Regenerative endodontic treatment: a clinical focus and review

Regenerative endodontic treatment (RET) has been described as a 'paradigm shift' in the treatment of immature teeth with pulp necrosis. It has been suggested that RET should be the first option for treating immature teeth when the roots are not yet fully developed. The European Society of Endodontology and the American Association of Endodontists have released position statements and clinical considerations for RET. Treatment modalities rely on the tissue engineering concept components stem cells, scaffolds and signalling molecules. Clinically, the treatment involves disinfection of, and often the introduction of a blood clot into, the root canal space. RET has three goals: 1) resolution of clinical signs and symptoms; 2) further root maturation; and 3) restoration of neurogenesis. To date, RET has been unable to establish a real regeneration of the pulp tissue and dentine space. Histologically, healing is achieved with repair from tissues derived primarily for the periodontal and osseous tissues such as bone-like tissue and cementum, rather than pulp tissue and odontoblasts. This review aims to present a clinical focus on RET and to provide a current view on this emerging clinical technique.