Evolution of regenerative endodontic in young permanent teeth: a literature review

Abstract

Objective: to compare different protocols available for regenerative endodontic. Methodology: articles published between 2001 and 2021 were searched on the database PubMed using the following keywords: “pulp revascularization” or “pulp revitalization” or “apexification”. Inclusion criteria were studies on humans, patients with immature permanent teeth with necrosis or irreversible pulpitis, a follow-up of at least 12 months, clearly described protocols and in English language. Results: The search produced 944 results. After applying the inclusion and exclusion criteria, only 35 were selected. 11 articles were added following a bibliographic review of the selected articles and a total of 46 cases were included. The success rate outcome for regenerative endodontic was of 80% observed in a total of 278 teeth. During irrigation, NaOCL was used in most of the cases with concentration varying from 0.5% to 6% and TAP has been the most used intracanal medication (32.7%). Periapical healing and resolution of the symptoms were observed in 95.7%, while apexogenesis was observed in 80.2%. Increase in root length reach 60%, root thickness 64.8% and apical closure 61,9%. Pulp vitality was found in 7.2% of the cases and discoloration in 29.5%. Conclusion: Regenerative endodontic showed signs of apexogenesis in most cases, and a pronounced increase in root thickness, root length and closure of the apex. Due to a high number of protocols and their heterogenicity, the superiority of one over the others cannot be established. More randomized clinical trials are needed to determine the most effective protocol.