Pulp regeneration: Following the recommendations
Hernandez, Magali
Pulp regeneration: Following the recommendations - 2023.
20
Introduction: What if we changed our point of view? What if we approached endodontics from a biological perspective rather than a mechanistic one? What if, in the case of pulpal tissue necrosis, we were to consider an alternative to apexification therapies? Is pulp tissue regeneration now possible? Objective: Regenerative endodontic therapy (RET) aims to regenerate the pulp-dentin complex damaged by infection, trauma, or developmental anomaly of immature permanent teeth with necrotic pulp. The new intracanal tissue formation is expected to display pulp-like architecture and functions. There are two different approaches based on tissue engineering available for performing RET: cell-free CF-RET, which attempts to induce host endogenous cells or stem cells to migrate into the root canal for regeneration; and cell-based CB-RET, which introduces exogenously prepared cells or stem cells into the canal for regeneration. Materials and method: CB-RET is the basis of current protocols recommended by the American Association of Endodontists (AAE) and the European Society of Endodontology (ESE) for the treatment of necrotic immature permanent teeth, with or without LIPOE. In this article, after defining the above-mentioned concepts, we will describe the ESE protocol and discuss the key steps for “getting started with endodontic regeneration.” Conclusion: Each stage of the protocol must be carried out rigorously so as not to compromise the stages of the various biological processes involved. The practitioner must stay informed of advances in knowledge resulting from research and new protocols due to be published.
Pulp regeneration: Following the recommendations - 2023.
20
Introduction: What if we changed our point of view? What if we approached endodontics from a biological perspective rather than a mechanistic one? What if, in the case of pulpal tissue necrosis, we were to consider an alternative to apexification therapies? Is pulp tissue regeneration now possible? Objective: Regenerative endodontic therapy (RET) aims to regenerate the pulp-dentin complex damaged by infection, trauma, or developmental anomaly of immature permanent teeth with necrotic pulp. The new intracanal tissue formation is expected to display pulp-like architecture and functions. There are two different approaches based on tissue engineering available for performing RET: cell-free CF-RET, which attempts to induce host endogenous cells or stem cells to migrate into the root canal for regeneration; and cell-based CB-RET, which introduces exogenously prepared cells or stem cells into the canal for regeneration. Materials and method: CB-RET is the basis of current protocols recommended by the American Association of Endodontists (AAE) and the European Society of Endodontology (ESE) for the treatment of necrotic immature permanent teeth, with or without LIPOE. In this article, after defining the above-mentioned concepts, we will describe the ESE protocol and discuss the key steps for “getting started with endodontic regeneration.” Conclusion: Each stage of the protocol must be carried out rigorously so as not to compromise the stages of the various biological processes involved. The practitioner must stay informed of advances in knowledge resulting from research and new protocols due to be published.
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