title: Paradigm Shift from Stem Cells to Cell-Free Regenerative Endodontic Procedures: A Critical Review.
abstract: Regenerative endodontic procedures of immature teeth with necrotic pulp have become a part of therapeutic endodontic spectrum and are considered as an alternative to calcium hydroxide or mineral trioxide aggregate apexification. In last decade, numerous case reports and series with usage of cell-free approaches known as revascularization, revitalization, or maturogenesis have been published. This cell-free approach prevails in clinical regenerative endodontics because of its relative ease of performance, lower financial demands, and absence of complications such as tumorigenesis of used stem cells. In this article, the integral steps of cell-free treatment approaches such as source of stem cells, possible endogenous scaffolds, sources of growth factors, and width of apical foramen in the context of sufficient disinfection of root canal system and outcome of treatment are discussed. Despite not being a fully established treatment protocol, the achieved outcomes are promising regardless of it having a reparative character than a regenerative one.
authors: 1 Faculty of Medicine and Dentistry, Department of Dentistry, Institute of Dentistry and Oral Sciences, Palacky University , Olomouc, Czech Republic .
authors: Radovan
authors: R
authors: Žižka
authors: 2 Faculty of Medicine and Dentistry, Department of Anatomy, Palacky University , Olomouc, Czech Republic .
authors: Jiří
authors: J
authors: Šedý
mesh_terms: D001424:Bacterial Infections / Q000628:therapy; D002474:Cell-Free System; D004708:Endodontics / Q000379:methods*; D006801:Humans; D012038:Regeneration / Q000502:physiology*; D013234:Stem Cells / Q000166:cytology*
keywords: blood clot; dental pulp stem cell; regenerative endodontic procedure; revascularization; revitalization; stem cells from apical papilla