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Regenerative endodontics can be defined as a group of procedures that use tissue engineering, gene therapy, and stem cell-based approaches to regenerate tissue in tooth cavities. One of the main advantages of dental pulp revitalization compared to traditional endodontic treatments is that, by maintaining living tissue in the tooth cavity, teeth retain their defensive, nutritional, and sensory abilities which can provide protection against potential infection. This review discusses the application of stem cells in dental pulp regeneration, with an emphasis on tissue engineering strategies. In particular, tissue engineered scaffolds, which can provide a supportive structure for stem cell growth, will be examined. We discuss characteristics of an ideal scaffold, the use of growth factors which can have an important impact on cell proliferation and differentiation, and current therapies based on tissue engineering for dental pulp revitalization. [ABSTRACT FROM AUTHOR]

Fused or gemmated teeth require complex and multi-faceted treatment to maintain their health, functionality, and appearance. The current paper describes the multidisdpHnaiy/minimally invasive treatment of fused immature permanent teeth. A 9-year-old-girl with an abnormally large left permanent maxillary lateral incisor was referred to the Paediatric Outpatient Clinic. The treatment plan of the referring orthodontist included the extraction of left maxillary lateral incisor, which was fused to a supernumerary tooth, followed by subsequent orthodontic and prosthetic treatments. In the paraclinic evaluation, cone-beam computed tomography (CBCT) showed two separate roots and two root canals, with communication between the pulp chambers of the double teeth. The modified treatment plan was to section the geminated tooth, remove the supernumerary and save the lateral incisor. During the sectioning procedure, the pulp of the remaining tooth was inevitably exposed. Direct pulp capping with Biodentine™ was performed. Next, glass-ionomer cement was applied as a temporary restoration and the supernumerary tooth was removed. The distal surface of the tooth was restored two weeks later so as to re¬establish the original shape of the lateral incisor. Clinical and radiographic control examinations revealed that the tooth was symptom-free. Follow-up appointments after 3,6,12 and 18 months included standard clinical examinations and sensivity tests including electric pulp testing, which showed a fully functional, healthy tooth with apical maturation. Careful clinical and radiographic evaluations/examinations are essential for determining the correct treatment of a double tooth. The proposed multidisciplinary and minimally invasive treatment of the double tooth using a bioactive cement may facilitate the maturation of immature teeth and result in a desirable aesthetics and function. [ABSTRACT FROM AUTHOR]

Introduction: Traumatic injuries to immature permanent teeth are one of the most recurrent and urgent emergency treatment cases in pediatric dental practice. In many instances, the protocol for responding to this kind of emergency is not correct, and is not performed in a timely manner. Delays in seeking treatment following a complicated crown fracture in young individuals can result in irreversible pulpitis or pulp necrosis. It can leave a wide-open apex and brittle dentinal walls that are unfavorable to manage with conventional endodontic treatment (apexification). Materials and methods: The present report describes the clinical case of a complicated crown fracture in young permanent central incisor, with 18 months of clinical and radiographic follow- up. The traumatized incisor was successfully treated using a coronal pulpotomy technique and tricalcium silicate cement - BiodentineTM. Results: The presented treatment approach provided elimination of the symptoms, an absence of pain episodes, and positive reactions to pulp sensitivity tests. The follow up radiological assessment revealed evidence of a dentin bridge formation and continuation of root maturation. Conclusions: Coronal pulpotomies using tricalcium silicate cement are quick and easy to perform, and unlike endodontic treatment, preserve the tooth structure for the reattached tooth fragment. The restorative technique, the reattachment of fractured tooth fragment, and tooth restoration with a composite resin, represents an aesthetic, functional approach, and is an excellent and easy restorative option for clinicians and young impatient patients. [ABSTRACT FROM AUTHOR]