![]() Herman was a pioneer in preserving the pulp tissue following amputation. Hermann published a case report of a vital-amputated dental pulp capped with Calxyl ( 10). The history of REPs can be traced back to 1952 when Dr. Regenerative endodontic procedures are defined as “biologically-based procedures aimed to replace damaged structures, including dentin and root structures, as well as cells of the pulp-dentin complex” ( 9). This explains why there has been an increasing interest in using regenerative endodontic procedures (REPs) to revitalize replacement pulp tissues in IPT following pulp necrosis to attempt to continue root development and to continue dentin deposition along the dentinal walls to make them thicker, stronger, and less prone to fracture. Because there is no vital dental pulp, root development has stopped and the dentinal walls will remain thin, fragile, and weak. Immature permanent teeth do not benefit from a traditional root canal treatment or apexification because although the infected and necrotic pulp tissues can be removed, the remaining dentinal walls are thin, fragile, and weak, making them prone to fracture. On the one hand, if an IPT becomes infected, the pulp has a strong resistance to disease and excellent self-healing capacity on the other hand, an infection can spread quickly and cause periapical periodontitis and in these cases to alleviate patient suffering, a root canal treatment or apexification should be performed ( 7). IPT also have a large vascularized intracanal dental pulp root canal space and open apical foramen. In addition, the dentine is weaker because the diameter of dentin tubules is large and the peritubule dentin and intertubule dentin are less mineralized ( 8). IPT are especially prone to fracture because the enamel and dentinal walls can be very thin and weak ( 7). This is because the dentinal walls can be very thin and if the tooth becomes fractured, it may not be restorable and the whole tooth is lost. ![]() Due to the fact that the root development of immature permanent teeth (IPT) is not complete, these teeth can be fragile and prone to fracture. Dental trauma can create many complications such as pulpitis, pulp necrosis, periapical periodontitis, root hypoplasia, root/alveolar bone resorption, tooth fracture, and shedding of a permanent tooth ( 5, 6). Dental trauma usually causes injuries to the enamel, dentin, pulp, periodontium, gingiva, and supporting bone structures ( 4). Therefore, the objective of this review is to compare the different approaches to REPs in case reports by highlighting their advantages and limitations.ĭental trauma can affect 7.4–58% of children aged 8–11 years old ( 1– 3). However, the effectiveness of REPs and the precise methods to successfully accomplish REPs are controversial. In an attempt to save IPT, there has been a growing interest among dentists to use regenerative endodontic procedures (REPs) to revitalize a replace dental pulp to continue root development and strengthen the dentinal walls to help prevent a subsequent loss of the tooth. ![]() As a consequence, IPT with thin dentinal walls can be prone to fracture and if a fracture occurs, the patient will likely suffer the loss of the tooth. ![]() Traditional endodontic root canal treatments and apexification cannot revitalize the necrotic pulp to revitalize the tooth to promote further root development. 3Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, ChinaĪfter dental trauma to immature permanent teeth (IPT), there can be pulpitis, necrotic, and periapical periodontitis, which will halt further root development.2School of Stomatology, Tongji Medical College, Hulazhong University of Science and Technology, Wuhan, China.1Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Caixia Zhou 1,2,3 † Zhenglin Yuan 1,2,3 † Hanxin Xu 1,2,3 Linrui Wu 1,2,3 Chun Xie 1,2,3 * Jiarong Liu 1,2,3 * ![]()
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