Regenerative Endodontics by Cell homing-a review of recent clinical trials

Abstract

The conventional treatment for irreversibly inflamed or necrotic teeth is root canal treatment or apexification. As an alternative approach, regenerative endodontics aims to regenerate the damaged ‘‘pulp-like’’ tissue, which can preserve the teeth’ vitality and sensitivity while avoiding necrosis, offering solutions to overcome the limitations of conventional treatments. The main clinical benefit is root maturation. The ‘‘pulp-like’’ tissue does not refer to regenerated pulp tissue with an odontoblastic layer or the formation of pulp-dentin complexes. The cell homing technique is built on endogenous stem cells and their capacity to regenerate tissue. Its Regenerative Endodontic Procedures success criteria are defined by the American Association of Endodontists (AAE). The purpose of this article is to provide an overview of vital pulp tissue and various strategies to promote regeneration of damaged pulp tissue. The cell homing technique will be reviewed through clinical trials. Cell homing refers to the migration or infiltration of endogenous cells into the cite when stimulated by physiochemical or biological stimuli or by passive flow with a blood clot from the apical tissue. The local microenvironment is critical for the settlement, proliferation, and differentiation of the infiltrated cells to regenerate the damaged pulp tissue. Current possibilities and the limits of today’s cell homing therapy will be discussed.