(PR30) Outcomes of Regenerative Endodontic Procedures Using a Bioactive Scaffold: A Retrospective Study

Human-derived amnion-chorion membrane (ACM) has been used as a bioactive scaffold in regenerative medicine. ACM contains growth factors and cytokines that are essential for cell homing and tissue regeneration. To date there have been no clinical studies using ACM for regenerative endodontic procedures (REPs). The aim of this study was to investigate the clinical and radiographic outcomes of REPs using ACM in immature necrotic permanent teeth. Immature necrotic permanent teeth treated with REPs using ACM between 2011 and 2019 with a minimum follow-up of six months were included. Outcomes included success, survival, root development, and pulp vitality. Root development was evaluated using the radiographic root area (RRA). Predictors were analyzed using Cox regression and generalized linear models over follow-up time for survival, RRA change, and pulp vitality. 21 teeth with a mean follow-up of 21.2 months met the selection criteria. 85.7% of cases healed or were healing, and 90.5% survived after initial REPs. After re-REPs survival and success rates reached 95.2%. Root development occurred in 90.5% of cases, and 42.9% showed pulp vitality. Age, sex, etiology, stage of root development, and periapical diagnosis had no significant effect on the outcomes, including survival, RRA change, and pulp vitality (p>0.05). There was a significant association between pulp vitality and change in RRA (p < 0.05) after adjustment for follow-up time. REPs using ACM provided satisfactory clinical and radiographic outcomes, including the healing of apical periodontitis, continued root development, and the return of pulp vitality. Re-REPs may enhance the longevity of non-healing teeth.