Regeneration of Pulp-Dentin Complex in a Tooth with Symptomatic Irreversible Pulpitis and Open Apex Using Regenerative Endodontic Procedures

Regenerative endodontic procedures are undertaken on permanent teeth with necrotic pulps and open apices in an attempt to resolve symptoms, to allow the continued development of the root(s), and to reestablish vitality. The available histologic analysis of these teeth has, in the majority of studies, shown that true regeneration of the pulp-dentin complex is not achieved. A recent investigation using an animal model outlined a procedure wherein pulpal amputation a few millimeters short of the apex followed by evoked bleeding allowed the complete regeneration of the normal pulp-dentin complex in immature vital teeth of ferrets. By implementation of this procedure, we report successful pulp regeneration outcome evidenced by continued root development and a positive response to pulp vitality tests in a maxillary central incisor with an open apex diagnosed with symptomatic irreversible pulpitis. these teeth compare favorably with apexification, appearing to elicit greater gains in both root width and root length4,5. Although there has been some debate as to the most appropriate terminology used to describe REP (ie, regeneration, revascularization, and revitalization)6,7, the few reports of histologic outcomes of REP on these teeth have mostly shown that true regeneration of the pulp-dentin complex does not occur. Instead, a mixture of fibrous and mineralized tissue is found within the pulp space without

Automated summary

Regenerative endodontic procedures aim to restore root development and vitality in certain teeth, although true regeneration of the pulp-dentin complex has not been achieved in most studies. An animal model study demonstrated successful regeneration of the normal pulp-dentin complex in immature teeth through a specific procedure, suggesting potential for further research and improvements in regenerative endodontics.