Preserving and Restoring Pulp Vitality: When, Why and How to Do It

Regenerative endodontics represents a paradigm shift in endodontics that has the primary goal of preservation or reestablishment of homeostatic physiological pulp functions. An inflamed dental pulp has been thought to be incapable of healing. This dogma is even reflected in the diagnostic term: “irreversible pulpitis”. Also, pulp necrosis has been a condition that required root canal spaces to be filled with inert materials to prevent growth of microorganisms. Unfortunately, obturation also prevents the growth of patients own living tissues that could bring back important physiological functions lost due to partial or total pulp necrosis. Advancements in biological understanding, techniques and materials have made regenerative endodontic procedures (vital pulp therapies and revitalization) alternatives to teeth requiring non-surgical endodontic treatment. In this lecture, the application of regenerative endodontic approaches will be discussed in light of real clinical scenarios, presenting the advantages and disadvantages of these procedures and their possible pitfalls while contrasting with what is well-known in more “traditional” non-surgical endodontic therapies.