SP-18 Histological Outcomes and Potential Predictive Factors of REPs Cases in Mature & Immature Human teeth
CE Hours: 0.75
Description: 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.
Learning Objectives:
- List the histological findings after REPs in animal study and human case reports.
- Discuss potential predictive factors influencing REPs outcomes.
- Perform REPs more confidently on selected cases.
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Xiaofei Zhu, D.M.D
Dr. Xiaofei Zhu is an Assistant Professor and the Director of Research in the Endodontics Department at Boston University School of Dental Medicine. He received his DDS from Peking University, Beijing, China, in 2009. Since then, he had worked as an assistant professor and later as an associate professor (in 2015) at his alma mater. Dr. Zhu joined the Boston University Postgraduate Endodontic Program in 2019. He served on the Regenerative Endodontics committee of the AAE from 2020 to 2021. In 2021, Dr. Zhu started working at Boston University. He earned the Diplomate of the American Board of Endodontics in 2022. Dr. Zhu's primary research interest relates to dental pulp regeneration and stem cells.
Speaker Disclosure
I declare that I have no proprietary, financial, or other personal interest of any nature or kind in any product, service, course, and/or company, or in any firm beneficially associated therewith, that will be discussed or considered during the proposed presentation.