Scientific advances in the creation of restorative biomaterials, in vitro cell culture technology, tissue grafting, tissue engineering, molecular biology and the human genome project provide the basis for the introduction of new technologies into dentistry. Non-vital infected teeth have long been treated with root canal therapy (for mature root apex) and apexification (for immature root apex), or doomed to extraction. Although successful, current treatments fail to re-establish healthy pulp tissue in these teeth. But, what if the non-vital tooth could be made vital once again? That is the hope offered by regenerative endodontics, an emerging field focused on replacing traumatized and diseased pulp with functional pulp tissue. Restoration of vitality of non-vital tooth is based on tissue engineering and revascularization procedures.
Regenerative endodontic procedures can be defined as biologically based procedures designed to create and deliver tissues to replace diseased, missing and traumatized pulp-dentin complex. The science of regenerative endodontics has a long history dating back to 1952 when Dr. BW Hermann reported on the application of calcium hydroxide in a case report of vital pulp amputation. [1] Presently, two concepts exist in regenerative endodontics to treat non-vital infected teeth – one is the active pursuit of pulp-dentine regeneration to implant or regrow pulp (tissue engineering technology), and the other in which new living tissue is expected to form from the tissue present in the teeth itself, allowing continued root development (revascularization).
Tissue engineering can be defined as ‘an interdisciplinary field that applies the principles of engineering and life sciences toward the development of biological substitutes that restore, maintain, or improve tissue function.
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