Revascularization/Revitalization & Regeneration in Endodontics - Quo Vadis?

Abstract

Endodontics (Endodontology) is that branch of dentistry that deals with the morphology, physiology, and pathology of the human dental pulp and tooth-supporting peri-radicular tissues. Management of diseases of these tissues clinically and technically is often quite challenging due to the highly diverse anatomical nature of the pulpal space, and the ability of root canal procedures to remove the diseased pulp and permit healing of the supporting tissues. In a small percentage of teeth that require treatment, the formation of the apical root structure (Hertwigs Epithelial Root Sheath - HERS) may be incomplete (open apex) due to trauma or carious invasion of the pulp. In these situations alternative procedures have been identified, with the regeneration of a functional pulp tissue as optimal [1]. While optimal, there are no randomized clinical trials upon which to base treatment decisions [2]. Outcomes have been scanty at best with speculation as to success based on two-dimensional radiographic findings. Furthermore, clinical protocols are highly variable with claims being made by authors as to what is the best choice [3-8].