International Journal of Growth Factors and Stem Cells in Dentistry

: 2018  |  Volume : 1  |  Issue : 2  |  Page : 47-

Current practices and research in regenerative endodontics: A brief summary

Thomas Anthony Montagnese 
 Associate Professor, Department of Endodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA

Correspondence Address:
Dr. Thomas Anthony Montagnese
1550 Cooper Foster Park Road West, Lorain, Ohio 44053

How to cite this article:
Montagnese TA. Current practices and research in regenerative endodontics: A brief summary.Int J Growth Factors Stem Cells Dent 2018;1:47-47

How to cite this URL:
Montagnese TA. Current practices and research in regenerative endodontics: A brief summary. Int J Growth Factors Stem Cells Dent [serial online] 2018 [cited 2023 Dec 1 ];1:47-47
Available from:

Full Text

Regenerative techniques are not new to endodontics. Procedures such as direct pulp capping, apexogenesis, and apexification use bioactive materials to stimulate growth factors to form hard tissue barriers or to allow for continued growth of pulp tissue.[1] These procedures have been done in the past without the intentional activation of growth factors to induce stem cells to form specific types of tissue.

At present, work is being done to “re-vascularize” the root canal system of immature teeth with necrotic pulps. The intention is to stimulate the formation of dentin and to allow the complete development of the root. The three main elements are stem cells,[2] scaffolds,[3] and growth factors.[4]

The main difficulty to overcome in re-vascularization attempts is disinfection of the infected root canal system.[5] Initially, a triple antibiotic paste consisting of minocycline, metronidazole, and ciprofloxacin has been used to disinfect the root canal system, and work is being done using a double antibiotic paste.[6] This is to eliminate the staining caused by minocycline.[7] The search continues to find and develop ways to accomplish this without destroying stem cells and growth factors.

The ultimate goal in re-vascularization is to stimulate the formation of normal pulp tissue which in turn will allow the normal development and function of the tooth.

The American Association of Endodontists in the publication of Colleagues for Excellence (Spring 2013)[4] provides an excellent summary on the topic.


1Nathaniel Lawson D. Examining bioactive restorative materials. J Multidiscip Care Decis Dent 2018.
2He L, Zhong J, Gong Q, Kim SG, Zeichner SJ, Xiang L, et al. Treatment of necrotic teeth by apical revascularization: Meta-analysis. Sci Rep 2017;7:13941.
3Bottino MC, Yassen GH, Platt JA, Labban N, Windsor LJ, Spolnik KJ, et al. A novel three-dimensional scaffold for regenerative endodontics: Materials and biological characterizations. J Tissue Eng Regen Med 2015;9:E116-23.
4AAE. Endodontics colleagues for excellence. Chicago: American Association of Endodontists; 2013. Regenerative endodontics; p. 1-8.
5Fouad AF. The microbial challenge to pulp regeneration. Adv Dent Res 2011;23:285-9.
6Sabrah AH, Yassen GH, Liu WC, Goebel WS, Gregory RL, Platt JA, et al. The effect of diluted triple and double antibiotic pastes on dental pulp stem cells and established enterococcus faecalis biofilm. Clin Oral Investig 2015;19:2059-66.
7Kirchhoff AL, Raldi DP, Salles AC, Cunha RS, Mello I. Tooth discolouration and internal bleaching after the use of triple antibiotic paste. Int Endod J 2015;48:1181-7.