Revascularization- a Critical Analysis

The revitalization approach for managing immature permanent teeth with infected pulp and/or apical periodontitis allows the ingrowth of vital tissue consisting of tissues resembling cementum, PDL, bone. These tissues are not pulp tissues. They do not function like pulp tissue. Therefore revitalization is better termed as wound repair. Pulp tissue may survive infection, recover, and remain healthy. The clinical case reports have shown narrowing of canal and root lengthening however. Although revitalization procedure is more favorable than the traditional apexification procedures in terms of having vital tissues including cementum like deposited on canal walls, the long term outcome of these new tissues in the canal space needs further investigation. The available case reports of pulp revascularization were generally reported on young patients (with high stem cell populations) and teeth with open apices. However, for regenerative endodontic procedures to be widely available and predictable, Endodontists will have to depend on tissue engineering therapies to regenerate pulp dentin tissue.