Regenerative endodontics
Restoring a tooth's living pulp rather than replacing it with filling material — promise and present limits.
Conventional root canal treatment removes infected pulp and fills the space with inert material. The tooth is retained but no longer vital: without a blood supply it cannot sense, defend itself, or lay down new dentin, and it becomes more brittle over time.
Regenerative endodontic therapies aim at the alternative — rebuilding living tissue inside the root. Published approaches leverage polymer-based scaffolds, stem cells, and growth factors to regenerate damaged pulp, restoring vitality and prolonging tooth function. Some strategies transplant cells; others rely on cell homing, recruiting the patient's own cells into a scaffold.
The constraints are severe. Blood must enter through an apex often less than a millimetre across, so revascularization dominates the outcome, and the site is frequently infected at the outset. Much of this work remains preclinical or early clinical, and we present it as research rather than as an available treatment.
Related articles
- DentalDental pulp stem cellsMultipotent cells recoverable from the soft tissue inside a tooth — and a surprisingly accessible source for regeneration research.
- DentalThe dentin-pulp complexWhy dentin and pulp are treated as one functional unit, and what makes rebuilding it so difficult.
- CellsCell homingRecruiting the patient's own cells into a scaffold instead of transplanting cells at all.
- DentalBioactive glass and calcium silicate materialsMaterials that do not merely fill a space but chemically provoke a biological response.
- FoundationsVascularization: the diffusion limitWhy engineered tissue thicker than a couple of hundred microns fails without a blood supply — the field's most stubborn bottleneck.
- DentalSHED: stem cells from exfoliated deciduous teethA stem cell population recovered from baby teeth — younger, faster-proliferating, and ethically uncomplicated.