Regeneration of the Dentine-Pulp Complex

A special issue of Cells (ISSN 2073-4409). This special issue belongs to the section "Stem Cells".

Deadline for manuscript submissions: closed (30 September 2020) | Viewed by 4099

Special Issue Editors


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Guest Editor
1. Department of Biomedical, Surgical, Dental Sciences, Università degli Studi di Milano, 20122 Milano, Italy
2. IRCCS Orthopedic Institute Galeazzi, 20161 Milano, Italy
Interests: tissue regeneration; bone healing; platelet-rich plasma; growth factors; oral surgery; periodontics; endodontics
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Guest Editor
Faculty of Dentistry, Universidad de La Frontera, 4811230 Temuco, Chile
Interests: pulp regeneration; stem cells; odontoblast-like differentiation; regenerative endodontics

Special Issue Information

Dear Colleagues,

Over the last two decades, the development of a biologically based treatment for immature necrotic teeth has opened an exciting new field of research in endodontics. Regenerative endodontic or revitalization is aimed at regenerating the form and function of pulp tissue and inducing further root development of the immature tooth to improve its prognosis. In vivo studies have shown satisfactory clinical outcomes with resolution of signs and symptoms, healing of periapical lesions, and root development in most cases, together with a positive response to vitality pulp testing in some cases. However, it is also known that the newly formed tissue after therapy is neither pulp nor dentine but an ectopic tissue similar to cementum or osteodentin, and an unorganized connective tissue that lacks cells with a distinct odontoblast phenotype.

The material used during the therapy, the cause of pulp necrosis, and the remaining infection in the root canal system and periapical tissues seem to play key roles in the lack of formation of tissues that resemble the original pulp and dentine, as well as in the clinical success of the therapy. However, since the early case reports published at the beginning of the 21st Century until now, much has been learned regarding the factors influencing the biological mechanisms and outcomes of the therapy.

Regenerative endodontics is now facing now the challenge of identifying all possible factors that hinder odontoblast-like differentiation and secretion of tubular dentin in vivo in order to plan the most effective therapeutic strategies. Likewise, it is necessary to identify unique molecular markers for the odontoblast phenotype to evaluate the type of tissue formed after the therapy with scientific certainty, and finally, to evaluate the feasibility of applying this treatment in mature necrotic teeth, which would benefit from the revascularization and recovery of the natural immune system of the pulp.

This Special Issue of Cells aims to provide a comprehensive global view of the current state of knowledge on the regeneration/repair of the pulp–dentin complex. Potential topics include, but are not limited to (i) cellular and molecular mechanisms related to the regeneration and repair of the pulp–dentin complex; (ii) the clinical outcomes of regenerative endodontics in immature necrotic teeth; (iii) the most recent advances in regenerative endodontic therapy for immature necrotic teeth; (iv) the application and outcomes of regenerative endodontics for mature necrotic teeth, having a special focus on aspects that might make the application of the therapy a greater clinical challenge in closed apex teeth; and (v) the challenges and future perspectives of regeneration of the dentin–pulp complex in teeth with necrotic pulp.

Researchers and university groups are invited to share relevant experimental, clinical, and review studies from both basic and translational sciences.

Prof. Massimo Del Fabbro
Dr. Cristina Bucchi
Guest Editors

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Keywords

  • regenerative endodontics
  • revitalization
  • pulp regeneration
  • necrotic teeth
  • tubular dentine
  • odontoblasts
  • pulp cells

Published Papers (1 paper)

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Review

17 pages, 2157 KiB  
Review
Effectiveness of Autologous Platelet Concentrates in Management of Young Immature Necrotic Permanent Teeth—A Systematic Review and Meta-Analysis
by Saurav Panda, Lora Mishra, Heber Isac Arbildo-Vega, Barbara Lapinska, Monika Lukomska-Szymanska, Shahnawaz Khijmatgar, Abhishek Parolia, Cristina Bucchi and Massimo Del Fabbro
Cells 2020, 9(10), 2241; https://doi.org/10.3390/cells9102241 - 07 Oct 2020
Cited by 23 | Viewed by 3624
Abstract
The use of autologous platelet concentrates (APCs) in regenerative endodontic procedures is inconsistent and unclear. The aim of this meta-analysis was to evaluate the effectiveness of autologous platelet concentrates compared to traditional blood-clot regeneration for the management of young, immature, necrotic, permanent teeth. [...] Read more.
The use of autologous platelet concentrates (APCs) in regenerative endodontic procedures is inconsistent and unclear. The aim of this meta-analysis was to evaluate the effectiveness of autologous platelet concentrates compared to traditional blood-clot regeneration for the management of young, immature, necrotic, permanent teeth. The digital databases MEDLINE, SCOPUS, CENTRAL, Web of Science, and EMBASE were searched to identify ten randomized clinical trials. The outcomes at postoperative follow-up, such as dentinal wall thickness (DWT), increase in root length (RL), calcific barrier formation (CB), apical closure (AC), vitality response (VR), and success rate (SR), were subjected to both qualitative synthesis and quantitative meta-analysis. The meta-analysis showed that APCs significantly improved apical closure (risk ratio (RR) = 1.17; 95% CI: 1.01, 1.37; p = 0.04) and response to vitality pulp tests (RR = 1.61; 95% CI: 1.03, 2.52; p = 0.04), whereas no significant effect was observed on root lengthening, dentin wall thickness, or success rate of immature, necrotic teeth treated with regenerative endodontics. APCs could be beneficial when treating young, immature, necrotic, permanent teeth regarding better apical closure and improved response to vitality tests. Full article
(This article belongs to the Special Issue Regeneration of the Dentine-Pulp Complex)
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