Pages: 10-17

Abstract

Regenerative endodontics (RET) has become a biologically based alternative to the traditional apexification procedure to treating immature permanent teeth with necrotic pulps. Various methods, such as absorption of vitality and absorption of vitality plus bone morphogenetic protein, can be performed using conventional approaches by attempting to co-culture stem cells, scaffold, and signalling molecules. This narrative review summarizes the latest development within the field of RET in the period between 2019 and 2025 with focus on advances in the biologics, scaffolding techniques, irrigants, and adjunctive modalities. Sources of stem cells, e.g. dental pulp stem cells, stem cells of the apical papilla, and stem cells derived from human exfoliated deciduous teeth also express a regenerative capacity. Platelet-rich plasma, platelet-rich fibrin, and synthetic hydrogels are characterized by consistent high success rate; none is better than the other. New adjuncts, including nanotechnology, photobiomodulation, and artificial intelligence, are improving the predictability of treatment and improving biological outcomes. Although promising developments have been reported, some issues need to be addressed, namely, microbial control, interpatient variability and protocol standardization. As clinical endodontics is rapidly evolving, endodontics has given way to a more natural and biologically superior treatment path towards successful tooth preservation.

Keywords: Endodontics, Regeneration, Randomized controlled trials, Dentistry

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