Regeneration of the living pulp

Abstract

The regeneration of a living dental pulp is the ideal outcome for the treatment of necrotic immature permanent teeth. A living pulp enables completion of root formation, protective dentin formation in response to caries progression, influx of immune cells that can defend the host against bacterial infection, and nociceptive responses that can alert the patient when harmful conditions are present. However, the clinical translation of procedures for dental pulp regeneration in necrotic teeth faces important challenges. Cell-based approaches for dental pulp tissue regeneration have intrinsic safety issues (e.g., ex vivo handling of cells) that must be overcome before they can be used routinely in dental practices. On the other hand, cell-free approaches have not consistently resulted in complete regeneration of dental pulps throughout the entire root canal in necrotic human teeth, and therefore their clinical outcomes are still rather unpredictable. In this chapter, we will discuss the regenerative potential of the dental pulp in light of the development of clinically relevant approaches for generation of new pulps in the treatment of necrotic teeth.