EFFICACY OF REGENERATIVE ENDODONTIC TREATMENTS IN MATURE AND IMMATURE TEETH WITH PULP NECROSIS
DOI:
https://doi.org/10.36557/2674-8169.2025v7n1p1950-1966Keywords:
Dental pulp necrosis, Periapical Periodontitis, Regenerative endodonticsAbstract
Objectives: To evaluate the effectiveness of regenerative endodontic treatments (REPs) in mature and immature teeth with pulp necrosis and/or apical periodontitis and compare them to conventional endodontic treatment. Literature Review: This study is a literature review conducted between December 2024 and January 2025. The guiding question was: "Are regenerative endodontic procedures effective for treating necrotic teeth?" A search was conducted in the PubMed (U.S. National Library of Medicine) and BVS (Virtual Health Library) databases, covering the last 5 years. The search strategy was based on the combination of indexed descriptors in DeCS/MeSH: "Dental Pulp Necrosis," "Periapical Periodontitis," and "Regenerative Endodontics," combined with the Boolean operator "AND." Selection criteria included studies published in the last 5 years, related to the guiding question, with full text available in Portuguese, English, or Spanish, systematic reviews, meta-analyses, and randomized clinical trials. The initial search identified 183 articles, of which 7 were included in the study. Conclusion: Regenerative endodontic treatments (REPs) are effective for teeth with pulp necrosis, promoting healing and root development. While promising, they face challenges such as crown discoloration and limited organization of regenerated tissue.
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AGGARWAL, Vivek; MIGLANI, Sanjay; SINGLA, Mamta. Conventional apexification and revascularization induced maturogenesis of two non-vital, immature teeth in same patient: 24 months follow up of a case. Journal of Conservative Dentistry, v. 15, n. 1, p. 68-72, 2012.
ALAGL, Adel et al. Use of platelet-rich plasma for regeneration in non-vital immature permanent teeth: Clinical and cone-beam computed tomography evaluation. Journal of International Medical Research, v. 45, n. 2, p. 583-593, 2017.
ARSLAN, Hakan et al. Regenerative endodontic procedures in necrotic mature teeth with periapical radiolucencies: a preliminary randomized clinical study. Journal of endodontics, v. 45, n. 7, p. 863-872, 2019.
DARWISH, Omnia Badawy; AZIZ, Said Mohamed Abdel; SADEK, Hany Samy. Healing potentiality of blood clot, S-PRF and A-PRF as scaffold in treatment of non-vital mature single rooted teeth with chronic peri-apical periodontitis following regenerative endodontic therapy: randomized clinical trial. BMC Oral Health, v. 25, n. 1, p. 50, 2025.
DAWOOD, Alaa E. et al. Calcium silicate‐based cements: composition, properties, and clinical applications. Journal of investigative and clinical dentistry, v. 8, n. 2, p. e12195, 2017.
DEL FABBRO, Massimo et al. Autologous platelet concentrates for pulp and dentin regeneration: a literature review of animal studies. Journal of endodontics, v. 42, n. 2, p. 250-257, 2016.
DIOGENES, Anibal et al. An update on clinical regenerative endodontics. Endodontic topics, v. 28, n. 1, p. 2-23, 2013.
EL-KATEB, Noha Mohamed et al. Quantitative assessment of intracanal regenerated tissues after regenerative endodontic procedures in mature teeth using magnetic resonance imaging: a randomized controlled clinical trial. Journal of endodontics, v. 46, n. 5, p. 563-574, 2020.
GLYNIS, Antonios et al. Regenerative endodontic procedures for the treatment of necrotic mature teeth with apical periodontitis: a systematic review and meta-analysis of randomized controlled trials. Journal of Endodontics, v. 47, n. 6, p. 873-882, 2021.
HARGREAVES, Kenneth M.; DIOGENES, Anibal; TEIXEIRA, Fabricio B. Treatment options: biological basis of regenerative endodontic procedures. Pediatric dentistry, v. 35, n. 2, p. 129-140, 2013.
JHA, Preeti; VIRDI, Mandeep S.; NAIN, Suman. A regenerative approach for root canal treatment of mature permanent teeth: comparative evaluation with 18 months follow-up. International journal of clinical pediatric dentistry, v. 12, n. 3, p. 182, 2019.
KAVITHA, Mahendran et al. Comparative evaluation of platelet-rich fibrin and concentrated growth factor as Scaffolds in Regenerative Endodontic Procedure: a Randomized Controlled Clinical Trial. J Contemp Dent Pract, v. 23, n. 12, p. 1211-7, 2022.
KHADEMI, Abbas Ali et al. Outcomes of revascularization treatment in immature dog's teeth. Dental Traumatology, v. 30, n. 5, p. 374-379, 2014.
KOC, Simay; DEL FABBRO, Massimo. Does the etiology of pulp necrosis affect regenerative endodontic treatment outcomes? A systematic review and meta-analyses. Journal of Evidence Based Dental Practice, v. 20, n. 1, p. 101400, 2020.
KONTAKIOTIS, Evangelos G. et al. Regenerative endodontic therapy: a data analysis of clinical protocols. Journal of endodontics, v. 41, n. 2, p. 146-154, 2015.
LI, Jiahua et al. Treatment outcome of regenerative endodontic procedures for necrotic immature and mature permanent teeth: a systematic review and Meta-analysis based on randomised controlled trials. Oral Health Prev Dent, v. 21, n. 1, p. 141-52, 2023.
LOVELACE, Tyler W. et al. Evaluation of the delivery of mesenchymal stem cells into the root canal space of necrotic immature teeth after clinical regenerative endodontic procedure. Journal of endodontics, v. 37, n. 2, p. 133-138, 2011.
MARCIANO, Marina Angélica et al. Assessment of color stability of white mineral trioxide aggregate angelus and bismuth oxide in contact with tooth structure. Journal of Endodontics, v. 40, n. 8, p. 1235-1240, 2014.
METLERSKA, Joanna; FAGOGENI, Irini; NOWICKA, Alicja. Efficacy of autologous platelet concentrates in regenerative endodontic treatment: a systematic review of human studies. Journal of endodontics, v. 45, n. 1, p. 20-30. e1, 2019.
ONG, Teng Kai et al. Quantitative assessment of root development after regenerative endodontic therapy: a systematic review and meta-analysis. Journal of endodontics, v. 46, n. 12, p. 1856-1866. e2, 2020.
ÖSTBY, B. Nygaard. The role of the blood clot in endodontic therapy an experimental histologic study. Acta Odontologica Scandinavica, v. 19, n. 3-4, p. 323-353, 1961.
RAHUL, Morankar et al. Effect of intracanal scaffolds on the success outcomes of regenerative endodontic therapy-a systematic review and network meta-analysis. Journal of endodontics, v. 49, n. 2, p. 110-128, 2023.
RIZK, Hazim Mohamed; AL-DEEN, Mohamed Sherif Mohamed Salah; EMAM, Asmaa Aly. Comparative evaluation of Platelet Rich Plasma (PRP) versus Platelet Rich Fibrin (PRF) scaffolds in regenerative endodontic treatment of immature necrotic permanent maxillary central incisors: A double blinded randomized controlled trial. The Saudi Dental Journal, v. 32, n. 5, p. 224-231, 2020.
SABETI, Mohammad et al. Treatment outcomes of regenerative endodontic therapy in immature permanent teeth with pulpal necrosis: A systematic review and network meta‐analysis. International Endodontic Journal, v. 57, n. 3, p. 238-255, 2024.
SCHMALZ, Gottfried; WIDBILLER, Matthias; GALLER, Kerstin M. Clinical perspectives of pulp regeneration. Journal of endodontics, v. 46, n. 9, p. S161-S174, 2020.
TORABINEJAD, Mahmoud et al. Histologic examination of teeth with necrotic pulps and periapical lesions treated with 2 scaffolds: an animal investigation. Journal of endodontics, v. 41, n. 6, p. 846-852, 2015.
ULUSOY, Ayca Tuba et al. Evaluation of blood clot, platelet-rich plasma, platelet-rich fibrin, and platelet pellet as scaffolds in regenerative endodontic treatment: a prospective randomized trial. Journal of endodontics, v. 45, n. 5, p. 560-566, 2019.
WIKSTRÖM, A. et al. What is the best long-term treatment modality for immature permanent teeth with pulp necrosis and apical periodontitis?. European Archives of Paediatric Dentistry, v. 22, p. 311-340, 2021.
ZHOU, Ronghui et al. Radiographic, histologic, and biomechanical evaluation of combined application of platelet-rich fibrin with blood clot in regenerative endodontics. Journal of endodontics, v. 43, n. 12, p. 2034-2040, 2017.
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Copyright (c) 2025 Maria Eduarda Darigo Vasconcelos, Ana Karinne da Silva Ferreira, André Luiz Campos dos Santos, Antônio Marcos Barboza de Oliveira, Graziella Valda Oliveira Sousa Bôa-Morte, Ingrid Carla Mascarenhas Santos, João Henrique Martins Fernandes da Silva, Juliana Patrícia Barboza Santos, Raylana Vitória da Silva Vasconcelos, Renata Lira do Nascimento Fidelis, Rodrigo Cavalcante de Albuquerque Reis, Romaiana Máximo Rodrigues do Amaral, Samantha Soares de Paula, Vanessa Maria Alves da Silva Pereira Oliveira

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