Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
Curr Stem Cell Res Ther. 2021;16(5):577-588. doi: 10.2174/1574888X15999201116162256.
The concept of regenerative endodontics wherein one can replace damaged pulp structures and recuperate the functionality in erstwhile necrotic and infected root canal systems has been a cutting-edge technology. Though the notion started as early as the 1960s, even before the discovery of stem cells and regenerative medicine, it was in the 2000s that this procedure gained momentum. Ever since then, researchers continue to discover its essential benefit to immature teeth and its ability to overcome the caveats of endodontic therapy, which is commonly known as root canal treatment. Further, through this therapy, one can redevelop root even in immature teeth with necrotic pulps, which overall helps in maintaining skeletal and dental development. Past literature indicates that regenerative endodontic procedures seem to be successful, especially when compared with other conventional techniques such as Mineral Trioxide Aggregate apexification. Besides, many clinicians have begun to apply regenerative endodontic procedures to mature teeth in adult patients, with several clinical case reports that have shown complete resolution of signs and symptoms of pulp necrosis. Generally, the three most desirable outcomes anticipated by clinicians from this procedure include resolution of clinical signs and symptoms, root maturation and redevelopment of the neurogenesis process. Despite this, whether these objectives and true regeneration of the pulp/dentin complex are achieved is still a question mark. Following the discovery that regenerative endodontics indeed is a stem cell-based treatment, addressing the fundamental issue surrounding stem cells might assist in achieving all identified clinical outcomes while favoring tissue formation that closely resembles the pulp-dentin complex.
再生牙髓学的概念是指可以替换受损的牙髓结构，并恢复曾经坏死和感染的根管系统的功能，这是一项前沿技术。尽管这一概念早在 20 世纪 60 年代就已经提出，甚至早于干细胞和再生医学的发现，但直到 21 世纪，这项技术才开始得到发展。从那时起，研究人员不断发现其对未成熟牙齿的重要益处，以及克服根管治疗（通常称为根管治疗）的局限性的能力。此外，通过这种治疗，即使在牙髓坏死的未成熟牙齿中也可以重新发育牙根，这有助于维持骨骼和牙齿的发育。过去的文献表明，再生牙髓学治疗似乎是成功的，尤其是与矿化三氧化物凝聚体根尖成形术等其他传统技术相比。此外，许多临床医生已经开始将再生牙髓学治疗应用于成年患者的成熟牙齿，多项临床病例报告显示，牙髓坏死的迹象和症状已经完全消失。通常，临床医生期望从该治疗中获得的三个最理想的结果包括临床症状和体征的消除、牙根成熟和神经发生过程的重新发育。尽管如此，这些目标和牙髓/牙本质复合体的真正再生是否能够实现仍然是一个问号。随着人们发现再生牙髓学确实是一种基于干细胞的治疗方法，解决围绕干细胞的根本问题可能有助于实现所有已确定的临床结果，同时有利于组织形成，使其与牙髓/牙本质复合体非常相似。
