J Korean Acad Conserv Dent.  2010 Jul;35(4):238-245. 10.5395/JKACD.2010.35.4.238.

Pulp tissue regeneration and root formation of permanent teeth with pulpal/periapical deseases

• Yoo YJ
• Baek SH
• Son HH

• KMID: 2176376
• DOI: http://doi.org/10.5395/JKACD.2010.35.4.238

Abstract

Numerous cases about additional growth of roots or pulp tissue regeneration by using various intracanal medicaments in immature permanent teeth with periapical or pulpal disease have been reported. The underlying mechanism has not been clearly delineated, but it has been widely accepted that undifferentiated mesenchymal cells and stem cells are involved. Moreover, the growth and deposition of osteoid or cementoid tissues have been observed in regenerated pulp and roots. This new and non-invasive treatment has brightened the future of endodontics, and enlarged the vision of regenerative root canal treatment with multi-potent stem cells and various tissue engineering techniques.

Keyword

Revascularization; Pulp tissue regeneration; Root formation; Tri-antibiotic paste; Tissue engineering

MeSH Terms

Dental Pulp Cavity
Endodontics
Regeneration
Stem Cells
Tissue Engineering
Tooth
Vision, Ocular

Reference

1. Rafter M. Apexification: a review. Dental Traumatology. 2005. 21:1–8.

2. Bishop BG, Woollard GW. Modern endodontic therapy for an incompletely developed tooth. General Dentistry. 2002. 50:252–256.

3. Goldstein S, Sedaghat-Zandi A, Greenberg M, Friedman S. Apexification & apexogenesis. The New York State Dental Journal. 1999. 65:23–25.

4. Webber RT. Apexogenesis versus apexification. Dent Clin North Am. 1984. 28:669–697.

5. Iwaya SI, Ikawa M, Kubota M. Revascularization of an immature permanent tooth with apical periodontitis and sinus tract or/not. Dental Traumatology. 2001. 17:185–187.

6. Rafter M. Vital pulp therapy-a review. Journal of the Irish Dental Association. 2001. 47:115–121.

7. Gronthos S, Brahim J, Li W, et al. Stem cell properties of human dental pulp stem cells. J Dent Res. 2002. 81:531–535.

8. Chueh L-H, Huang GTJ. Immature teeth with periradicular periodontitis or abscess undergoing apexogenesis: a paradigm shift. J Endod. 2006. 32:1205–1213.

9. Banchs F, Trope M. Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod. 2004. 30:196–200.

10. Thibodeau B, Trope M. Pulp revascularization of a necrotic infected immature permanent tooth: case report and review of the literature. Pediatric Dentistry. 2007. 29:47–50.

11. Lieberman J, Trowbridge H. Apical closure of non vital permanent incisor teeth where no treatment was performed: case report. J Endod. 1983. 9:257–260.

12. Nevins A, Wrobel W, Valachovic R, Finkelstein F. Hard tissue induction into pulpless open-apex teeth using collagen-calcium phosphate gel. J Endod. 1977. 3:431–433.

13. Krebsbach P, Kuznetsov SA, Satomura K, Emmons RV, Rowe DW, Robey PG. Bone formation in vivo: comparison of osteogenesis by transplanted mouse and human marrow stromal fibroblasts. Transplantation. 1997. 63:1059–1069.

14. Gronthos S, Mankani M, Brahim J, Robey PG, Shi S. Postnatal human dental pulp stem cells (DPSCs) in vitro and in vivo. Proc Natl Acad Sci USA. 2000. 97:13625–13630.

15. Wang Q, Lin XJ, Lin ZY, Liu GX, Shan XL. Expression of vascular endothelial growth factor in dental pulp of immature and mature permanent teeth in human. Shanghai Kou Qiang Yi Xue. 2007. 16:285–289.

16. Nevins A, Finkelstein F, Laporta R, Borden BG. Induction of hard tissue into pulpless open apex teeth using collagen-calcium phosphate gel. J Endod. 1978. 4:76–81.

17. Nevins A, Wrobel W, Valachovic R, Finkelstein F. Hard tissue induction into pulpless open apex teeth using collagen-calcium phosphate gel. J Endod. 1977. 3:431–433.

18. Ellis E 3rd, Cox CF, Hitchcock R, Baker J. Vital apicoectomy of the teeth: a 1-4 week histopathological study in Macaca mulatta. J Oral Pathol. 1985. 14:718–732.

19. Hitchcock R, Ellis E 3rd, Cox CF. Intentional vital root transection: a 52-week histopathologic study in Macaca mulatta. Oral Surg Oral Med Oral Pathol. 1985. 60:2–14.

20. Wei X, Ling J, Wu L, Liu L, Xiao Y. Expression of mineralization markers in dental pulp cells. J Endod. 2007. 33:703–708.

21. Huang GT, Shagramanova K, Chan SW. Formation of odontoblast-like cells from cultured human dental pulp cells on dentin in vitro. J Endod. 2006. 32:1066–1073.

22. Ritter AL, Ritter AV, Murrah V, Sigurdsson A, Trope M. Pulp revascularization of replanted immature dog teeth after treatment with minocyline and doxycycline assessed by laser Doppler flowmetry, radiography, and histology. Dent Traumatol. 2004. 20:75–84.

23. Wang X, Thibodeau B, Trope M, Lin LM, Huang GTJ. Histologic Characterization of Regenerated Tissues in Canal Space after the Revitalization/Revascularization Procedure of Immature Dog Teeth with Apical Periodontitis. J Endod. 2010. 36:56–63.

24. Cooke C, Rowbotham TC. The closure of open apices in nonvital immature incisor teeth. British Dental Journal. 1988. 165:420–421.

25. Sonoyama W, Liu Y, Yamaza T, Tuan RS, Wang S, Shi S, et al. Characterization of the apical papilla and its residing stem cells from human immature permanent teeth: a pilot study. J Endod. 2008. 34:166–171.

26. Kaiser HJ. Management of wide open apex canals with calcium hydroxide. Presented at the 21st Annual Meeting of the American Association of Endodontists. April 17 1964; Washington DC.

27. Klein SH, Levy BA. Histologic evaluation of induced apical closure of a human pulpless tooth. Oral Surg. 1974. 38:954–959.

28. Schroder U, Granath L. Early reaction of intact human teeth to calcium hydroxide following experimental pulpotomy and its significance to the development of hard tissue barrier. Odontol Revy. 1971. 22:379–395.

29. Pisanti S, Sciaky I. Origin of calcium in the repair wall after pulp exposure in the dog. J Dent Res. 1964. 43:641–644.

30. Ghose LJ, Bagdady VS, Hikmat BYM. Apexification of immature apices of pulpless permanent anterior teeth with calcium hydroxide. J Endod. 1987. 13:285–290.

31. Baldassari-Cruz LA, Walton RE, Johnson WT. Scanning electron microscopy and histologic analysis of an apexification 'cap'. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998. 86:465–468.

32. Trope M. Treatmente of immature teeth with non-vital pulps and apical periodontitis. Endodontic Topics. 2006. 14:51–59.

33. Sim TP, Knowles JC, Ng YL, Shelton J, Gulabivala K. Effect of sodium hypochlorite on mechanical properties of dentine and tooth surface strain. Int Endod J. 2001. 34:120–132.

34. Driscoll CO, Dowker SE, Anderson P, Wilson RM, Gulabivala K. Effects of sodium hypochlorite solution on root dentine composition. J Mater Sci Mater Med. 2002. 13:219–223.

35. Grigoratos D, Knowles J, Ng Y-L, Gulabivala K. Effect of exposing dentin to sodium hypochlorite and calcium hydroxide on its flexural strength and elastic modulus. Int Endod J. 2001. 34:113–119.

36. Sato I, Ando-Kurihara N, Kota K, Iwaku M, Hoshino E. Sterilization of infected root-canal dentine by topical application of amixture of ciprofloxacin, metronidazole and minocycline in situ. Int Endod J. 1996. 29:118–124.

37. Hoshino E, Kurihara-Ando N, Sato I, Uematsu H, Sato M, Kota K, et al. In-vitro antibacterial susceptibility of bacteria taken from infected root dentine to a mixture of ciprofloxacin, metronidazole and minocycline. Int Endod J. 1996. 29:125–130.

38. Thibodeau B, Teixeira F, Yamauchi M, Caplan DJ, Trope M. Pulp revascularization of immature dog teeth with apical periodontitis. J Endod. 2007. 33:680–689.

39. Jung IY, Lee SJ, Hargreaves KM. Biologically based treatment of immature permanent teeth with pulpal necrosis; a case series. J Endod. 2008. 34:876–887.