Special Issue "Regeneration and Repair in Endodontics"

A special issue of Dentistry Journal (ISSN 2304-6767).

Deadline for manuscript submissions: closed (31 December 2015).

Special Issue Editors

Prof. Dr. Louis M. Lin
E-Mail Website
Guest Editor
Department of Endodontics, New York University College of Dentistry, 345 East 24th Street, New York, NY 10010, USA
Interests: wound healing; programmed cell death; guided tissue regeneration; inflammation and stem cell function; endodontic biology
Prof. Dr. George T.-J. Huang
E-Mail Website
Co-Guest Editor
Director for Stem Cells and Regenerative Therapies, Department of Bioscience Research, College of Dentistry, University of Tennessee, Health Science Center Lab, Cancer Research Building 19 S. Manassas St. Lab Rm 225, office 222, Memphis, TN 38163, USA

Special Issue Information

Dear Colleagues,

Endodontics is a specialized discipline in dentistry that concerns the morphology, physiology, and pathology of the pulp-dentin complex, root, and peri-radicular tissues. These tissues possess various regeneration potentials when damaged. The discovery of dental stem cells in the past decade has helped researchers in this field to examine the regeneration and repair of these endodontic tissues from a new perspective. This Special Issue launches a comprehensive review covering the recent understanding of regeneration and repair of the dentin-pulp complex and the periapical tissues after injury, as well as the advancement in regenerative endodontic therapy. The following specific areas will be discussed: (i) cellular and molecular biology of wound healing concerning the mechanisms of regeneration and repair; (ii) the outcomes of various treatments of pulpal and periapical disease, including direct pulp capping, apexogenesis, apexification, root canal treatment and regenerative endodontic therapy in the context of regeneration and repair; (iii) the challenges and hopes of regeneration of the dentin-pulp complex in teeth with necrotic pulps; and (iv) recent advances in regenerative endodontic therapy of immature and mature teeth with infected or non-infected necrotic pulps.

Prof. Dr. Louis M. Lin
Prof. Dr. George T.-J. Huang
Guest Editor

Keywords

  • Pulp-dentin complex;
  • Apexogenesis;
  • Apexifiction;
  • Direct pulp capping;
  • Dental stem cells;
  • Regeneration;
  • Regenerative endodontic therapy;
  • Repair;
  • Wound healing;
  • Root canal therapy;
  • Periapical tissues;
  • Clinical outcome.

Published Papers (6 papers)

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Editorial

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Editorial
Regeneration and Repair in Endodontics—A Special Issue of the Dentistry Journal
Dent. J. 2015, 3(3), 77-78; https://doi.org/10.3390/dj3030077 - 19 Aug 2015
Cited by 1 | Viewed by 2515
Abstract
Endodontics is a specialized discipline in dentistry that concerns the morphology, physiology, and pathology of the pulp-dentin complex, root, and peri-radicular tissues. [...] Full article
(This article belongs to the Special Issue Regeneration and Repair in Endodontics)

Research

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Article
Attitudes towards Prosthodontic Clinical Decision-Making for Edentulous Patients among South West Deanery Dental Foundation Year One Dentists
Dent. J. 2016, 4(2), 12; https://doi.org/10.3390/dj4020012 - 10 May 2016
Cited by 2 | Viewed by 2784
Abstract
The aim of this study was to describe Dental Foundation year one dentists’ attitudes towards prosthodontic decision making for edentulous patients, and identify whether there are gender differences in these attitudes. All South West Deanery trainees were invited to take part in the [...] Read more.
The aim of this study was to describe Dental Foundation year one dentists’ attitudes towards prosthodontic decision making for edentulous patients, and identify whether there are gender differences in these attitudes. All South West Deanery trainees were invited to take part in the study between May and June 2011 and a previously piloted questionnaire was administered to the trainees by their training programme directors. The questionnaire posed questions based upon a clinical scenario of discussing treatment options with patients. Seventy-two questionnaires were used in the analysis (91% overall response rate). Trainees perceived their own values to be less important than the patient’s values (p < 0.001) in decision making, but similar to the patient’s friend’s/relative’s values (p = 0.1). In addition, the trainees perceived the patient’s values to be less important than their friend’s/relatives (p < 0.001). Sixty-six per cent of trainees acknowledged an influence from their own personal values on their presentation of material to patients who are in the process of choosing among different treatment options, and 87% thought their edentulous patients were satisfied with the decision making process when choosing among different treatment options. Fifty-eight per cent of trainees supported a strategy of negotiation between patients and clinicians (shared decision making). There was no strong evidence to suggest gender had an influence on the attitudes towards decision making. The finding of a consensus towards shared decision making in the attitudes of trainees, and no gender differences is encouraging and is supportive of UK dental schools’ ability to foster ethical and professional values among dentists. Full article
(This article belongs to the Special Issue Regeneration and Repair in Endodontics)
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Review

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Review
Dental Pulp Stem Cell Recruitment Signals within Injured Dental Pulp Tissue
Dent. J. 2016, 4(2), 8; https://doi.org/10.3390/dj4020008 - 25 Mar 2016
Cited by 16 | Viewed by 4199
Abstract
The recruitment of dental pulp stem cells (DPSC) is a prerequisite for the regeneration of dentin damaged by severe caries and/or mechanical injury. Understanding the complex process of DPSC recruitment will benefit future in situ tissue engineering applications based on the stimulation of [...] Read more.
The recruitment of dental pulp stem cells (DPSC) is a prerequisite for the regeneration of dentin damaged by severe caries and/or mechanical injury. Understanding the complex process of DPSC recruitment will benefit future in situ tissue engineering applications based on the stimulation of endogenous DPSC for dentin pulp regeneration. The current known mobilization signals and subsequent migration of DPSC towards the lesion site, which is influenced by the pulp inflammatory state and the application of pulp capping materials, are reviewed. The research outcome of migration studies may be affected by the applied methodology, which should thus be chosen with care. Both the advantages and disadvantages of commonly used assays for investigating DPSC migration are discussed. This review highlights the fact that DPSC recruitment is dependent not only on the soluble chemotactic signals, but also on their interaction with neighboring cells and the extracellular matrix, which can be modified under pathological conditions. These are discussed to explain how these modifications lead to the stimulation of DPSC recruitment. Full article
(This article belongs to the Special Issue Regeneration and Repair in Endodontics)
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Review
Infection and Pulp Regeneration
Dent. J. 2016, 4(1), 4; https://doi.org/10.3390/dj4010004 - 10 Mar 2016
Cited by 15 | Viewed by 4442
Abstract
The regeneration of the pulp-dentin complex has been a great challenge to both scientists and clinicians. Previous work has shown that the presence of prior infection may influence the characteristics of tissues formed in the root canal space after regenerative endodontic treatment. The [...] Read more.
The regeneration of the pulp-dentin complex has been a great challenge to both scientists and clinicians. Previous work has shown that the presence of prior infection may influence the characteristics of tissues formed in the root canal space after regenerative endodontic treatment. The formation of ectopic tissues such as periodontal ligament, bone, and cementum has been observed in the root canal space of immature necrotic teeth with apical periodontitis, while the regeneration of dentin and pulp has been identified in previously non-infected teeth. The current regenerative endodontic therapy utilizes disinfection protocols, which heavily rely on chemical irrigation using conventional disinfectants. From a microbiological point of view, the current protocols may not allow a sufficiently clean root canal microenvironment, which is critical for dentin and pulp regeneration. In this article, the significance of root canal disinfection in regenerating the pulp-dentin complex, the limitations of the current regenerative endodontic disinfection protocols, and advanced disinfection techniques designed to reduce the microorganisms and biofilms in chronic infection are discussed. Full article
(This article belongs to the Special Issue Regeneration and Repair in Endodontics)
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Review
Regeneration and Repair in Endodontics—A Special Issue of the Regenerative Endodontics—A New Era in Clinical Endodontics
Dent. J. 2016, 4(1), 3; https://doi.org/10.3390/dj4010003 - 27 Feb 2016
Cited by 19 | Viewed by 8193
Abstract
Caries is the most common cause of pulp-periapical disease. When the pulp tissue involved in caries becomes irreversibly inflamed and progresses to necrosis, the treatment option is root canal therapy because the infected or non-infected necrotic pulp tissue in the root canal system [...] Read more.
Caries is the most common cause of pulp-periapical disease. When the pulp tissue involved in caries becomes irreversibly inflamed and progresses to necrosis, the treatment option is root canal therapy because the infected or non-infected necrotic pulp tissue in the root canal system is not accessible to the host's innate and adaptive immune defense mechanisms and antimicrobial agents. Therefore, the infected or non-infected necrotic pulp tissue must be removed from the canal space by pulpectomy. As our knowledge in pulp biology advances, the concept of treatment of pulpal and periapical disease also changes. Endodontists have been looking for biologically based treatment procedures, which could promote regeneration or repair of the dentin-pulp complex destroyed by infection or trauma for several decades. After a long, extensive search in in vitro laboratory and in vivo preclinical animal experiments, the dental stem cells capable of regenerating the dentin-pulp complex were discovered. Consequently, the biological concept of ‘regenerative endodontics’ emerged and has highlighted the paradigm shift in the treatment of immature permanent teeth with necrotic pulps in clinical endodontics. Regenerative endodontics is defined as biologically based procedures designed to physiologically replace damaged tooth structures, including dentin and root structures, as well as the pulp-dentin complex. According to the American Association of Endodontists’ Clinical Considerations for a Regenerative Procedure, the primary goal of the regenerative procedure is the elimination of clinical symptoms and the resolution of apical periodontitis. Thickening of canal walls and continued root maturation is the secondary goal. Therefore, the primary goal of regenerative endodontics and traditional non-surgical root canal therapy is the same. The difference between non-surgical root canal therapy and regenerative endodontic therapy is that the disinfected root canals in the former therapy are filled with biocompatible foreign materials and the root canals in the latter therapy are filled with the host's own vital tissue. The purpose of this article is to review the potential of using regenerative endodontic therapy for human immature and mature permanent teeth with necrotic pulps and/or apical periodontitis, teeth with persistent apical periodontitis after root canal therapy, traumatized teeth with external inflammatory root resorption, and avulsed teeth in terms of elimination of clinical symptoms and resolution of apical periodontitis. Full article
(This article belongs to the Special Issue Regeneration and Repair in Endodontics)
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Review
Dentinogenic Specificity in the Preclinical Evaluation of Vital Pulp Treatment Strategies: A Critical Review
Dent. J. 2015, 3(4), 133-156; https://doi.org/10.3390/dj3040133 - 27 Nov 2015
Cited by 2 | Viewed by 2644
Abstract
Reviews on the clinical performance of vital pulp treatment strategies and capping materials repeatedly showed an insufficient grade of evidence concerning their therapeutic validity. The biological mechanisms underlying the regenerative potential of pulp-dentin complex have attracted much attention during the last two decades, [...] Read more.
Reviews on the clinical performance of vital pulp treatment strategies and capping materials repeatedly showed an insufficient grade of evidence concerning their therapeutic validity. The biological mechanisms underlying the regenerative potential of pulp-dentin complex have attracted much attention during the last two decades, since new pulp treatment modalities have been designed and tested at the preclinical level. It has been recognized that evaluation should be based on the specific ability of therapeutic interventions to signal recruitment and differentiation of odontoblast-like cells forming a matrix in a predentin-like pattern, rather than uncontrolled hard tissue deposition in a scar-like form. The aim of the present article was to critically review data from histological experimental studies on pulp capping, published during the last 7 decades. A comprehensive literature search covering the period from 1949 to 2015 was done using the Medline/Pubmed database. Inclusion of a study was dependent on having sufficient data regarding the type of capping material used and the unit of observation (human permanent tooth in vivo or animal permanent dentition; primary teeth were excluded). The post-operatively deposited matrix was categorized into three types: unspecified, osteotypic, or dentin-like matrix. One hundred fifty-two studies were included in the final evaluation. Data from the present systematic review have shown that only 30.2% of the 152 experimental histological pulp capping studies described the heterogenic nature of the hard tissue bridge formation, including osteotypic and tubular mineralized tissue. Structural characteristics of the new matrix and the associated formative cells were not provided by the remaining 106 studies. Analysis showed that more careful preclinical evaluation with emphasis on the evidence regarding the dentinogenic specificity of pulp therapies is required. It seems that selection of appropriate vital pulp treatment strategies and pulp capping materials would be further facilitated in terms of their therapeutic validity if international consensus could be reached on a select number of mandatory criteria for tissue-specific dentinogenic events. Full article
(This article belongs to the Special Issue Regeneration and Repair in Endodontics)
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