Insights into the July 2023 Issue of the Journal of Endodontics

Abstract

Almost 20 years since the first case report on the regenerative endodontic procedure was published, there is still a lack of definitive clinical guidelines due to the scarcity of high-level evidence. One area of debate and controversy is the type of intracanal medicament. Both calcium hydroxide and triple antibiotic paste (TAP) have been advocated with each having its advantages and limitations. Calcium hydroxide is easy to use, has low cytotoxicity and allows stem cell differentiation, but may have inferior antibacterial effects compared to TAP. TAP is highly effective in its antibacterial actions but is toxic to stem cells especially at high concentrations and can lead to staining of the crowns. In this issue of the JOE, Al-Qudah and colleagues ( 1 Al-Qudah A. Almomani M. Hassoneh L. Awawdeh L. Outcome of Regenerative Endodontic Procedures in Non-Vital Immature Permanent Teeth Using Two Intracanal Medications: A Prospective Randomized Clinical Study. J Endod. 2023; 49: x-y Google Scholar ) reported the outcomes of regenerative endodontic procedures using either calcium hydroxide or a modified TAP as the intracanal medicament on 50 teeth in a randomized controlled trial. Nineteen teeth in each group were available for follow-up after 36 months. A success rate of 84.2% was reported for the calcium hydroxide group and 78.9% reported for the mTAP group. The survival rate was 100%. A majority of the cases in both groups showed evidence of continued root development. No significant differences were found between the groups. This study provided additional evidence to support the use of both medicaments in the regenerative endodontic procedure. However, additional studies with larger sample sizes are needed to determine whether the difference between the groups is statistically significant and clinically meaningful.