title: Regenerative endodontic procedure of an infected immature permanent human tooth: an immunohistological study.
abstract: OBJECTIVE
  An immunohistological study of an infected immature permanent human tooth after a regenerative endodontic procedure (REP) was conducted in order to determine the histologic outcome of this procedure. Besides observed signs of angiogenesis and neurogenesis, repair and/or regeneration of the pulp-dentin complex was also investigated.
  
  
  METHODS
  A REP was performed on tooth 45 of a 10-year-old girl. Eleven months post-treatment, the tooth had to be removed for orthodontic reasons. The following investigations were performed: immunohistology and radiographic quantification of root development. After hematoxylin-eosin (HE) staining, the following immunomarkers were selected: neurofilament (NF), pan cytokeratin (PK), osteocalcin (OC), and CD34.
  
  
  RESULTS
  The REP resulted in clinical and radiographic healing of the periradicular lesion and quantifiable root development. The HE staining matches with the medical imaging post-REP: underneath the mineral trioxide aggregate a calcified bridge with cell inclusions, connective pulp-like tissue (PLT) with blood vessels, osteodentin against the root canal walls, on the root surface cementum (Ce), and periodontal ligament (PDL). The PDL was PK(+). The blood vessels in the PLT and PDL were CD34(+). The Ce, osteodentin, and stromal cells in the PLT were OC(+). The neurovascular bundles in the PLT were NF(+).
  
  
  CONCLUSIONS
  Immunohistologically, REP of this infected immature permanent tooth resulted in an intracanalar connective tissue with a regulated physiology, but not pulp tissue.
  
  
  CONCLUSIONS
  REP of an immature permanent infected tooth may heal the periapical infection and may result in a combination of regeneration and repair of the pulp-dentin complex.
authors.affiliation: Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium. nastaran.meschi@med.kuleuven.be.
authors.forename: Nastaran
authors.initials: N
authors.lastname: Meschi
authors.affiliation: Laboratory of Morphology, Biomedical Research Institute (BIOMED), Hasselt University, 3590, Diepenbeek, Belgium.
authors.forename: Petra
authors.initials: P
authors.lastname: Hilkens
authors.affiliation: Laboratory of Morphology, Biomedical Research Institute (BIOMED), Hasselt University, 3590, Diepenbeek, Belgium.
authors.forename: Ivo
authors.initials: I
authors.lastname: Lambrichts
authors.affiliation: Laboratory of Translational Cell and Tissue Research, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Van den Eynde
authors.affiliation: Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Athina
authors.initials: A
authors.lastname: Mavridou
authors.affiliation: Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Olaf
authors.initials: O
authors.lastname: Strijbos
authors.affiliation: , H. Horriestraat 40 a bus 13, 8800, Roeselare, Belgium.
authors.forename: Marieke
authors.initials: M
authors.lastname: De Ketelaere
authors.affiliation: Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Gertrude
authors.initials: G
authors.lastname: Van Gorp
authors.affiliation: Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Paul
authors.initials: P
authors.lastname: Lambrechts
mesh_terms: D056624:Apexification; D003782:Dental Pulp; D003790:Dental Pulp Necrosis; D005260:Female; D006801:Humans; D019227:Tooth Apex; D014092:Tooth Root
keywords: Angiogenesis; Pulp biology; Stem cell(s); Tooth development