Resource Centre for Rare Oral Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Dent Traumatol. 2012 Feb;28(1):13-8. doi: 10.1111/j.1600-9657.2011.01057.x. Epub 2011 Sep 20.
Regeneration (revitalization) of infected necrotic pulp tissue has been an important issue in endodontics for more than a decade. Based on a series of case reports, there appears to be evidence that new soft tissue can enter the root canal with a potential for subsequent hard tissue deposition resulting in a narrowing of the root canal. Very little is presently known about the exact nature of this tissue growing into the canal and how it may behave in the long term. In the case of regeneration of necrotic non-infected pulp tissue, a series of clinical and histological studies have shown that such events may take place in four variants: (i) Revascularization of the pulp with accelerated dentin formation leading to pulp canal obliteration. This event has a good long-term prognosis. (ii) Ingrowth of cementum and periodontal ligament (PDL). The long-term prognosis for this event is not known. (iii) Ingrowth of cementum, PDL, and bone. The long-term prognosis is only partly known, but cases developing an internal ankylosis have been described. (iv) Ingrowth of bone and bone marrow is a rare phenomenon and the long-term prognosis does not appear to be good. Based on current knowledge, expectations with respect to pulp regeneration (revitalization) of infected necrotic dental pulps are difficult to predict; more information than now available is needed before procedures for pulpal regeneration can be routinely recommended with a predictable long-term prognosis.
感染性坏死牙髓组织的再生（复兴）问题在牙髓学领域已经存在了十多年。基于一系列病例报告，似乎有证据表明，新的软组织可以进入根管，并且有可能随后发生硬组织沉积，从而导致根管变窄。目前对于这种组织进入根管的确切性质以及其在长期内的行为方式知之甚少。对于感染性非坏死牙髓组织的再生，一系列临床和组织学研究表明，这种情况可能以四种变体发生：（i）牙髓的血管再生成，伴随着加速的牙本质形成，导致牙髓管闭塞。这种情况具有良好的长期预后。（ii）牙骨质和牙周膜（PDL）的向内生长。对于这种情况的长期预后尚不清楚。（iii）牙骨质、PDL 和骨的向内生长。这种情况的长期预后只有部分已知，但已经描述了发展为内部粘连的病例。（iv）骨髓内骨的向内生长是一种罕见现象，长期预后似乎不佳。基于目前的知识，对于感染性坏死牙髓的牙髓再生（复兴）的预期很难预测；在可以常规推荐具有可预测的长期预后的牙髓再生程序之前，需要比现在更多的信息。
