Pulp Regenerative Therapy using Autologous Dental Pulp Stem Cells in a Mature Tooth with Apical Periodontitis: A Case Report
Abstract
The utility and feasibility of pulp regenerative therapy with autologous dental pulp stem cells (DPSCs) in mature teeth with irreversible pulpitis were clinically demonstrated. On the other hand, there is no evidence of the utility of DPSCs in mature teeth with apical periodontitis. The aim of this case report is to describe the potential utility of regenerative cell therapy in mature teeth with apical periodontitis. A 44-year-old male was referred for the pulp regeneration of his maxillary first premolar with a periapical lesion. Root canal disinfection was performed by irrigation and intracanal medication by nanobubbles with levofloxacin and amphotericin B in addition to conventional irrigation. Autologous DPSCs isolated from an extracted third molar were transplanted into the root canal after residual bacteria and fungi were below the detection level by PCR assay using universal genes to amplify specific regions within bacterial 16S rDNA and fungal rDNA (ITS1), respectively. There was no adverse events or systemic toxicity assessed for clinical evaluations during the 79 week-follow-up period and laboratory evaluations after 4 weeks. The affected tooth was responsive to the electric pulp test. The cone-beam computed tomographic (CBCT) imaging revealed much reduced lesion size, remission of the periapical tissue and mineralized tissue formation in the apical part of the canal after 79 weeks. The signal intensity on magnetic resonance imaging of the regenerated tissue in the…
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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