Regenerative endodontics: repair or true regeneration? A narrative review

Abstract

Regenerative endodontics therapy (RET) is a pioneering approach in dentistry that aims to restore damaged dental pulp and promote tissue regeneration in non-vital teeth. It belongs to the broader field of regenerative medicine, where stem cells, scafolds, and bioactive molecules are central components. The goal of RET is to achieve true tissue regeneration, fully restoring both the structure and function of damaged tissues, in contrast to repair, which only restores basic functionality through scar formation or tissue remodeling. Histological studies conducted in various research models, ranging from animal studies to human case studies, have provided valuable insights into the nature of tissue regeneration in RET. However, the quality of regenerated tissue can vary significantly among studies. Some research reports have described the presence of fibrous or fibrovascular tissue with limited functionality, resembling repair rather than true regeneration. This variation can be attributed to the impact of disinfection protocols on stem cell viability and differentiation potential. In conclusion, RET has the potential for both repair and true regeneration processes, with outcomes influenced by factors such as disinfection methods and the source of stem cells. Despite the remaining challenges, promising results suggest that RET could revolutionize dental pulp regeneration, especially when approaches that utilize the body's stem cells are optimized for clinical use. Further research and protocol refinement is essential to fully unlock the regenerative potential of this exciting field.