Dental & Oral Health

For many years, we have used regenerative endodontics procedure (REPs) in immature teeth with necrotic pulps and the results were impeccable as the clinical signs and symptoms were eliminated in addition to thickening of the canal walls or continued root development however the question or debate still remains whether we can used it also in mature teeth with necrotic pulp as an alternative to other kind of treatments, there has been many cases that used the (REPs) with a very promising results rendering REPs suitable treatment in some cases. REPs can repair or renovate the vitality of tissue in the canals of immature or mature permanent teeth previously destroyed by infection or trauma. The induction of periapical bleeding into the disinfected canal of immature or mature permanent teeth during REPs brings mesenchymal stem cells and likely growth factors (platelet-derived growth factor, platelet-derived endothelial growth factor, transforming growth factor and insulin like growth factor) mainly derived from platelets as well as fibrin scaffold from the periapical tissues into the canal space. The stem cells capable of producing mineralized tissue have migrated into the canals and formed hard tissue on the canal walls and at the root apex. Therefore, it is likely that new vital tissue might also be able to generate in the canals of human mature permanent teeth with necrotic pulps after REPs. REPs may become a feasible treatment for mature permanent teeth with infected or non-infected necrotic pulps which indicate that we still have not discovered all the possibilities of steam cells that should be taken in consideration.