Upload
soumita-maity
View
39
Download
3
Embed Size (px)
Citation preview
THE HOLY GRAIL OF ENDODONTICS
REGENERATION
INTRODUCTION• There is a high rate of success in retention of teeth by endodontic therapy but
many teeth are not restorable because of apical resorption, fracture, incompletely formed roots or carious destruction of coronal structures.
• A novel approach to restore tooth structure is based on biology i.e. regenerative endodontic procedures by the
application of tissue engineering.
• Regenerative endodontics was founded by Dr. Nygaard- Ostby in 1960s.
OBJECTIVES• The goal of Regenerative Dentistry is to induce biologic replacement
of dental tissues and their supporting structures.
DEFINITION• According to American Association of Endodontists, regenerative
endodontic therapy has been defined as “biologically based procedures designed to replace damaged structures, including dentin and root structures, as well as cells of the pulp-dentin complex’’.
TISSUE ENGINEERING is an emerging multidisciplinary field that applies the principles of
engineering and life sciences for the development of biological substitutes that can restore, enhance or improve tissue function.
COMPONENTS
SCAFFOLDS
STEM CELLS GROWTH FACTORS
• Tissue engineering involves the interplay among stem cells, growth factors and scaffolds.
STEM CELLS
Stem cells are undifferentiated cells which have the capability to produce cells of the same type or more differentiated cells.
DEFINITION
CLASSIFICATION
HUMAN DENTAL STEM CELLS• Dental pulp stem cells (DPSC)• Stem cells from human exfoliated deciduous
teeth(SHED)• Stem cells from apical papilla(SCAP) • Periodontal ligament stem cells (PDLSC)• Tooth germ progenitor cells (TGPCs)• Dental follicle stem cells (DFSCs)
GROWTH FACTORS
DEFINITION:Growth factors are polypeptides which have the ability to bind to specific receptors on the target cells (in this case the stem cells and other pulpal cells) and modulate or facilitate certain activities like migration, proliferation, differentiation, and apoptosis .
DIFFERENT TYPES:• Bone morphogenetic proteins (BMPs)• Platelet derived growth factor
(PDGF)• Transforming growth factor (TGF)• Fibroblast growth factors (FGF)• Insulin like growth factors (IGF)• Nerve growth factor (NGF)• Vascular endothelial growth factor
(VEGF)
FGF TGF BMPs
SCAFFOLDSA scaffold denotes a temporary platform for repairing or erecting a building. In a similar manner, all multicellular living organisms have natural scaffolds that surround the cells and provide structural support for formation and maintenance of tissues and organs.
Natural scaffolds Synthetic scaffolds
CollagenPlatelet rich plasmaFibrinGlycosaminoglycans
Polylactic acid (PLA), Polyglycolic acid (PGA),Polycaprolactone (PCL).Polyethyleneglycol (PEG)
HYDROXYAPETITE
COLLAGEN 3- D HYDROGEL
PROCEDURES
FUTURE DEVELOPEMENT
It has the potential for regenerating both pulp and dentin tissues. Thus, may offer an alternative method to save teeth that may have compromised structural integrity.
The possibility of pulp tissue regeneration is restricted by several factors, like, the dental pulp has minimal collateral blood supply, impairing the ability of the immune system to combat infections.
ADVANTAGE
DISADVANTAGE
Shah and Logani: Sealbio: Non-obturation endodontic treatment:Journal of Conservative Dentistry | Oct-Dec 2012 |Vol 15| Issue 4
CONCLUSION• Regenerative endodontic procedures have proven to be an
invaluable tool for teeth .
• Research needs to be done in many areas so as to make the regenerative procedures more predictable.
• Nevertheless, the applicability of stem cells and biomaterial sciences for dental reconstruction cannot be understated and offers a promising future.
MY SINCERE GRATITUDE TO-• Dr. Debaprasad Das- Professor & Head of the department
• Dr. Anirban Bhattacharyya- Professor
• Dr. Asim Bikash Maity- Reader
• Dr. Sourabh Bhattacharyya- Lecturer
• Dr. Sanhita Goswami- Lecturer
• My Senior PGTs
REFERENCES• Cohen’s Pathways Of The Pulp, 11th edition: Regenerative Endodontics
• Vimal K Shikri, Essentials Of Endodontics: Regenarative Endodontics
• Murray et al; Regenerative Endodontics: JOE- Vol-33, Number 4, April 2007
• Pankaj Gupta et al; Regenerative Endodontics: J Cont Med A Dent January- April 2015, Volume-3, Issue 1.
• Regenerative Endodontics : "A Road From Dead To Alive”: ©Indian Journal of Dental Sciences. (October 2014 Supplementary Issue, Issue:4, Vol.:6)
• Shah and Logani: Sealbio: Non-obturation endodontic treatment: Journal of Conservative Dentistry | Oct-Dec 2012 | Vol 15 | Issue 4