(PR27) Case Report: Regenerative Endodontic Procedure on a Tooth with Symptomatic Irreversible Pulpitis

Abstract: Recent studies reported complete regeneration of the pulp complex in immature vital teeth of ferrets and in humans. This case report aims to assess a regenerative endodontic procedure on a mature single rooted tooth diagnosed with symptomatic irreversible pulpitis. Patient presented to the clinic with tooth #29 having pain and percussion sensitivity. Tooth had lingering cold sensitivity greater than 30 seconds and was positive to EPT. No neighboring teeth tested positive to cold during pulp sensibility testing. The tooth was isolated with rubber dam, accessed using a sterile diamond, and pulp tissue was removed to a level 5mm from the apex using a sterile 40 K-file. Working length was obtained using a CBCT. Irrigation with sterile saline and 17% EDTA was used throughout. After pulp amputation, intracanal bleeding was induced, and the blood was allowed to reach a level 3mm below the cementoenamel junction. A 3mm BC putty plug was placed in contact with the blood clot. Patient presented to re-evaluation at one and three months post treatment. Patient was asymptomatic at both visits. Sensibility testing was done at both follow up appointments, where tooth #29 tested positive to EPT, had no response to cold, and no pain on percussion. This case report aims to demonstrate successful regeneration of pulp vitality confirmed by EPT in a human. Successful regenerative endodontic procedures can support the idea of minimally invasive endodontics by preserving and regenerating the original pulpal tissue in teeth diagnosed with irreversible pulpitis.