REJENERATİF ENDODONTİK TEDAVİDE BİYOMALZEME SEÇİMİ VE DOKU MÜHENDİSLİĞİ UYGULAMALARI

Abstract

Dental pulp is a soft connective tissue that is surrounded by highly mineralized tissues such as enamel, dentin, cementum and provides homeostasis of the tooth. Pulp tissue is a specialized mineralized tissue with a limited regeneration ability due to the anatomical arrangement and postmitotic structure of odontoblastic cells. Classical endodontic treatment is based on removing the infected pulp tissue and root dentin and filling the disinfected canal cavity with a bioinert material to ensure hermetically sealed. It may quickly become necrotic due to tooth decay or inflammation and may require endodontic treatment. In immature that have not completed root formation and necrotic pulp teeth, an apical barrier is formed by using Ca(OH)2 and MTA (Mineral Trioxide Aggregate). There is no increase in root length and thickness in the tooth treated with these methods. For this reason, these teeth remain devital and weak teeth for life. The most desired in endodontic treatment is the replacement of devital and necrotic pulp with healthy pulp tissue. Regenerative endodontic therapy is an alternative to classical endodontic therapy. Regenerative endodontic therapy is defined as '' bio-based procedures designed to treat damaged tooth structures, including cells of the pulp-dentin complex, as well as dentin and root structures. ''Recent advances in biomaterial science and tissue engineering technology have encouraged the development of regenerative endodontic treatment method. Numerous studies are carried out in the field of regenerative endodontic treatment with stem cells, tissue scaffold and growth factors, which are the basis of tissue engineering. Pulp regeneration techniques that are currently proposed are still under development. In this review, studies on different stem cells, growth factors and tissue scaffolds used as the classical tissue engineering trio used in current regenerative endodontics are reviewed and the stages of the treatment procedure developed for routine clinical applications are summarized. In addition, organoids and organ-o-a-chip treatment approaches developed for regenerative endodontic applications were also presented. The relationship between regeneration and cancer was given. Finally, the stages of the treatment procedure developed for routine clinical applications were included.