Disinfection in regenerative endodontics and effect of commonly used antimicrobials on stem cell fate: A comprehensive review

The endodontic management of necrotic immature permanent teeth is often challenging for the clinician. Regenerative endodontic treatment has emerged as an important alternative to the traditional apexification treatment in such cases. In regenerative endodontics, elimination of microbes from the root canal is important for the survival, proliferation, and differentiation of stem cells. Translational studies suggest that irrigants and medicaments used for root canal disinfection may adversely affect stem cells and ultimately, the regenerative outcome. Conventionally, irrigants and medicaments have been chosen for their maximum antimicrobial effect without considering their effects on stem cells and the dentinal microenvironment. In this review, advances in disinfection for regenerative endodontics are discussed.