The Future: Stem Cells and Biological Approaches for Pulp Regeneration

Abstract

Achieving long-lasting and complete pulp regeneration in teeth with deep caries or severe trauma remains a significant clinical challenge. In teeth with immature apices and exposed vital pulp tissue, partial or complete pulpotomy is typically indicated to preserve pulp function and allow for continued root development. In cases where injury caused loss of pulp vitality and arrested root development, teeth may remain with poor crown-to-root ratio, a root with very thin walls, and an open apex. The ideal treatment in such cases would be to regenerate a functional dentin–pulp complex that would enable the completion of root development and thickening of dentinal walls. Emerging evidence suggests that this can be achieved with the recruitment of apical stem cells toward the root canal and/or the transplantation of stem cells using a tissue engineering-based approach. In this chapter, we will discuss the evidence that provides the rationale for regenerative approaches for the treatment of pulp injury or pulp necrosis.