Comparative Evaluation of Regenerative endodontic procedure and conventional non-surgical endodontic procedure for treatment of necrosed mature permanent teeth with apical periodontitis - A Randomized Control Trial

Pulp regeneration continues to receive increasing
research attention. Regenerative endodontic procedures (REPs) have been
associated with revascularization procedures originally proposed more than 50
years ago. Effective
sealing at both the apical and coronal ends of a disinfected root canal
system are the essential requisites of a successful root canal treatment.
Gutta-percha along with a sealer has been the material of choice for
obturating the root canals. The periapex contains a variety of progenitor
cells which may participate in the regeneration of tissues as a response to
injury. Thus, regeneration rather than replacement of tissues with an
artificial substitute is the alternative direction in which endodontics is
progressing. Biodentine
was developed as a new class of dental material, introduced in 2010 by Gilles
and Olivier which could conciliate high mechanical properties with excellent
biocompatibility, as well as a bioactive behavior. Biodentine is a new
tricalcium silicate (Ca3SiO5) based inorganic restorative commercial cement
and advertised as ‘bioactive dentine substitute’. The material is claimed to
possess better physical and biological properties compared to other
tricalcium silicate cements such as mineral trioxide aggregate (MTA) and
Bioaggregate(Bioaggregate).  It is used
for crown and root dentin repair treatment, repair of perforations or
resorptions, apexification, root-end fillings and as permanent dentine
substitute in large carious lesions.

   Thus, this study compares the non-obturating regenerative endodontic procedure using biodentine and modified triple antibiotic paste with conventional non-surgical gutta percha obturation procedure for the treatment of necrosed mature permanent teeth with apical periodontitis.