usually a clinical challenge. With appropriate case selection, regenerative treatment can be effective, providing a desirable outcome. However, there is still no consensus on the optimal methods to achieve predictable clinical outcome. To ensure a successful regenerative procedure, it is essential to investigate the appropriate disinfection protocols and the use of biocompatible molecules in order to control the release of growth factors and the differentiation of stem cells. This systematic review summarizes the present knowledge regarding the effect of intracanal irrigants on the dental derived stem cells fate in regenerative endodontic procedures. Keywords: Chlorhexidine; Growth factors; Intracanal irrigants; NaOCl; Regenerative endodontics;
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Naidu, Menda Akkulu. "In Vivo Efficacy of Advanced Drug Delivery System Loaded with Different Medicaments For Regenerative Endodontics." International Journal of Ayurvedic Medicine 15, S1 (2024): 43–47. https://doi.org/10.47552/ijam.v15is1.5564.
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Aim: The aim of this study is to evaluate the efficacy of an advanced drug delivery system loaded with calcium hydroxide and calcium silicate for regenerative endodontic procedures. Materials & Methods: Preparation of Drug Delivery System: A biocompatible carrier material hydrogel is prepared which is capable of encapsulating calcium hydroxide and calcium silicate particles. Characterisation: The drug delivery system is characterised for its morphology and release kinetics. Animal Study: In vivo studies are conducted using animal models of pulpal injury or infection. The drug delivery system is applied in root canal procedures, and the regeneration of pulp tissue and formation of hard tissue barriers are assessed using histological and radiographic analyses. Results & Discussion: Sustained Release Property: The drug delivery system exhibits potent endodontics regeneration property with sustained release of calcium hydroxide contributing to effective bacterial elimination. Tissue Regeneration: The incorporation of calcium silicate promotes dentinogenesis and facilitates the formation of hard tissue barriers, leading to enhanced tissue regeneration within the root canal space. Conclusion: In conclusion, the advanced drug delivery system loaded with calcium hydroxide and calcium silicate shows great promise for enhancing regenerative endodontic procedures. Its ability to provide sustained release of medicaments, promote tissue regeneration, and improve treatment outcomes makes it a valuable tool in modern endodontic practice.
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Dong, Xu, and Xin Xu. "Bioceramics in Endodontics: Updates and Future Perspectives." Bioengineering 10, no. 3 (2023): 354. http://dx.doi.org/10.3390/bioengineering10030354.
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Bioceramics, with excellent bioactivity and biocompatibility, have been widely used in dentistry, particularly in endodontics. Mineral trioxide aggregate (MTA) is the most widely used bioceramic in endodontics. Recently, many new bioceramics have been developed, showing good potential for the treatment of endodontic diseases. This paper reviews the characteristics of bioceramics and their applications in various clinical endodontic situations, including root-end filling, root canal therapy, vital pulp therapy, apexification/regenerative endodontic treatment, perforation repair, and root defect repair. Relevant literature published from 1993 to 2023 was searched by keywords in PubMed and Web of Science. Current evidence supports the predictable outcome of MTA in the treatment of endodontic diseases. Although novel bioceramics such as Biodentine, EndoSequence, and calcium-enriched mixtures have shown promising clinical outcomes, more well-controlled clinical trials are still needed to provide high-level evidence for their application in endodontics. In addition, to better tackle the clinical challenges in endodontics, efforts are needed to improve the bioactivity of bioceramics, particularly to enhance their antimicrobial activity and mechanical properties and reduce their setting time and solubility.
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Gong, Ting, Boon Chin Heng, Edward Chin Man Lo, and Chengfei Zhang. "Current Advance and Future Prospects of Tissue Engineering Approach to Dentin/Pulp Regenerative Therapy." Stem Cells International 2016 (2016): 1–13. http://dx.doi.org/10.1155/2016/9204574.
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Recent advances in biomaterial science and tissue engineering technology have greatly spurred the development of regenerative endodontics. This has led to a paradigm shift in endodontic treatment from simply filling the root canal systems with biologically inert materials to restoring the infected dental pulp with functional replacement tissues. Currently, cell transplantation has gained increasing attention as a scientifically valid method for dentin-pulp complex regeneration. This multidisciplinary approach which involves the interplay of three key elements of tissue engineering—stem cells, scaffolds, and signaling molecules—has produced an impressive number of favorable outcomes in preclinical animal studies. Nevertheless, many practical hurdles need to be overcome prior to its application in clinical settings. Apart from the potential health risks of immunological rejection and pathogenic transmission, the lack of a well-established banking system for the isolation and storage of dental-derived stem cells is the most pressing issue that awaits resolution and the properties of supportive scaffold materials vary across different studies and remain inconsistent. This review critically examines the classic triad of tissue engineering utilized in current regenerative endodontics and summarizes the possible techniques developed for dentin/pulp regeneration.
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Syeda Abeerah Tanveer, Zainab Haji, and Robia Ghafoor. "Clinical applications and novel approaches in stem cell: an insight to dental pulp regeneration." Journal of the Pakistan Medical Association 73, no. 2 (2023): S40—S46. http://dx.doi.org/10.47391/jpma.akus-07.
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Objectives: The aim of the review is to present the currently applied tissue regeneration through stem cells technology in regenerative endodontics. This review also summarises the various preclinical models used for the evaluation of stem cell-based therapies, their limitations, recent advances and challenges related to clinical applications of human stem cells. Methodology: A literature survey from 2010 to August 2022 was carried out in various electronic databases to identify the articles required for review on Pulp Regeneration through Stem Cells Technology. MeSH terms/keywords such as “Pulp regeneration,” “Pulp Revascularization,” “Pulp revitalization,” “Regenerative Endodontics” were used to search in the electronic databases comprised of PubMed database, SCOPUS, COCHRANRE library, EMBASE, CINAHL, ICTRP, Science Direct and a manual search was also done using the cross references and textbooks. Results: The searches revealed 299 articles. After reading the full text articles and applying the inclusion and exclusion criteria 15 articles were selected for the review fulfilling the criteria of the study. Conclusion: Currently in regenerative endodontics, there is a broad consent that the final tissue acquired is more likely to bone-like tissue mixed with connective tissue rather than the pulp-dentin complex. Moreover, re-innervation from sensory axons in regenerated tissue, is still to date, difficult to achieve. Keywords: Endodontics, Biocompatible, Pulp, Stem Cells, Tissue, Dentin, Axons
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Matoug-Elwerfelli, M., H. Nazzal, M. Duggal, and R. El-Gendy. "What the future holds for regenerative endodontics: novel antimicrobials and regenerative strategies." European Cells and Materials 41 (June 25, 2021): 811–33. http://dx.doi.org/10.22203/ecm.v041a51.
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Regenerative/revitalisation endodontic techniques are increasingly used as a treatment approach for the management of immature permanent teeth with necrotic pulps. Different chemical irrigants and medicaments are routinely used clinically for intra-canal disinfection. However, despite remarkable progress in this field, coronal discolouration, cell cytotoxicity, difficulty of removal of organic biofilm from the root canal, development of sensitisation and antimicrobial resistance are still challenges to this line of treatment. This review critically discusses and challenges the current status quo of antimicrobials used in regenerative endodontics and sheds the light on future alternative antimicrobial materials with regenerative potential.
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Dorterler, Ozgul C., Berre Akgun, Mehlika Alper, and Fatma Ayhan. "Improving Antimicrobial Properties of GelMA Biocomposite Hydrogels for Regenerative Endodontic Treatment." Polymers 16, no. 12 (2024): 1675. http://dx.doi.org/10.3390/polym16121675.
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Regenerative endodontics is a developing field involving the restoration of tooth structure and re-vitality of necrotic pulp. One of the most critical clinical considerations for regenerative endodontic procedures is the disinfection of the root canal system, since infection interferes with regeneration, repair, and stem cell activity. In this study, we aimed to provide the synthesis of injectable biopolymeric tissue scaffolds that can be used in routine clinical and regenerative endodontic treatment procedures using Gelatin methacryloyl (GelMA), and to test the antimicrobial efficacy of Gelatin methacryloyl/Silver nanoparticles (GelMA/AgNP), Gelatin methacryloyl/Hyaluronic acid (GelMA/HYA), and Gelatin methacryloyl/hydroxyapatite (GelMA/HA) composite hydrogels against microorganisms that are often encountered in stubborn infections in endodontic microbiology. Injectable biocomposite hydrogels exhibiting effective antimicrobial activity and non-cytotoxic behavior were successfully synthesized. This is also promising for clinical applications of regenerative endodontic procedures with hydrogels, which are proposed based on the collected data. The GelMA hydrogel loaded with hyaluronic acid showed the highest efficacy against Enterococcus faecalis, one of the stubborn bacteria in the root canal. The GelMA hydrogel loaded with hydroxyapatite also showed a significant effect against Candida albicans, which is another bacteria responsible for stubborn infections in the root canal.
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Kong, Qingyue, Yujie Wang, Nan Jiang, et al. "Exosomes as Promising Therapeutic Tools for Regenerative Endodontic Therapy." Biomolecules 14, no. 3 (2024): 330. http://dx.doi.org/10.3390/biom14030330.
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Pulpitis is a common and frequent disease in dental clinics. Although vital pulp therapy and root canal treatment can stop the progression of inflammation, they do not allow for genuine structural regeneration and functional reconstruction of the pulp–dentin complex. In recent years, with the development of tissue engineering and regenerative medicine, research on stem cell-based regenerative endodontic therapy (RET) has achieved satisfactory preliminary results, significantly enhancing its clinical translational prospects. As one of the crucial paracrine effectors, the roles and functions of exosomes in pulp–dentin complex regeneration have gained considerable attention. Due to their advantages of cost-effectiveness, extensive sources, favorable biocompatibility, and high safety, exosomes are considered promising therapeutic tools to promote dental pulp regeneration. Accordingly, in this article, we first focus on the biological properties of exosomes, including their biogenesis, uptake, isolation, and characterization. Then, from the perspectives of cell proliferation, migration, odontogenesis, angiogenesis, and neurogenesis, we aim to reveal the roles and mechanisms of exosomes involved in regenerative endodontics. Lastly, immense efforts are made to illustrate the clinical strategies and influencing factors of exosomes applied in dental pulp regeneration, such as types of parental cells, culture conditions of parent cells, exosome concentrations, and scaffold materials, in an attempt to lay a solid foundation for exploring and facilitating the therapeutic strategy of exosome-based regenerative endodontic procedures.
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Ivica, A., M. Zehnder, and FE Weber. "Therapeutic potential of mesenchymal stem cell-derived extracellular vesicles in regenerative endodontics." European Cells and Materials 41 (March 3, 2021): 233–44. http://dx.doi.org/10.22203/ecm.v041a17.
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Regenerative endodontic procedures are an alternative to conventional root-canal treatment and apexification. There are two different tissue engineering approaches that are currently followed, both aiming at the colonisation of the cleaned pulp space by pluripotent cells and subsequent pulp regeneration. Firstly, the transplantation of mesenchymal stem cells (MSCs), and secondly a cell-free strategy that relies on bioactive molecules to trigger the recruitment of the patient’s own cells. The first approach is hampered by costs and regulatory issues. Despite great initial enthusiasm with a clinically used cell-free approach that relies on induced bleeding into the pulp space, results have been revealed to be rather unpredictable, and mere repair rather than regeneration of the pulp-dentin complex is what is typically achieved. Moreover, the extent of further root development is variable, and the concept is limited to immature teeth. This article discusses a third possible way of regenerative endodontics that involves the application of MSC-derived exosomes. These are extracellular vesicles that contain proteins, lipids, and nucleic acids, reflecting the secretome of MSCs. Based on the first in vitro and in vivo studies, exosomes appear to be a potent tool to improve pulp regeneration. This narrative review aims to investigate the therapeutic use of human MSCs or dental pulp-derived exosomes in regenerative endodontics. Furthermore, the focus of this review is on targeting important questions that should be investigated in future in-vivo and clinical studies, such as the choice of scaffold material for exosome delivery into the pulp space.
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Sreedev, CP, K. Karthick, Sebeena Mathew, and Iswarya Raju. "Regenerative endodontics: An overview." Journal of Indian Academy of Dental Specialist Researchers 4, no. 1 (2017): 18. http://dx.doi.org/10.4103/jiadsr.jiadsr_16_17.
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Smith, Anthony J., and Paul R. Cooper. "Regenerative Endodontics: Burning Questions." Journal of Endodontics 43, no. 9 (2017): S1—S6. http://dx.doi.org/10.1016/j.joen.2017.06.002.
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Clark, Stephen J. "Summary of: Regenerative endodontics." British Dental Journal 216, no. 6 (2014): 356–57. http://dx.doi.org/10.1038/sj.bdj.2014.225.
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Abdellatif, Dina, Alfredo Iandolo, Giuseppina De Benedetto, et al. "Pulp regeneration treatment using different bioactive materials in permanent teeth of pediatric subjects." Journal of Conservative Dentistry and Endodontics 27, no. 5 (2024): 458–84. http://dx.doi.org/10.4103/jcde.jcde_140_24.
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Background and Objectives: The present systematic review aims to assess the success rate of the pulp regeneration treatment, according to the American Association of Endodontists (AAE) criteria, using different bioactive materials in permanent teeth of pediatric subjects (6–17 years of age). Materials and Methods: The study protocol was registered on PROSPERO and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. The question formulation was accomplished using the PICO model, and an electronic search was carried out on Scopus, MEDLINE/PubMed, Web of Science, and Cochrane databases till April 1, 2023. A total of 30 studies were established to fulfill the inclusion criteria of this systematic review. Results: A total of 273 teeth have been treated with pulp regeneration treatment. By comparing different biomaterials and the success criteria defined by the AAE, the material associated with a higher success rate was found to be the white mineral trioxide aggregate. However, the overall success rate of pulp regeneration treatment was reported for 248 out of 273 teeth (91.20%). Conclusions: Data obtained support the potential that regenerative endodontics aids in continuing root development in permanent immature teeth. Further studies are needed for a more extensive evaluation of the use of different biomaterials and the success rate in regenerative endodontics.
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Khan, Mohammad Kamran, and Arjun Unnikrishnan. "Undesirable Aspects of Regenerative Endodontic Therapy and its Management in Pediatric Patients: A Comprehensive Review of Evidence-based Literature." Journal of Datta Meghe Institute of Medical Sciences University 20, no. 1 (2025): 30–37. https://doi.org/10.4103/jdmimsu.jdmimsu_641_24.
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Abstract Pediatric endodontics is evolving rapidly with the advent of newer scientifically sound endodontic procedures and materials/medicaments to preserve the affected teeth in children with growing phase. Regenerative endodontic therapy (RET) is one such procedure which has been reported to be a success in addressing the nonvital immature permanent teeth in pediatric patients. However, there is existing literature which have reported various unfavorable outcomes and drawbacks of RET procedures. However, there is no comprehensive review article present in the existing literature regarding this. Hence, there is a need of comprehensive review article describing the adverse effects and shortcomings of RET, and also their possible clinical solutions and dental management. The aim of this comprehensive review article was to unveil and highlight the current evidence-based literature about the aforementioned aspects of regenerative endodontics. The relevant literature was searched extensively using the suitable keywords/MeSH related to the topic in several electronic biomedical databases, i.e., PubMed, Cochrane, Lilacs, and Scielo along with manual/hand search in Google Scholar and subsequently, clinically important and relevant findings from the current evidence-based literature have been summarized under suitable headings/subheadings. Moreover, information about newer advancements and researches in this regard to improve the success outcomes has been described in this article. This review will be quite useful in disseminating the current literature-based information to dental clinicians and researchers about the aforementioned aspects of regenerative endodontics.
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Brizuela, C., George T. J. Huang, A. Diogenes, T. Botero, and M. Khoury. "The Four Pillars for Successful Regenerative Therapy in Endodontics: Stem Cells, Biomaterials, Growth Factors, and Their Synergistic Interactions." Stem Cells International 2022 (September 19, 2022): 1–17. http://dx.doi.org/10.1155/2022/1580842.
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Endodontics has made significant progress in regenerative approaches in recent years, thanks to advances in biologically based procedures or regenerative endodontic therapy (RET). In recent years, our profession has witnessed a clear conceptual shift in this therapy. RET was initially based on a blood clot induced by apical bleeding without harvesting the patient’s cells or cell-free RET. Later, the RET encompassed the three principles of tissue engineering, stromal/stem cells, scaffolds, and growth factors, aiming for the regeneration of a functional dentin pulp complex. The regenerated dental pulp will recover the protective mechanisms including innate immunity, tertiary dentin formation, and pain sensitivity. This comprehensive review covers the basic knowledge and practical information for translational applications of stem cell-based RET and tissue engineering procedures for the regeneration of dental pulp. It will also provide overall information on the emerging technologies in biological and synthetic matrices, biomaterials, and signaling molecules, recent advances in stem cell therapy, and updated experimental results. This review brings useful and timely clinical evidence for practitioners to understand the challenges faced for a successful cell-based RET and the importance of preserving or reestablishing tooth vitality. The clinical translation of these current bioengineering approaches will undoubtedly be beneficial to the future practice of endodontics.
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Khan, Mohammad Kamran, Divya Sanjay Sharma, and Mahendra Kumar Jindal. "Laser Photobiomodulation as Noninvasive Therapeutic Modality in Pediatric Endodontics: A Comprehensive Review." Journal of the Scientific Society 51, no. 2 (2024): 147–52. http://dx.doi.org/10.4103/jss.jss_48_23.
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Endodontics is evolving with modern innovations for conservatively managing the various dental problems involving pulpal or periradicular tissue of primary and permanent teeth. Lasers have been reported with favorable clinical evidence, particularly in tackling the endodontic problems effectively. Recently, the application of lasers in the form of photobiomodulation therapy or low-level laser therapy has been reported in many recent scientific studies/researches with successful results. Hence, this narrative review critically appraise the existing scientific literature and highlights the photobiomodulation technique of lasers as noninvasive therapeutic modality in different pediatric endodontic therapies or procedures (direct pulp capping, pulpotomy, noninvasive treatment of periapical lesion, regenerative endodontics, postendodontic pain management, etc.).
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Valsan, Dhanya, ManojKumar Pulyodan, SunilParamel Mohan, Namitha Divakar, Shabna Moyin, and Shamsheer Thayyil. "Regenerative endodontics: A paradigm shift in clinical endodontics." Journal of Pharmacy And Bioallied Sciences 12, no. 5 (2020): 20. http://dx.doi.org/10.4103/jpbs.jpbs_112_20.
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Aljifan, Mohammad Khaled, Abdulrhman Ali Alshuwayi, Abdulaziz Saeed Almatrafi, et al. "The role of stem cell therapy in endodontics and its future." International Journal Of Community Medicine And Public Health 9, no. 2 (2022): 1029. http://dx.doi.org/10.18203/2394-6040.ijcmph20220074.
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Regenerative therapy has been introduced in the literature for a long time and is currently being practiced in different fields, including dentistry and endodontics. Many applications have been reported in the literature for stem cell therapy. However, many complications and adverse events were reported in this context. The present literature review sheds more light on the clinical applications of stem cell therapy in regenerative endodontics and the future perspectives in this field. There are no doubts that there are many questions to be answered despite the huge advances in this field. In response to tissue injury, it has been shown that stem cell therapy can strengthen the efficacy of physiological response to these events and improve tissue regeneration. They can be used for managing cases of reversible pulpitis. Moreover, evidence indicates that they can enhance the revascularization of necrotic pulp tissues. Accordingly, these outcomes can significantly change the perspectives of clinical endodontic practice, and current root canal management modalities and perhaps draws researchers into discovering further future applications for other currently untreatable conditions. However, further future investigations are still needed to understand more about the mechanisms of these modalities and improve their clinical applicability.
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Bucchi, Cristina, Alain Arias-Betancur, Nicolás Badilla-Wenzel, and Carlos Zaror. "The Impact of Orthodontic Treatment on Teeth Previously Treated with Regenerative Endodontics: A Systematic Review." Applied Sciences 14, no. 1 (2023): 210. http://dx.doi.org/10.3390/app14010210.
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Objective: To assess the tooth survival rates, adverse events, and need for further treatment of teeth previously treated with regenerative endodontics undergoing orthodontic treatment. Material and Methods: A literature search was performed using MEDLINE, EMBASE, Cochrane, Scopus, and Lilacs databases, grey literature, and endodontic journals, and the date of the last search was 20 April 2022. The included studies involved patients undergoing orthodontic treatment and at least one tooth that was previously treated with regenerative endodontics. A narrative synthesis of the findings was made. The risk of bias and evidence quality were assessed using the Effective Public Health Practice Project tool and the GRADE approach. Results: Five case reports included seven patients and eight teeth with a follow-up of 4 to 11 years. The overall risk of bias was high, and the certainty of evidence was very low. The survival rate was 87.5%. Adverse effects included sinus tracts, root resorption, symptomatology, apical periodontitis, and intracanal tissue necrosis. Five out of eight teeth required further intervention after orthodontics. Conclusions: A high prevalence of adverse effects and further intervention is observed in teeth treated with regenerative endodontics undergoing orthodontic treatment. The low quality of evidence highlights the need for comparative studies and evidence-based guidelines for managing these teeth during orthodontic treatment.
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Claudia, García-Guerrero, Mora-Pinza Tania, Quijano-Guauque Sara, Leal-Fernández Carolina, and Baldión-Elorza Paula. "Clinical, Histological, and Molecular Perspective on Regenerating Nonvital Immature Teeth." Contemporary Clinical Dentistry 14, no. 3 (2023): 220–26. http://dx.doi.org/10.4103/ccd.ccd_44_23.
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Abstract Background: Disinfection and dentin conditioning promote a favorable scenario for regenerative endodontic treatment. Clinical reports have confirmed periapical normality with high variability in disinfection protocols; nevertheless, the nature of neoformed tissue varied between them. Thus, this study aimed to present the impact of disinfection protocols on the clinical, histological, and molecular outcomes of regenerative endodontics procedures in permanent teeth with incomplete root formation. Materials and Methods: Eighteen teeth with incomplete root formation which required endodontic regenerative treatment were treated with different disinfection and conditioning agents and followed under clinical control. One case was evaluated under histological and immunohistochemical analyses. Results: Clinical outcomes revealed periapical repair in 17/18 cases. Histological and immunohistochemical analyses confirmed the neoformation of the dentinal matrix and its mineralization. Conclusions: Chemical conditioning could impact the outcome of regenerative endodontic procedures. The histological and immunohistochemical analysis showed the nature of the newly formed tissue that correlates with the clinical outcome.