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Review Article
Stem cell-derived exosomes for dentin-pulp complex regeneration: a mini-review
Dina A. Hammouda, Alaa M Mansour, Mahmoud A. Saeed, Ahmed R. Zaher, Mohammed E. Grawish
Restor Dent Endod 2023;48(2):e20.   Published online May 3, 2023
DOI: https://doi.org/10.5395/rde.2023.48.e20
AbstractAbstract PDFPubReaderePub

This mini-review was conducted to present an overview of the use of exosomes in regenerating the dentin-pulp complex (DPC). The PubMed and Scopus databases were searched for relevant articles published between January 1, 2013 and January 1, 2023. The findings of basic in vitro studies indicated that exosomes enhance the proliferation and migration of mesenchymal cells, as human dental pulp stem cells, via mitogen-activated protein kinases and Wingless-Int signaling pathways. In addition, they possess proangiogenic potential and contribute to neovascularization and capillary tube formation by promoting endothelial cell proliferation and migration of human umbilical vein endothelial cells. Likewise, they regulate the migration and differentiation of Schwann cells, facilitate the conversion of M1 pro-inflammatory macrophages to M2 anti-inflammatory phenotypes, and mediate immune suppression as they promote regulatory T cell conversion. Basic in vivo studies have indicated that exosomes triggered the regeneration of dentin-pulp–like tissue, and exosomes isolated under odontogenic circumstances are particularly strong inducers of tissue regeneration and stem cell differentiation. Exosomes are a promising regenerative tool for DPC in cases of small pulp exposure or for whole-pulp tissue regeneration.

Citations

Citations to this article as recorded by  
  • Cell Homing Strategies in Regenerative Endodontic Therapy
    David Kim, Sahng G. Kim
    Cells.2025; 14(3): 201.     CrossRef
  • Exosomes as Promising Therapeutic Tools for Regenerative Endodontic Therapy
    Qingyue Kong, Yujie Wang, Nan Jiang, Yifan Wang, Rui Wang, Xiaohan Hu, Jing Mao, Xin Shi
    Biomolecules.2024; 14(3): 330.     CrossRef
  • Role and Molecular Mechanism of miR-586 in the Differentiation of Dental Pulp Stem Cells into Odontoblast-like Cells
    Gang Pan, Qianwen Zhou, Chenhua Pan, Yingxue Zhang
    Cell Biochemistry and Biophysics.2024; 83(1): 507.     CrossRef
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Research Articles
Dentinal tubule penetration of sodium hypochlorite in root canals with and without mechanical preparation and different irrigant activation methods
Renata Aqel de Oliveira, Theodoro Weissheimer, Gabriel Barcelos Só, Ricardo Abreu da Rosa, Matheus Albino Souza, Rodrigo Gonçalves Ribeiro, Marcus Vinicius Reis Só
Restor Dent Endod 2023;48(1):e1.   Published online December 1, 2022
DOI: https://doi.org/10.5395/rde.2023.48.e1
AbstractAbstract PDFPubReaderePub
Objectives

This study evaluated the dentinal penetration depth of 2.5% sodium hypochlorite (NaOCl) in root canals with and without preparation and different irrigant activation protocols.

Materials and Methods

Sixty-three bovine mandibular incisors were randomly allocated to 6 groups (n = 10): G1, preparation + conventional needle irrigation (CNI); G2, preparation + passive ultrasonic irrigation (PUI); G3, preparation + Odous Clean (OC); G4, no preparation + CNI; G5, no preparation + PUI; G6, no preparation + OC; and CG (negative control; n = 3). Samples were filled with crystal violet for 72 hours. Irrigant activation was performed. Samples were sectioned perpendicularly along the long axis, 3 mm and 7 mm from the apex. Images of the root thirds of each block were captured with a stereomicroscope and analyzed with an image analysis software. One-way analysis of variance, followed by the Tukey post hoc test, and the Student’s t-test were used for data analysis, with a significance level of 5%.

Results

The NaOCl penetration depth was similar when preparation was performed, regardless of the method of irrigation activation (p > 0.05). In the groups without preparation, G6 showed greater NaOCl penetration depth (p < 0.05). The groups without preparation had a greater NaOCl penetration depth than those with preparation (p = 0.0019).

Conclusions

The NaOCl penetration depth was similar in groups with root canal preparation. Without root canal preparation, OC allowed deeper NaOCl penetration. The groups without preparation had greater NaOCl penetration than those undergoing root canal preparation.

Citations

Citations to this article as recorded by  
  • Impact of different activation procedures on sodium hypochlorite penetration into dentinal tubules after endodontic retreatment via confocal laser scanning microscopy
    Betul Gunes, Kübra Yeşildal Yeter, Yasin Altay
    BMC Oral Health.2024;[Epub]     CrossRef
  • Debridement ability of the WaveOne Gold and TruNatomy systems in the apical third of root canals: ex vivo assessment
    Sara Carvalho Avelar de Oliveira, Carlos Eduardo da Silveira Bueno, Rina Andréa Pelegrine, Carlos Eduardo Fontana, Alexandre Sigrist de Martin, Carolina Pessoa Stringheta
    Brazilian Dental Journal.2024;[Epub]     CrossRef
  • Combined effect of electrical energy and graphene oxide on Enterococcus faecalis biofilms
    Myung-Jin LEE, Mi-Ah KIM, Kyung-San MIN
    Dental Materials Journal.2023; 42(6): 844.     CrossRef
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Evaluation of blood clot, platelet-rich plasma, and platelet-rich fibrin–mediated regenerative endodontic procedures in teeth with periapical pathology: a CBCT study
Swati Markandey, Haridas Das Adhikari
Restor Dent Endod 2022;47(4):e41.   Published online October 21, 2022
DOI: https://doi.org/10.5395/rde.2022.47.e41
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Objectives

This study compared the clinical and radiological outcomes of regenerative endodontic procedures (REPs) using blood clots (BCs), platelet-rich plasma (PRP), and platelet-rich fibrin (PRF) through intraoral periapical radiography (IOPAR) and cone-beam computed tomography (CBCT).

Materials and Methods

Forty-five single-rooted necrotic teeth with periapical pathology were randomly allocated to receive BC, PRP, or PRF as an individual scaffold. Outcomes were evaluated in 35 teeth in 23 patients with a follow-up period of 12–24 months through qualitative IOPAR scoring and quantitative CBCT measurements. Healing of periapical lesions and in immature teeth, changes in the apical foramen diameter (AFD), root wall thickness (RWT), and root length (RL) were assessed. A p value less than 0.05 was considered to indicate statistical significance.

Results

All teeth were asymptomatic except 1 in the PRP group. Periapical lesion healing was seen in all except 2 teeth in the BC group and 3 in the PRP group. Both IOPAR and CBCT revealed no significant differences in bone healing or changes in AFD, RWT, and RL among the 3 groups. A positive pulp sensibility response to the cold test was seen in 2 teeth in the BC group, but none to the electric pulp test. Intracanal calcification (ICC) was evident in more teeth in the BC group than in the PRP and PRF groups, and was also significantly higher in immature teeth.

Conclusions

Our results revealed that BC, PRP, and PRF have similar potential as scaffolds in REPs, and ICC may be a concern for long-term outcomes.

Citations

Citations to this article as recorded by  
  • Regenerative potential of concentrated growth factor compared to platelet-rich fibrin in treatment of necrotic mature teeth: a randomized clinical trial
    Taghreed Salah, Wael Hussein, Heba Abdelkafy
    BDJ Open.2025;[Epub]     CrossRef
  • Biomimetic pulp scaffolds prepared from extracellular matrix derived from stem cells from human exfoliated deciduous teeth promote pulp–dentine complex regeneration
    Ning Yang, Rou Shen, Wenxiao Yang, Shengcai Zhang, Tianxing Gong, Yao Liu
    International Endodontic Journal.2024; 57(9): 1279.     CrossRef
  • Arrest and Repair of Inflammatory Root Resorption After an Endodontic Regeneration Procedure – A Hypothesis and Case Report
    Arieh Y. Kaufman, Bill Kahler
    Journal of Endodontics.2024; 50(12): 1743.     CrossRef
  • Effect of Platelet Rich Plasma in Regenerative Endodontic Treatment: A Review of Clinical Trials
    Hojat Rezazadeh, Mehrnaz Okhovatfard
    Research Journal of Pharmacy and Technology.2023; : 5562.     CrossRef
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Clinical and radiographic outcomes of regenerative endodontic treatment performed by endodontic postgraduate students: a retrospective study
Hadi Rajeh Alfahadi, Saad Al-Nazhan, Fawaz Hamad Alkazman, Nassr Al-Maflehi, Nada Al-Nazhan
Restor Dent Endod 2022;47(2):e24.   Published online May 9, 2022
DOI: https://doi.org/10.5395/rde.2022.47.e24
AbstractAbstract PDFPubReaderePub
Objectives

Regenerative endodontic treatment is a clinical procedure aimed at biologically regenerating damaged root canal tissue of immature permanent teeth. This study aimed to report the outcomes of regenerative endodontic treatment performed by endodontic postgraduate students.

Materials and Methods

Clinical and radiographic data of 27 patients, aged 10–22 years, who underwent regenerative treatment of immature permanent teeth from 2015 to 2019 were followed up, wherein clinical and radiographic examinations were performed for each patient. Postoperative success rate and tooth survival were analyzed, and the postoperative radiographic root area changes were quantified.

Results

A total of 23 patients attended the dental appointments, showing that all teeth survived and were asymptomatic. Specifically, 7 periapical pathosis cases were completely healed, 12 were incompletely healed, and 4 cases failed. Moreover, significant differences were found between discolored and non-discolored teeth, and between the presence or absence of periapical radiolucency. Additionally, 3 anterior teeth showed complete closure of the apical foramen, while the apical foramen width was reduced in 17 teeth and failed in 3 teeth. Root length was also found to have been increased in 7 anterior and 4 posterior teeth, and the average length ranged from 4.00–0.63 mm in the anterior teeth, 2.85–1.48 mm of the mesial root, and 2.73–2.16 mm of the molar teeth distal root. Furthermore, calcified tissue deposition was observed in 7 teeth.

Conclusions

A favorable outcome of regenerative endodontic treatment of immature permanent teeth with necrotic pulp was achieved with a high survival rate.

Citations

Citations to this article as recorded by  
  • Allogeneic Bone Marrow Mesenchymal Stromal Cell Transplantation Induces Dentin Pulp Complex-like Formation in Immature Teeth with Pulp Necrosis and Apical Periodontitis
    Jose Francisco Gomez-Sosa, José E. Cardier, Olga Wittig, Dylana Díaz-Solano, Eloisa Lara, Kharelys Duque, Giselle Ramos-González
    Journal of Endodontics.2024; 50(4): 483.     CrossRef
  • Radiographic assessment of dental post and core placement at different educational levels in an undergraduate student clinic: a 4-year retrospective study
    Turki Alshehri, Nourhan M. Aly, Raand Altayyar, Deena Alghamdi, Shahad Alotaibi, Passent Ellakany
    F1000Research.2024; 12: 976.     CrossRef
  • Evaluation of the efficacy of injectable platelet‐rich fibrin versus platelet‐rich plasma in the regeneration of traumatized necrotic immature maxillary anterior teeth: A randomized clinical trial
    Maha Mohamed Abo‐Heikal, Jealan M. El‐Shafei, Samia A. Shouman, Nehal N. Roshdy
    Dental Traumatology.2024; 40(1): 61.     CrossRef
  • Radiographical assessment of post and core placement errors encountered by Saudi dental students at different educational levels
    Turki Alshehri, Nourhan M. Aly, Raand Altayyar, Deena Alghamdi, Shahad Alotaibi, Passent Ellakany
    F1000Research.2023; 12: 976.     CrossRef
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Comparative analysis of bond strength to root dentin and compression of bioceramic cements used in regenerative endodontic procedures
Maykely Naara Morais Rodrigues, Kely Firmino Bruno, Ana Helena Gonçalves de Alencar, Julyana Dumas Santos Silva, Patrícia Correia de Siqueira, Daniel de Almeida Decurcio, Carlos Estrela
Restor Dent Endod 2021;46(4):e59.   Published online November 9, 2021
DOI: https://doi.org/10.5395/rde.2021.46.e59
AbstractAbstract PDFPubReaderePub
Objectives

This study compared the Biodentine, MTA Repair HP, and Bio-C Repair bioceramics in terms of bond strength to dentin, failure mode, and compression.

Materials and Methods

Fifty-four slices obtained from the cervical third of 18 single-rooted human mandibular premolars were randomly distributed (n = 18). After insertion of the bioceramic materials, the push-out test was performed. The failure mode was analyzed using stereomicroscopy. Another set of cylindrically-shaped bioceramic samples (n = 10) was prepared for compressive strength testing. The normality of data distribution was analyzed using the Shapiro-Wilk test. The Kruskal-Wallis and Friedman tests were used for the push-out test data, while compressive strength was analyzed with analysis of variance and the Tukey test, considering a significance level of 0.05.

Results

Biodentine presented a higher median bond strength value (14.79 MPa) than MTA Repair HP (8.84 MPa) and Bio-C Repair (3.48 MPa), with a significant difference only between Biodentine and Bio-C Repair. In the Biodentine group, the most frequent failure mode was mixed (61%), while in the MTA Repair HP and Bio-C Repair groups, it was adhesive (94% and 72%, respectively). Biodentine showed greater resistance to compression (29.59 ± 8.47 MPa) than MTA Repair HP (18.68 ± 7.40 MPa) and Bio-C Repair (19.96 ± 3.96 MPa) (p < 0.05).

Conclusions

Biodentine showed greater compressive strength than MTA Repair HP and Bio-C Repair, and greater bond strength than Bio-C Repair. The most frequent failure mode of Biodentine was mixed, while that of MTA Repair HP and Bio-C Repair was adhesive.

Citations

Citations to this article as recorded by  
  • Comparación de la resistencia compresiva entre el Agregado Trióxido Mineral y BiodentineTM en perforaciones de furca de molares inferiores permanentes
    Jheymy Gerardo Huatuco-Granda, John Paul Torres-Navarro, Rosa Josefina Roncal-Espinoza
    Revista Facultad de Odontología.2024;[Epub]     CrossRef
  • Effects of different calcium-silicate based materials on fracture resistance of immature permanent teeth with replacement root resorption and osteoclastogenesis
    Gabriela Leite de Souza, Gabrielle Alves Nunes Freitas, Maria Tereza Hordones Ribeiro, Nelly Xiomara Alvarado Lemus, Carlos José Soares, Camilla Christian Gomes Moura
    Restorative Dentistry & Endodontics.2023;[Epub]     CrossRef
  • Evaluation the Marginal Adaptation for the Bio C Repair and Other Root end Filling Material by Using Scanning Electron Microscope (A Comparative In Vitro Study)
    Fatimah HAMADHİ, Zainab M.
    Cumhuriyet Dental Journal.2023; 26(3): 261.     CrossRef
  • Dentin Bond Strength of Calcium Silicate-Based Materials: A Systematic Review of In Vitro Studies
    Natalia Radulica, José Luis Sanz, Adrián Lozano
    Applied Sciences.2023; 14(1): 104.     CrossRef
  • Evaluation Of The Push-out Bond Strength Of The Bio-C Repair And Compare It With The Mineral Trioxide Aggregate And Amalgam When Used As Root-end Filling Material
    Fatimah R. Hammadi, Zainab M Abdul-Ameer
    Dental Hypotheses.2023; 14(2): 62.     CrossRef
  • Effect of different root canal irrigants on push-out bond strength of two novel root-end filling materials
    Nada Omar, Rasha M. Abdelraouf, Tamer M. Hamdy
    BMC Oral Health.2023;[Epub]     CrossRef
  • Effect of irrigation systems on the bond strength of calcium-silicate-based cement used as pulp barrier in regenerative endodontic treatment
    Cihan Hascizmeci, Burak Buldur
    Journal of Adhesion Science and Technology.2023; 37(23): 3393.     CrossRef
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Effect of hydrogel-based antibiotic intracanal medicaments on crown discoloration
Rayan B. Yaghmoor, Jeffrey A. Platt, Kenneth J. Spolnik, Tien Min Gabriel Chu, Ghaeth H. Yassen
Restor Dent Endod 2021;46(4):e52.   Published online October 5, 2021
DOI: https://doi.org/10.5395/rde.2021.46.e52
AbstractAbstract PDFPubReaderePub
Objectives

This study evaluated the effects of low and moderate concentrations of triple antibiotic paste (TAP) and double antibiotic paste (DAP) loaded into a hydrogel system on crown discoloration and explored whether application of an adhesive bonding agent prevented crown discoloration.

Materials and Methods

Intact human molars (n = 160) were horizontally sectioned 1 mm apical to the cementoenamel junction. The crowns were randomized into 8 experimental groups (calcium hydroxide, Ca[OH]2; 1, 10, and 1,000 mg/mL TAP and DAP; and no medicament. The pulp chambers in half of the samples were coated with an adhesive bonding agent before receiving the intracanal medicament. Color changes (ΔE) were detected by spectrophotometry after 1 day, 1 week, and 4 weeks, and after 5,000 thermal cycles, with ΔE = 3.7 as a perceptible threshold. The 1-sample t-test was used to determine the significance of color changes relative to 3.7. Analysis of variance was used to evaluate the effects of treatment, adhesive, and time on color change, and the level of significance was p < 0.05.

Results

Ca(OH)2 and 1 and 10 mg/mL DAP did not cause clinically perceivable tooth discoloration. Adhesive agent use significantly decreased tooth discoloration in the 1,000 mg/mL TAP group up to 4 weeks. However, adhesive use did not significantly improve coronal discoloration after thermocycling when 1,000 mg/mL TAP was used.

Conclusions

Ca(OH)2 and 1 and 10 mg/mL DAP showed no clinical discoloration. Using an adhesive significantly improved coronal discoloration up to 4 weeks with 1,000 mg/mL TAP.

Citations

Citations to this article as recorded by  
  • Root Canal Dentin Microhardness after Contact with Antibiotic Medications: An In Vitro Study
    Amanda Palmeira Arruda Nogueira, Renata Grazziotin-Soares, Adriana Marques Mesquita Leal, Sérgio Alves Guida Freitas Júnior, Bruna Laís Lins Gonçalves, José Bauer, Meire Coelho Ferreira, Ceci Nunes Carvalho
    Dentistry Journal.2024; 12(7): 201.     CrossRef
  • Potential Crown Discoloration Induced by the Combination of Various Intracanal Medicaments and Scaffolds Applied in Regenerative Endodontic Therapy
    NB Altun, A Turkyilmaz
    Nigerian Journal of Clinical Practice.2024; 27(7): 897.     CrossRef
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  • 3 Web of Science
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A novel antimicrobial-containing nanocellulose scaffold for regenerative endodontics
Victoria Kichler, Lucas Soares Teixeira, Maick Meneguzzo Prado, Guilherme Colla, Daniela Peressoni Vieira Schuldt, Beatriz Serrato Coelho, Luismar Marques Porto, Josiane de Almeida
Restor Dent Endod 2021;46(2):e20.   Published online March 16, 2021
DOI: https://doi.org/10.5395/rde.2021.46.e20
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this study was to evaluate bacterial nanocellulose (BNC) membranes incorporated with antimicrobial agents regarding cytotoxicity in fibroblasts of the periodontal ligament (PDLF), antimicrobial activity, and inhibition of multispecies biofilm formation.

Materials and Methods

The tested BNC membranes were BNC + 1% clindamycin (BNC/CLI); BNC + 0.12% chlorhexidine (BNC/CHX); BNC + nitric oxide (BNC/NO); and conventional BNC (BNC; control). After PDLF culture, the BNC membranes were positioned in the wells and maintained for 24 hours. Cell viability was then evaluated using the MTS calorimetric test. Antimicrobial activity against Enterococcus faecalis, Actinomyces naeslundii, and Streptococcus sanguinis (S. sanguinis) was evaluated using the agar diffusion test. To assess the antibiofilm activity, BNC membranes were exposed for 24 hours to the mixed culture. After sonicating the BNC membranes to remove the remaining biofilm and plating the suspension on agar, the number of colony-forming units (CFU)/mL was determined. Data were analyzed by 1-way analysis of variance and the Tukey, Kruskal-Wallis, and Dunn tests (α = 5%).

Results

PDLF metabolic activity after contact with BNC/CHX, BNC/CLI, and BNC/NO was 35%, 61% and 97%, respectively, compared to BNC. BNC/NO showed biocompatibility similar to that of BNC (p = 0.78). BNC/CLI showed the largest inhibition halos, and was superior to the other BNC membranes against S. sanguinis (p < 0.05). The experimental BNC membranes inhibited biofilm formation, with about a 3-fold log CFU reduction compared to BNC (p < 0.05).

Conclusions

BNC/NO showed excellent biocompatibility and inhibited multispecies biofilm formation, similarly to BNC/CLI and BNC/CHX.

Citations

Citations to this article as recorded by  
  • Topic: Perspectives on Success and Failure of Endodontic Treatments
    Ilma Robo, Manola Kelmendi, Eva Habazaj, Kleves Elezi, Rialda Xhizdari, Nevila Alliu
    SN Comprehensive Clinical Medicine.2025;[Epub]     CrossRef
  • Prospective and applications of bacterial nanocellulose in dentistry
    Yasmin Alimardani, Esmaeel Mirzakhani, Fereshteh Ansari, Hadi Pourjafar, Nadia Sadeghi
    Cellulose.2024; 31(13): 7819.     CrossRef
  • Bacterial nanocelluloses as sustainable biomaterials for advanced wound healing and dressings
    Atefeh Zarepour, Bahar Gok, Yasemin Budama-Kilinc, Arezoo Khosravi, Siavash Iravani, Ali Zarrabi
    Journal of Materials Chemistry B.2024; 12(48): 12489.     CrossRef
  • Sulfated endospermic nanocellulose crystals prevent the transmission of SARS-CoV-2 and HIV-1
    Enrique Javier Carvajal-Barriga, Wendy Fitzgerald, Emilios K. Dimitriadis, Leonid Margolis, R. Douglas Fields
    Scientific Reports.2023;[Epub]     CrossRef
  • A Novel Approach for the Fabrication of 3D-Printed Dental Membrane Scaffolds including Antimicrobial Pomegranate Extract
    Hatice Karabulut, Songul Ulag, Basak Dalbayrak, Elif Arisan, Turgut Taskin, Mehmet Guncu, Burak Aksu, Alireza Valanezhad, Oguzhan Gunduz
    Pharmaceutics.2023; 15(3): 737.     CrossRef
  • Current advances of nanocellulose application in biomedical field
    M.Y. Leong, Y.L. Kong, M.Y. Harun, C.Y. Looi, W.F. Wong
    Carbohydrate Research.2023; 532: 108899.     CrossRef
  • Bacterial cellulose as a potential biopolymer in biomedical applications: a state-of-the-art review
    Prachi Shrivastav, Sheersha Pramanik, Gayatri Vaidya, Mohamed A. Abdelgawad, Mohammed M. Ghoneim, Ajeet Singh, Bassam M. Abualsoud, Larissa Souza Amaral, Mohammed A. S. Abourehab
    Journal of Materials Chemistry B.2022; 10(17): 3199.     CrossRef
  • Nanocelluloses as new generation materials: natural resources, structure-related properties, engineering nanostructures, and technical challenges
    Ahmed Barhoum, Vibhore K. Rastogi, Bhupender K. Mahur, Amit Rastogi, Fatehy M. Abdel-Haleem, Pieter Samyn
    Materials Today Chemistry.2022; 26: 101247.     CrossRef
  • The current natural/chemical materials and innovative technologies in periodontal diseases therapy and regeneration: A narrative review
    Peyman Esmaeili Fard Barzegar, Reza Ranjbar, Mohsen Yazdanian, Elahe Tahmasebi, Mostafa Alam, Kamyar Abbasi, Hamid Tebyaniyan, Keyvan Esmaeili Fard Barzegar
    Materials Today Communications.2022; 32: 104099.     CrossRef
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Case Reports
Pulp revascularization with and without platelet-rich plasma in two anterior teeth with horizontal radicular fractures: a case report
Edison Arango-Gómez, Javier Laureano Nino-Barrera, Gustavo Nino, Freddy Jordan, Henry Sossa-Rojas
Restor Dent Endod 2019;44(4):e35.   Published online August 20, 2019
DOI: https://doi.org/10.5395/rde.2019.44.e35
AbstractAbstract PDFPubReaderePub

Pulp revascularization is an alternative treatment in immature traumatized teeth with necrotic pulp. However, this procedure has not been reported in horizontal root fractures. This is a case report of a 9-year-old patient with multiple horizontal root fractures in 2 upper central incisors that were successfully treated with pulp revascularization. The patient presented for treatment 2 years after the initial trauma, and revascularization was attempted after the initial treatment with calcium hydroxide had failed. Prior to pulp revascularization, cone-beam computed tomography and autoradiograms demonstrated multiple horizontal fractures in the middle and apical thirds of the roots of the 2 affected teeth. Revascularization was performed in both teeth; platelet-rich plasma (PRP) was used in one tooth (#11) and the conventional method (blood clot) was used in the other tooth (#21). Clinical and radiographic follow-up over 4 years demonstrated pulp calcification in the PRP-treated tooth. Neither of the 2 teeth were lost, and the root canal calcification of tooth #11 was greater than that of tooth #21. This case suggests that PRP-based pulp revascularization may be an alternative for horizontal root fractures.

Citations

Citations to this article as recorded by  
  • Dental pulp mesenchymal stem cells-response to fibrin hydrogel reveals ITGA2 and MMPs expression
    David Tong, Stéphanie Gobert, Alicia Reuzeau, Jean-Christophe Farges, Marianne Leveque, Marie Bolon, Arthur Costantini, Marielle Pasdeloup, Jérôme Lafont, Maxime Ducret, Mourad Bekhouche
    Heliyon.2024; 10(13): e32891.     CrossRef
  • Pulp regeneration treatment using different bioactive materials in permanent teeth of pediatric subjects
    Dina Abdellatif, Alfredo Iandolo, Giuseppina De Benedetto, Francesco Giordano, Davide Mancino, Edouard Euvrard, Massimo Pisano
    Journal of Conservative Dentistry and Endodontics.2024; 27(5): 458.     CrossRef
  • Retreatment of a Failed Regenerative Endodontic Treatment in an Immature Tooth with a Horizontal Root Fracture: A Case Report
    Zaher Marjy, Iris Slutzky-Goldberg
    International Journal of Clinical Pediatric Dentistry.2024; 17(10): 1168.     CrossRef
  • The Impact of the Preferred Reporting Items for Case Reports in Endodontics (PRICE) 2020 Guidelines on the Reporting of Endodontic Case Reports
    Sofian Youssef, Phillip Tomson, Amir Reza Akbari, Natalie Archer, Fayjel Shah, Jasmeet Heran, Sunmeet Kandhari, Sandeep Pai, Shivakar Mehrotra, Joanna M Batt
    Cureus.2023;[Epub]     CrossRef
  • Evaluation of postoperative pain and healing following regenerative endodontics using platelet‐rich plasma versus conventional endodontic treatment in necrotic mature mandibular molars with chronic periapical periodontitis. A randomized clinical trial
    Yassmin Elsayed Ahmed, Geraldine Mohamed Ahmed, Angie Galal Ghoneim
    International Endodontic Journal.2023; 56(4): 404.     CrossRef
  • Regenerative endodontic procedures for two traumatized mature anterior teeth with transverse root fractures
    Jing Lu, Bill Kahler
    BMC Oral Health.2022;[Epub]     CrossRef
  • Are platelet concentrate scaffolds superior to traditional blood clot scaffolds in regeneration therapy of necrotic immature permanent teeth? A systematic review and meta-analysis
    Qianwei Tang, Hua Jin, Song Lin, Long Ma, Tingyu Tian, Xiurong Qin
    BMC Oral Health.2022;[Epub]     CrossRef
  • Platelet-Rich Fibrin Used as a Scaffold in Pulp Regeneration: Case Series
    Ceren ÇİMEN, Selin ŞEN, Elif ŞENAY, Tuğba BEZGİN
    Cumhuriyet Dental Journal.2021; 24(1): 113.     CrossRef
  • Plasma rico en plaquetas en Odontología: Revisión de la literatura
    Hugo Anthony Rosas Rozas, Hugo Leoncio Rosas Cisneros
    Yachay - Revista Científico Cultural.2021; 10(1): 536.     CrossRef
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Retreatment of failed regenerative endodontic of orthodontically treated immature permanent maxillary central incisor: a case report
Musaed Fahad Al-Tammami, Saad A. Al-Nazhan
Restor Dent Endod 2017;42(1):65-71.   Published online October 28, 2016
DOI: https://doi.org/10.5395/rde.2017.42.1.65
AbstractAbstract PDFPubReaderePub

A revascularization procedure was shown to be the best alternative therapy for immature teeth with necrotic pulp and apical infection. A 12 year old female with a history of trauma to her upper central incisor and a sinus tract was referred for endodontic treatment. She was an active orthodontic patient and had undergone regenerative endodontic treatment for the past 2 years. Clinical examination revealed no response to sensibility, percussion, and palpation tests. The preoperative radiograph showed an open apex and apical rarefaction. The case was diagnosed as previously treated tooth with asymptomatic apical periodontitis. Regenerative endodontic retreatment was performed, and the case was followed for 3 years. Clinical, radiographic, and cone-beam computed tomography follow-up examination revealed an asymptomatic tooth, with evidence of periapical healing and root maturation.

Citations

Citations to this article as recorded by  
  • Revascularization of Non-Vital, Immature, Permanent Teeth with Two Bioceramic Cements: A Randomized Controlled Trial
    Alaa Shaker, Mohamed Salem Rekab, Mohammad Alharissy, Naji Kharouf
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    Danning Zhao, Kun Xue, Jiayuan Meng, Meijing Hu, Fei Bi, Xuelian Tan
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    Renato Lenzi, Sandra R Hernández, Flávio R F Alves, Isabela N Ro[Combining Circumflex Accent]c[COMBINING CEDILLA]as, Jose[Combining Acute Accent] F Siqueira
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    Enes Mustafa AŞAR, Murat Selim BOTSALI
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    Hadi Rajeh Alfahadi, Saad Al-Nazhan, Fawaz Hamad Alkazman, Nassr Al-Maflehi, Nada Al-Nazhan
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  • Histologic, Radiographic, and Micro-Computed Tomography Evaluation of Experimentally Enlarged Root Apices in Dog Teeth with Apical Periodontitis after Regenerative Treatment
    Mohammed S. Alenazy, Saad Al-Nazhan, Hezekiah A Mosadomi
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    Ali Nosrat, Behnam Bolhari, Shima Saber Tahan, Omid Dianat, Paul Michael Howell Dummer
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    Waleed Almutairi, Ghaeth H. Yassen, Anita Aminoshariae, Kristin A. Williams, Andre Mickel
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  • Alternative to Avoid Tooth Discoloration after Regenerative Endodontic Procedure: A Systematic Review
    Luciane Geanini Pena dos Santos, Luiz Alexandre Chisini, Camila Guerner Springmann, Beatriz Dulcineia Mendes de Souza, Fernanda Geraldo Pappen, Flávio Fernando Demarco, Mara Cristina Santos Felippe, Wilson Tadeu Felippe
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Research Articles
Biocompatibility of two experimental scaffolds for regenerative endodontics
Dephne Jack Xin Leong, Frank C. Setzer, Martin Trope, Bekir Karabucak
Restor Dent Endod 2016;41(2):98-105.   Published online March 28, 2016
DOI: https://doi.org/10.5395/rde.2016.41.2.98
AbstractAbstract PDFPubReaderePub
Objectives

The biocompatibility of two experimental scaffolds for potential use in revascularization or pulp regeneration was evaluated.

Materials and Methods

One resilient lyophilized collagen scaffold (COLL), releasing metronidazole and clindamycin, was compared to an experimental injectable poly(lactic-co-glycolic) acid scaffold (PLGA), releasing clindamycin. Human dental pulp stem cells (hDPSCs) were seeded at densities of 1.0 × 104, 2.5 × 104, and 5.0 × 104. The cells were investigated by light microscopy (cell morphology), MTT assay (cell proliferation) and a cytokine (IL-8) ELISA test (biocompatibility).

Results

Under microscope, the morphology of cells coincubated for 7 days with the scaffolds appeared healthy with COLL. Cells in contact with PLGA showed signs of degeneration and apoptosis. MTT assay showed that at 5.0 × 104 hDPSCs, COLL demonstrated significantly higher cell proliferation rates than cells in media only (control, p < 0.01) or cells co-incubated with PLGA (p < 0.01). In ELISA test, no significant differences were observed between cells with media only and COLL at 1, 3, and 6 days. Cells incubated with PLGA expressed significantly higher IL-8 than the control at all time points (p < 0.01) and compared to COLL after 1 and 3 days (p < 0.01).

Conclusions

The COLL showed superior biocompatibility and thus may be suitable for endodontic regeneration purposes.

Citations

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    M. Collado-González, M. P. Pecci-Lloret, D. García-Bernal, S. Aznar-Cervantes, R. E. Oñate-Sánchez, J. M. Moraleda, J. L. Cenis, F. J. Rodríguez-Lozano
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    Valérie Orti, Pierre-Yves Collart-Dutilleul, Sofía Piglionico, Orsolya Pall, Frédéric Cuisinier, Ivan Panayotov
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    Huiru Zou, Guanhua Wang, Fang Song, Xudong Shi
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Effect of dentin treatment on proliferation and differentiation of human dental pulp stem cells
Minjeong Park, Nan-Sim Pang, Il-Young Jung
Restor Dent Endod 2015;40(4):290-298.   Published online September 23, 2015
DOI: https://doi.org/10.5395/rde.2015.40.4.290
AbstractAbstract PDFPubReaderePub
Objectives

Sodium hypochlorite (NaOCl) is an excellent bactericidal agent, but it is detrimental to stem cell survival, whereas intracanal medicaments such as calcium hydroxide (Ca[OH]2) promote the survival and proliferation of stem cells. This study evaluated the effect of sequential NaOCl and Ca[OH]2 application on the attachment and differentiation of dental pulp stem cells (DPSCs).

Materials and Methods

DPSCs were obtained from human third molars. All dentin specimens were treated with 5.25% NaOCl for 30 min. DPSCs were seeded on the dentin specimens and processed with additional 1 mg/mL Ca[OH]2, 17% ethylenediaminetetraacetic acid (EDTA) treatment, file instrumentation, or a combination of these methods. After 7 day of culture, we examined DPSC morphology using scanning electron microscopy and determined the cell survival rate with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. We measured cell adhesion gene expression levels after 4 day of culture and odontogenic differentiation gene expression levels after 4 wk using quantitative real-time polymerase chain reaction.

Results

DPSCs did not attach to the dentin in the NaOCl-treated group. The gene expression levels of fibronectin-1 and secreted phosphoprotein-1 gene in both the Ca[OH]2- and the EDTA-treated groups were significantly higher than those in the other groups. All Ca[OH]2-treated groups showed higher expression levels of dentin matrix protein-1 than that of the control. The dentin sialophosphoprotein level was significantly higher in the groups treated with both Ca[OH]2 and EDTA.

Conclusions

The application of Ca[OH]2 and additional treatment such as EDTA or instrumentation promoted the attachment and differentiation of DPSCs after NaOCl treatment.

Citations

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Review Articles
A review of the regenerative endodontic treatment procedure
Bin-Na Lee, Jong-Wook Moon, Hoon-Sang Chang, In-Nam Hwang, Won-Mann Oh, Yun-Chan Hwang
Restor Dent Endod 2015;40(3):179-187.   Published online March 16, 2015
DOI: https://doi.org/10.5395/rde.2015.40.3.179
AbstractAbstract PDFPubReaderePub

Traditionally, apexification has been used to treat immature permanent teeth that have lost pulp vitality. This technique promotes the formation of an apical barrier to close the open apex so that the filling materials can be confined to the root canal. Because tissue regeneration cannot be achieved with apexification, a new technique called regenerative endodontic treatment was presented recently to treat immature permanent teeth. Regenerative endodontic treatment is a treatment procedure designed to replace damaged pulp tissue with viable tissue which restores the normal function of the pulp-dentin structure. After regenerative endodontic treatment, continued root development and hard tissue deposition on the dentinal wall can occur under ideal circumstances. However, it is difficult to predict the result of regenerative endodontic treatment. Therefore, the purpose of this study was to summarize multiple factors effects on the result of regenerative endodontic treatment in order to achieve more predictable results. In this study, we investigated the features of regenerative endodontic treatment in comparison with those of other pulp treatment procedures and analyzed the factors that have an effect on regenerative endodontic treatment.

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Platelet rich fibrin - a novel acumen into regenerative endodontic therapy
Kavita Hotwani, Krishna Sharma
Restor Dent Endod 2014;39(1):1-6.   Published online January 20, 2014
DOI: https://doi.org/10.5395/rde.2014.39.1.1
AbstractAbstract PDFPubReaderePub

Research into regenerative dentistry has added impetus onto the field of molecular biology. It can be documented as a prototype shift in the therapeutic armamentarium for dental disease. Regenerative endodontic procedures are widely being added to the current armamentarium of pulp therapy procedures. The regenerative potential of platelets has been deliberated. A new family of platelet concentrates called the platelet rich fibrin (PRF) has been recently used by several investigators and has shown application in diverse disciplines of dentistry. This paper is intended to add light on the various prospects of PRF and clinical insights to regenerative endodontic therapy.

Citations

Citations to this article as recorded by  
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    Journal of Conservative Dentistry and Endodontics.2024; 27(5): 458.     CrossRef
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    V. V. Medvediev, N. P. Oleksenko, L. D. Pichkur, S. A. Verbovska, S. I. Savosko, N. G. Draguntsova, Yu. A. Lontkovskyi, V. V. Vaslovych, V. I. Tsymbalyuk
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  • Advanced Platelet-rich Fibrin-mediated Regeneration of Necrotic Immature Permanent Teeth: A Clinico-radiographic Observational Study
    Ashi Chug, Sagrika Shukla, Tulika Wakhloo, Mridul Dhar
    International Journal of Clinical Pediatric Dentistry.2022; 15(4): 402.     CrossRef
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    V. V. Medvediev, N. P. Oleksenko, L. D. Pichkur, S. A. Verbovska, S. I. Savosko, N. G. Draguntsova, Yu. A. Lontkovskiy, V. V. Vaslovych, V. I. Tsymbalyuk
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    Saumya Johri, Promila Verma, Aseem Prakash Tikku, Rhythm Bains, Neera Kohli
    Journal of Tissue Engineering and Regenerative Medicine.2022; 16(12): 1208.     CrossRef
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Case Report
Prevention of tooth discoloration associated with triple antibiotics
Bona Kim, Min-Ju Song, Su-Jung Shin, Jeong-Won Park
Restor Dent Endod 2012;37(2):119-122.   Published online May 18, 2012
DOI: https://doi.org/10.5395/rde.2012.37.2.119
AbstractAbstract PDFPubReaderePub

Regenerative endodontics has a potential to heal a partially necrotic pulp, which can be beneficial for the continued root development and strengthening of immature teeth. For this purpose, triple antibiotic mixture of ciprofloxacin, metronidazole, and minocycline was recommended as intracanal medicament in an attempt to disinfect the root canal system for revascularization of a tooth with a necrotic pulp. However, discoloration of the tooth was reported after applying this. This case shows the idea for preventing the tooth discoloration using a delivery syringe (SW-O-01, Shinwoo dental) to avoid the contact between the clinical crown and the antibiotics.

Citations

Citations to this article as recorded by  
  • Non-surgical Management of a Large Periapical Lesion: A Case Study of the Successful Application of a Modified Triple Antibacterial Paste
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    N Velmurugan
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  • Treatment of non-vital immature teeth with amoxicillin-containing triple antibiotic paste resulting in apexification
    Hyon-Beom Park, Bin-Na Lee, Yun-Chan Hwang, In-Nam Hwang, Won-Mann Oh, Hoon-Sang Chang
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