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From Endodontic Therapy to Regenerative Endodontics: New Wine in Old Bottles

Author(s):

Ghee Seong Lim, Mang Chek Wey*, Noor Hayati Azami, Nora Sakina Mohd Noor, May Nak Lau, Nazmul Haque, Vijayendran Govindasamy and Noor Hayaty Abu Kasim*  

Abstract:


The concept of regenerative endodontics wherein one can replace damaged pulp structures and recuperate the functionality in erstwhile necrotic and infected root canal systems has been a cutting-edge technology. Though the notion started as early as the 1960s even before the discovery of stem cells and regenerative medicine, it was in the 2000s, this procedure gained momentum. Ever since then, researchers continue to discover its essential benefit to immature teeth and its ability to overcome the caveats of endodontic therapy which is commonly known as root canal treatment. Further, through this therapy, one can redevelop root even in immature teeth with necrotic pulps which overall helps in maintaining skeletal and dental development. Past literature indicates that regenerative endodontic procedures seem to be successful especially when compared with other conventional techniques such as Mineral Trioxide Aggregate apexification. Besides, many clinicians have begun to apply regenerative endodontic procedures to mature teeth in adult patients with several clinical case reports that have shown complete resolution of signs and symptoms of pulp necrosis. Generally, three most desirable outcomes anticipated by clinicians from this procedure namely resolution of clinical signs and symptoms, root maturation and redevelopment of neurogenesis process. Despite this, whether these objectives and true regeneration of the pulp/dentin complex are achieved is still a question mark. Following the discovery that regenerative endodontics indeed is a stem cell-based treatment, addressing the fundamental issue surrounding stem cells might assist in achieving all identified clinical outcomes, while favoring tissue formation that closely resembles pulp-dentin complex.

Keywords:

Dental pulp stem cells, immature teeth, mature teeth, pulpectomy, pulpotomy, apexification

Affiliation:

Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Oral Biology and Biomedical Sciences, Faculty of Dentistry, MAHSA University, Selangor, Department of Research and Development, CryoCord Sdn Bhd, Bio-X Centre, Cyberjaya, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur



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