Journal
JOURNAL OF ENDODONTICS
Volume 49, Issue 8, Pages 1051-1057Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.joen.2023.05.017
Keywords
Dentin formation; regeneration; regenerative endodontic procedures; revascularization; tissue engineering
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This case report describes the histologic and electron microscopic characteristics of a patient who underwent regenerative endodontic procedure for a chronic apical abscess. The regenerated root tissue exhibited a structure similar to the native root structure, indicating the regenerative potential of cell-free regenerative endodontic procedures for teeth with pulp necrosis and chronic apical abscess.
Previous studies have reported successful clinical outcomes after regenerative endodontic procedures (REPs) for immature permanent teeth with pulpal infection. However, it remains unclear whether the procedures promote true regeneration or repair. This case report describes the histologic and electron microscopic characteristics of a human immature permanent premolar with a chronic apical abscess that was treated with an REP. Tooth #20 of a 9-year-old girl underwent an REP. At the 6-year follow-up, the patient was asymptomatic, and closure of the apex and thickening of the dentinal walls were observed. However, 16 years after the procedure, apical periodontitis recurred, necessitating apical surgery. The resected root fragments were obtained during the surgery and analyzed using micro-computed tomography, light microscopy, and scanning electron microscopy. Distinct dentinal tubules and interglobular dentin were observed in the regenerated hard tissue. Cementum-like tissue and a root canal were also observed in the apical fragment. The regenerated root tissue in this case exhibited a structure similar to the native root structure. Therefore, we believe that cell -free REPs possess regenerative potential for teeth diagnosed with pulp necrosis and chronic apical abscess. (J Endod 2023;49:1051-1057.)
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