The Role of Revascularization in Saving and Restoring Teeth – A Comprehensive Review

Abstract

Pulp regeneration may be defined as the replacement of damaged tissue by cells identical to the lost tissue, leading to the complete reestablishment of biological function. Using revascularization procedures to induce apexogenesis and subsequently tissue regeneration, instead of replacing tissue with artificial substitutes, is a relatively new therapeutic modality for young teeth with non-vital pulp Revascularization/revitalization therapy is based on the idea that tissue repair can take place similarly to devitalized, uninfected, avulsed, immature permanent teeth if there are no bacteria present, a suitable three-dimensional scaffold, stem/progenitor cells, and a bacteria-tight seal formed inside the root canal space.  When it comes to revascularization, three things need to be taken into account: (i) cleaning the root canal system; (ii) providing a scaffold; and (iii) coronal sealing. The root canal system is most frequently reported to be disinfected with an irrigation solution of sodium hypochlorite (NaOCl) and chlorhexidine, followed by an antimicrobial dressing calcium hydroixde (Ca(OH)2) or antibiotic paste). This review focuses on the current concepts on revascularization and procedures when performed under current protocols have reportedly achieved successful clinical and radiographical outcomes for immature permanent teeth with non-vital pulps and its efficacy as Regenerative Endodontic Procedure