SP-18 - Histological Outcomes and Potential Predictive Factors of REPs Cases in Mature & Immature Human teeth

Presentation Description/Abstract: Numerous studies indicate the clinical success of regenerative endodontic procedures (REPs), as evidenced by symptom resolution, apical closure, canal wall thickening and lengthening, and restored reaction to vitality tests. However, the true nature of the regenerated human tissue after REPs remains unclear. Animal studies, employing various experimental protocols, have reported the greatest prevalence formation of cementum-like tissue, followed by bone-like tissue, and, to a lesser extent, dentin-like tissue. The question arises: does this conclusion also hold true for patients undergoing REPs? Ethical considerations preclude the conduct of cohort studies or randomized controlled trials in humans to evaluate histological outcomes of REPs. Nonetheless, a limited subset of investigations has delved into the histological outcomes after REPs, offering insights into the regenerative processes involved.
Our case-report-based systematic review, encompassing studies from PubMed, Embase, and Web of Science, yielded 17 articles reporting on 22 teeth (mature and immature) from a total of 389 studies published between 2001 and 2023. The findings indicate a predominant presence of fibrous connective tissue, along with cementum-like, and bone-like tissues, whereas true dentinal regeneration is notably rare. Histological outcomes may vary based on factors such as the preoperative condition of the tooth, disinfection protocols, and procedural techniques.
Furthermore, through a series of REPs cases from the presenter, we we’re going to discuss potential predictive factors influencing outcomes, including the status of the apical papilla, residual pulp tissue, patient age, and others.