04 February 2021

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Regenerative Endodontic Procedures: state of the art and clinical procedures

Authors:Barbara G. Nunez Torrijos, Gianluca Plotino, Simone Staffoli, Eugenio Pedullà, Maurizio Bossù, Gianluca Gambarini, Antonella Polimeni

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Calcium hydroxide apexification and Mineral Trioxide Aggregate (MTA) apexification are classical treatments for necrotic immature permanent teeth, but they still present some drawbacks. With both techniques, the root development is interrupted, compromising long-term prognosis of the tooth. New scientific literature has described a procedure that allows complete root development of these specific teeth.

This regenerative endodontic procedure (REP) proposes the use of a combination of antimicrobials and irrigants, no canal walls instrumentation, induced apical bleeding to form a blood clot and a tight seal into the root canal to promote healing.

MTA is the most used material to perform this seal, but updated guidelines advise the use of other bioactive endodontic cements that incorporate calcium and silicate in their compositions. They share most of their characteristics with MTA but claim to have fewer drawbacks with regards to manipulation and aesthetics.

The purpose of the present article is to review pertinent literature and to describe the clinical procedures protocol with its variations and their clinical application.