Clinical Perspectives of Pulp Regeneration.

Schmalz, Gottfried; Widbiller, Matthias; Galler, Kerstin M (2020). Clinical Perspectives of Pulp Regeneration. Journal of endodontics, 46(9S), S161-S174. Elsevier 10.1016/j.joen.2020.06.037

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INTRODUCTION

A sound and vital pulp is an essential prerequisite for long-term tooth survival and preservation. However, current endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by a synthetic biomaterial. Recently, total or partial pulp regeneration has been proposed as an alternative treatment concept. The aim of this review was to evaluate the current options of pulp treatment and regenerative approaches, both for immature and mature teeth, in a clinical context.

METHODS

Clinical success rates of classic treatment options such as pulpotomy or root canal filling after pulpectomy or the removal of necrotic tissue are compared with recent reports on regenerative approaches like revitalization or partial and total pulp regeneration.

RESULTS

Revitalization in immature teeth with pulp necrosis is an additional treatment option besides placing an apical plug, leading to clinically acceptable outcomes, although with low predictability regarding the completion of root formation. Coronal regeneration of the amputated pulp in immature teeth constitutes a promising scientific approach, but data from clinical studies are missing. Mature teeth display a reduced potential for regeneration. Regenerative procedures using cell transplantation or cell homing are mainly in the experimental phase with only 2 clinical studies on cell transplantation. In parallel to the further development of regenerative therapies, the classification of pulp diseases should be revised, and the diagnostic tools need improvement.

CONCLUSIONS

The rethinking of current concepts for biology-based treatments and improved diagnostic concepts might postpone the point of root canal filling depending on the clinical situation.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > School of Dental Medicine > Department of Periodontology

UniBE Contributor:

Schmalz, Gottfried Hans

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0099-2399

Publisher:

Elsevier

Language:

English

Submitter:

Doris Burri

Date Deposited:

25 Feb 2021 11:14

Last Modified:

25 Feb 2021 13:26

Publisher DOI:

10.1016/j.joen.2020.06.037

PubMed ID:

32950188

Uncontrolled Keywords:

Dental pulp necrosis pulpectomy pulpitis pulpotomy regenerative endodontics root canal obturation

BORIS DOI:

10.48350/152211

URI:

https://boris.unibe.ch/id/eprint/152211

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