Regenerative potential of the dental pulp

Author(s): Trope, Martin DMD
Journal: Pediatric Dentistry
Volume (number): 30:3
Month, Year: May/June 2008
Major topic: Dental Pulp
Minor topic(s:
Type of Article: Case report
Main Purpose: To review the regenerative potential of the pulp
Overview of method of research: N/A
Findings: N/A
Key points/Summary : The author reviews how the revasularization of young permanent teeth is permitted due to the open apex, short root and intact but necrotic pulp tissue. New tissue is then easily able to migrate to the root canal system and has only a short distance to the pulp horns. Experiments have shown that the apical portion of the pulp may remain vital and proliferate towards the crown of the tooth replacing the necrotic coronal portion. This must happen quickly due to the fact that bacteria are always trying to invade the pulp space and if vital pulp tissue is present it slows this process. The necrotic tissue then acts as a scaffold into which new tissue grows. The author then proposes that if you are able to disinfect an infected pulp, artificially place a scaffold and effectively seal the access cavity you could create similar revascularization to an avulsed tooth. The case report he reviewed involved an immature second lower right premolar with radiographic and clinical signs of apical periodontitis with a sinus tract. They used 5.25% sodium hypochlorite to irrigate the canal and placed a mixture of ciprofloxin, metronidazole, and minocyline. A blood clot was produce at the CEJ and a double seal of MTA was placed in the cervical area followed by a bonded resin coronal restoration. The radiolucency disappeared within 2 months and at the 24 month recall the root walls were thick and similar to adjacent teeth. The author recommends trying this method on necrotic immature permanent teeth and if no results are noticed within 3 months more traditional treatment can be performed.
Assessment of article: Excellent article it would be great to try this in the clinic.