Regenerative Endodontic Procedures: A Tissue Engineering Perspective

Abstract

Regenerative Endodontic Procedures (REP) are biologically based procedures designed to replace the damaged  dentin and root structures and cells of the pulp-dentin complex. The success of REP relies on incorporating three basic components: triad of tissue engineering  (growth factors, scaffold, and stem cells), disinfection of root canal spaces, and coronal seal. The stem cells proliferate and differentiate into desired cell types and synthesize matrices of new tissue. The scaffold mimics the matrix to be formed and provides the appropriate environment for stem cells until a new matrix is laid down. The growth factors are biomolecules that direct the entire process of regeneration. Regeneration of tissue is only possible in disinfected canal spaces achieved through irrigants and intracanal medicaments. An effective coronal seal maintains the disinfected environment and prevents re-infection of the root canal space. This review discusses the current knowledge of regenerative endodontics from a tissue engineering perspective. It summarizes the effects of multiple factors' on the result of regenerative endodontic procedures  to achieve more predictable results.