Regenerative Endodontic Procedures with Minced Pulp Tissue Graft in Mature Permanent Teeth: A Clinical study

Journal of Endodontics

Publication History:

Received May 22, 2024; Revised August 21, 2024; Accepted October 5, 2024; Published online October 12, 2024

Abstract

Introduction

Regenerative endodontic procedures (REPs) using cell-based approaches have emerged as novel treatment modalities. This clinical study aimed to present the outcomes and explore factors influencing REPs with minced pulp tissue (MP) grafts in a mature tooth.

Methods: Six healthy male patients aged 20-27 requiring non-surgical root canal treatment were enrolled in this study. MP tissue obtained from third molars was introduced into the instrumented, disinfected, and blood-filled root canal. The canal was sealed with bioceramic cement, and the coronal access cavity was restored. 

Results: Follow-ups for six cases ranged from 19 to 42 months. Radiographically, all the teeth showed favorable outcomes. Among the six teeth, two showed neither intracanal calcification nor recovery in sensibility tests, and one had no intracanal calcification with an inapplicable sensibility test evaluation. In two teeth, intracanal calcification was observed in the apical third; however, there was no recovery in the sensibility tests. One tooth exhibited intracanal calcification in the apical third and showed recovery in the sensibility tests. Considering these outcomes and clinical variables, the size of the apical foramen and the composition of the transplanted pulp tissue were identified as tentative influencing factors. 

Conclusions: This study on simplified cell-based therapy using autologous MP for pulp/dentin regeneration in adult teeth not only enhances our understanding of REPs but also suggests its potential as an alternative treatment option to conventional endodontic treatment.